Prescription Printout is the report card of your prescription writing software. It needs to be perfect because it is the only tangible output, for your Patients, from your EMR. Here are 5 questions to ask before buying a Prescription writing software.

 

1.      Intelligence – it must understand the negatives from the positives

You often go about completing Medical History and Examination templates without actually filling in every section. It is more likely that you would only make positive, or abnormal observations while leaving the rest of the sections un-touched.

In each of those cases, you would not want to have your prescription cluttered with insignificant NAD’s and negative observations. The Prescription generating software should be intelligent enough to figure out the relevant positive, clinically-significant data and show only them on the prescription.

 

2.      Design your Prescription Layout

Most software comes with pre-canned prescription layouts. It is a good starting point, but you must ask for the capability to get custom-designed layouts.  Some software allows you to customize the layout, but the customization is very restrictive. It cannot handle the most common way Doctors write out prescriptions i.e. 2 columns

CCVitals

Investigations Rx Advice Recall

 

You need to show a sample prescription to the software vendor and inquire if the prescription layout can be custom developed for you. If the answer is yes, ask for a “Conditional Sale” – book the software with an advance and make the balance payment conditional upon the precise layout being created for you. Make sure you get the vendor to mention this on the invoice.

To be fair, any form of customization comes with an additional cost for the vendor so be prepared to pay a nominal customization fee, but only after you get what you were after. If a vendor is capable of achieving your requirement, they will have no problem in getting the necessary changes done on the basis of an advance. Those who cannot find all kinds of excuses for you to first pay up 100% of the invoice and then wait for them to deliver. Good luck waiting!

 

3.      Speed of Prescription Generation

There are multiple ways of achieving the same goal. A vendor can use temporary hacks to create a fragile prescription layout, OR, the vendor may develop a robust customization engine that can meet your requirements. You need to figure out if the vendor has taken a shortcut or created a sustainable solution for you. I will show you how to spot this.

I have seen Prescription writing software taking as many 6-20 seconds in generating a customized layout for each patient visit. The time taken for generating the layout gives an indication of the amount of computing power going behind the generation. As more and more doctors buy the vendor’s product, more customization logic will be written in the software, making the process progressively slower. The solution has been achieved through fragile hacks and will not scale up in future.

A well-designed solution will be able to generate the customized prescription very quickly (usually under 4 seconds). Such solutions are running on sophisticated algorithms that are built to handle change. Stick with Speed as a measure, and you cannot go wrong.

 

4.      Flexibility of Drugs Database

You must have the ability to prescribe generic along with brands. As should be the ability to add your own drugs.

Drug-to-Drug interactions along with Drug-to-Allergy interactions, along with product and dosage monographs are great to have. However, you must ask your software vendor to reveal the source of this information. In developed countries like Australia or UK, MIMS has been proving drug databases for Doctors at a nominal charge payable annually. However, in developing countries, there are no such authentic providers of data. Drugs database in such countries is often collated by the vendor through pirated sources, plagiarizing textbooks or by searches on google. An easy way to figure this out is by asking the vendor the show the last couple of changes that were published by the pharmacology textbook you have subscribed to. You will discover that such updates are inevitably missing in the software. This is because drug database preparation is an industry of its own, and a vendor cannot match the process by simply googling.

I have found that Doctors often either ignore the issue of drugs database in demos or assume the proprietary of the vendor as long as they can see the brand names and interactions. It should however be the opposite. Those vendors who lack the drugs database do so because the information cannot be legally bought, they will usually stop at generics. Those who are providing it should be asked from where have they managed to get a hold of it? I am sure you would not want to be making clinical decisions based on unauthenticated data sources from questionable origins.

 

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