I don't remember exactly how the VA does it, whether you specify an 80 mg pill or a 40 mg dose, I think the pharmacy had some way of determining it when filling the script. I can check next tuesday (the only day I'm there) if you're still interested.
You can save anything as a "quick order". When you have the drug selection box open, before clicking "Accept", click "options" from the main toolbar then "Save as quick order". You are prompted for a name, which shows up at the top of the selection box the next time you open it. At the VA, I have all of my common meds saved this way. You can change the order before saving it. Also the "complex" tab allows for doses beyond what is listed in the drop down box (eg., 60MG prednisone) Mike Schrom Kevin Toppenberg wrote: > Thanks for the reply. > > I don't have access to a working CPRS, so I don't really know what all > it can do. Are you saying that even if the drug displays as, for > example 80 mg, you can write text instructions to take only 1/2 tablet > daily, and then save this as a quick order? Does this mess up the > pill counting system, whereby it knows whether #30 tablets is a 30 vs. > 60 day supply? > > Thanks > Kevin > > > On 7/3/06, Mike Schrom <[EMAIL PROTECTED]> wrote: > >>No one seems to have mentioned this, so forgive the late reply, I was in >>the wilds of eastern Quebec last week. >> >>We received instructions at the VA, probably two years ago, to do >>exactly that: Issue (reliable!) patients pill splitters and prescribe >>1/2 pill QD. It was for a drug I don't use, so I haven't done that, but >>I do frequently give out eye drops for external otitis (ear infections). >>Yes, you need to use a text order, but you can save it as a "quick >>order" and once it's saved it becomes very easy to order. Same thing >>with steroid tapers, since Medrol dosepaks aren't on formulary here. >> >>Mike Schrom >> >>Kevin Toppenberg wrote: >> >>>One of the doctors in our group used VistA while in residency at the >>>VA, and he has expressed his dislike of CPRS drug prescribing. He >>>described having to "stand on one's head" to prescribe drugs the way >>>one wants to. I didn't understand what he was talking to until now. >>> >>>I am finding that one can only dispense tablets in quantities that are >>>in the database, and this is a big hassle. >>> >>>For example, for cost savings, I have at times had patients take Zocor >>>80 mg tablet, 1/4 daily. To allow this for flexibility and for other >>>possible doses, the Zocor entry in file# 50 would have to this: >>> >>> 903-POSSIBLE DOSAGES : >>> Multiple Entry #1 >>> .01-DISPENSE UNITS PER DOSE : 0.25 >>> 1-DOSE : 20 >>> Multiple Entry #2 >>> .01-DISPENSE UNITS PER DOSE : .5 >>> 1-DOSE : 40 >>> Multiple Entry #3 >>> .01-DISPENSE UNITS PER DOSE : 1 >>> 1-DOSE : 80 >>> >>>With a Zocor 80, it wouldn't be approprite to give 2 pills, but with >>>some drugs it would be appropriate, or perhaps even more (i.e. >>>ibuprofen 200 mg * 4 tablets) >>> >>>So my plan has been to put the FDA drug data into VistA and let the >>>doctor use his medical training to write out the correct prescription, >>>to be submitted to an outpatient pharmacist for dispensing. It looks >>>like to do this I need to add the following possible dosing allowances >>>for EACH drug: >>> 0.25, 0.5, 1, 2, 3, 4 >>>Of course this is just for pills. What about creams, IV solutions? >>>The FDA database does not contain any information about typical >>>dosing, maximum daily dose, toxicity etc >>> >>>In summary, the VistA system seems designed to allow a pharmacist to >>>put in the appropriate dosing for a particular drug, and it is >>>difficult for a physcian to be more creative with dosing that was not >>>anticipated. But this approach makes the system nearly impossible to >>>completely fill with ALL possible medications due to the huge amount >>>of time this would take to put in each drug individually. I would >>>stongly suspect that this is why no one already has a complete >>>formulary. >>> >>>In CPRS there is a "complex dosing" tab. I wish there was a >>>multiplier column. This would allow a doctor to write: >>>Zocor 80 mg * [0.25] PO QHS. >>> >>>I just realized another limitation is the allowed frequencies. There >>>are the usualy Q1h, Q2h, even QOD, etc. But there is no allowance for >>>1x/month, 1x/week, 2x/wk, 4x/wk etc. >>>It looks like there are some free text fields that allow me to get >>>around some of this. But it does feel strongly like "standing on >>>one's head" to get the job done. And it looses the quantitated data >>>in fields that allow future data manipulation. >>> >>>Hmmm... I'll have to think about this.. >>> >>>Kevin >>> >>>Using Tomcat but need to do more? Need to support web services, security? >>>Get stuff done quickly with pre-integrated technology to make your job easier >>>Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo >>>http://sel.as-us.falkag.net/sel?cmd=lnk&kid=120709&bid=263057&dat=121642 >>>_______________________________________________ >>>Hardhats-members mailing list >>>Hardhats-members@lists.sourceforge.net >>>https://lists.sourceforge.net/lists/listinfo/hardhats-members >>> >> >>Using Tomcat but need to do more? Need to support web services, security? >>Get stuff done quickly with pre-integrated technology to make your job easier >>Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo >>http://sel.as-us.falkag.net/sel?cmd=lnk&kid=120709&bid=263057&dat=121642 >>_______________________________________________ >>Hardhats-members mailing list >>Hardhats-members@lists.sourceforge.net >>https://lists.sourceforge.net/lists/listinfo/hardhats-members >> > > > Using Tomcat but need to do more? Need to support web services, security? > Get stuff done quickly with pre-integrated technology to make your job easier > Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo > http://sel.as-us.falkag.net/sel?cmd=lnk&kid=120709&bid=263057&dat=121642 > _______________________________________________ > Hardhats-members mailing list > Hardhats-members@lists.sourceforge.net > https://lists.sourceforge.net/lists/listinfo/hardhats-members > Using Tomcat but need to do more? Need to support web services, security? Get stuff done quickly with pre-integrated technology to make your job easier Download IBM WebSphere Application Server v.1.0.1 based on Apache Geronimo http://sel.as-us.falkag.net/sel?cmd=lnk&kid=120709&bid=263057&dat=121642 _______________________________________________ Hardhats-members mailing list Hardhats-members@lists.sourceforge.net https://lists.sourceforge.net/lists/listinfo/hardhats-members
