Suggestions for "partial" or "alternative" dispensing in Bahmni

I may be missing something, but it seems as though there is no explicit solution for “partial” or “alternative” dispensing in the Bahmni medication tab. If a medication is not available at all or in the prescribed quantity, how should a pharmacist record what was actually dispensed?

One workaround I can see is to configure the Stop Medication reasons to include entries such as “Medication not Available” or “Prescribed Quantity not Available”. The pharmacist would need to stop the medication and then create a new prescription with the available medication/amount. Maybe not ideal but it might work. It would at least be preferable to having the pharmacist edit the prescription.

Any thoughts? Is there another recommended solution for this case? We are not using ERP at the moment.

Thanks, Dave

Hi David,

As of now, as you pointed out, we don’t have an explicit solution for “partial” dispensing. We need to enhance the current functionality to accommodate partial dispensing.

For now we can only have a workaround, the pharmacist can edit the prescribed drug or just leave a note in “additional instructions” section to mention the dispensed quantity.

Ideally, on clicking the dispense “D” button, there should be an option to dispense the full quantity or dispense partially. If partial dispense is selected, then there should be an way (text-box?) to capture the dispensed quantity.

Thanks for your response @akhilmalhotra. We would probably rather have the pharmacist enter in new entries than edit prescriptions entered by a doctor. It would be easy to see which entries were entered by a doctor vs a pharmacist.

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@ddesimone We have created a card in Bahmni backlog to enhance this functionality.

@akhilmalhotra, I’m curious why dispensing is captured at the place it is in the application. I would expect that dispensing is often done by the pharmacist at the pharmacy, rather than by the clinician in the consult room.

Yes, we feel the same way, @darius and @akhilmalhotra We will probably end up using dispensing in the way it is currently built but we consider it a workaround until it is available in a separate pharmacy app.

In the hospitals we work with, sometimes the physician dispenses the “physician’s free sample” they get from the representatives of different pharmaceutical companies so that the cost of treatment can be lowered for the given patient in case he/she is unable to pay for the medicines. The physician can click on the “D” button which is mapped to a “discount shop” in OpenERP. The pharmacist then can dispense only those drugs which the physician has not given to the patient. This functionality was actually built to record such transactions although it is being used at many places by the pharmacists to let the physician know that they have dispensed all or some of the medicines to the patient.

I’d be careful about stopping a prescription and entering a new one; the med list will now show a drug program different than what the physician intended. Presumably, the doc still wants the patient to be taking the original dose, as soon as that becomes available (especially important for long-term meds). On top of that, there’s no guarantee that the physician even knows about the change. I’d suggest that an edited notes/instructions section probably is less invasive to the treatment plan.

Of course, a note on the dispensing event is the real way to go. In fact, I’d imagine that the pharmacy dispensing form should accurately say how many were dispensed in any event – important for inventory and patient tracking among other reasons.