- Email: [email protected]
An Early Effort in Street Drug Analysis
Patient Record Systems The July 1973 Journal was devoted to patient record systems, and the editorial of that issue "From Concept to Reality" stated " . . . we welcome information on any patient record system- or unique uses of existing systems .... " Since then we have received letters on several systems- from individual pharmacists (November JAPhA, page 603; this Journal, page 659) and from firms specializing in patient record systems. The systems of three such firms are published here.
Cha~
No m• A dd .
John ri S mith Jr 1214 Main S treet Ca 94121 Ph. 6$$-1234
w,
Oakland
Dob
1-1-40
Fomily
John R S mith S r Paid Bx
Med #
•I
6.S.5:::!!J2.L
MD Brian Jones Ad d _!UZ..L.6.__sj;r.e..e..t.,_Qakl.and, Ca St• __G_2.3!l_ INDD
#
A
J
)234$6
:d--=====-------_--_-_-_ St # _ _ _ BND D _ _ _ _ _ _
ld io1ync:/ Med . Remoth
Allerg in Pen G, Aspirin Cronic illness= ulcer OTC =Mil ~ of Ma:z
The Chaij System is a time-saving system. · It has been in use on an experimental basis for about oneand-a-half years. Experience has shown that it is about 30 percent faster than the conventional method of dispensing prescriptions. In addition, it creates its own patient profiles. The system, developed by pharmacists Neil Maxwell and Jerry Beisner of Oakland, California, utilizes the patient chart as the prescription order. The 6" by 81/2" chart is designed to receive all the patient and prescriber information in the heading, and has spaces for 10 prescriptions in the body. The information legally required on a prescription heading is name and address of patient; and name, address, BNDD and/or state license number of the prescriber. In addition, the Chaij heading has spaces for information required andjor useful on a patient profile-patient's birthdate, telephone number, family affiliation, third-party billing information and idiosyncrasies/medical remarks. When the heading is filled in, the chart is numbered with any consecutive numbering system. The prescription number then becomes a combination of the chart number, plus the number of the line on which the prescription occurs, i.e., 7905-1. The rest of the information required on a prescription includes date and pharmacist's initials; name, strength, manufacturer if needed, quantity, and directions
''P, ;- ; ·. , ,:
11
~
!jglajds
Thyroid gr, 1 #100 One ta blet daily,
'")B ..U. I 7'12 il "'
The Chaij System utilizes duplicate label, the lower portion of -:-,..-. which is affixed to the Patient Medication Record Chart .
for use of the drug dispensed; renewal instructions, and prescriber, as indicated by his position in the heading. The back of the chart is divided into columns and numbered from 1 to 10 to receive renewal information. The system utilizes a duplicating label (Professional Tape Co., Inc., 144 Tower Dr., Burr Ridge, I L 60521) to facilitate transfer of the prescription information to the chart and reduce the time required for its completion. Also time-saving is the fact that all the patient and prescriber information need only be entered once for each 10 prescriptions dispensed for that patient. When a prescription order is received by telephone, all that is necessary is the typing of the duplicating label, (in California the name,
_L';"
---1!-,.,----------- ·- - - - - - · - - T ·· ;;-
strength, quantity and manufacturer if a generic, is required on the label) and entering the required information in the date, renewal, and "Dr.#" spaces on the chart, and the profile and the prescription file is completed. A written prescription is handled in the same manner except that the original (3" by 4") is filed according to law and maintained in a separate file, but it is never referred to again. Since the chart is actually the prescription order, each individual must have a separate chart. When a patient fills one page-i.e., 10 prescriptions-his chart number and heading information are transferred to a second page, and his next prescription number will be 7905-11. Each patient's chart is perpetual, Vol. NS13, No. 12, December 1973
667
regardless of the number of prescriptions he receives. The heading information must be transferred, however, to comply with the legal requirements of a prescription order. The charts are filed alphabetically to facilitate retrieval of lost numbers, and can be notched or color-coded according to their alphabetical position. The system also includes a daily log and a multi-line patient receipt, both on NCR paper and an income tax statement which can be mailed
automatically each year. A pharmacist dispensing 100 prescriptions daily will use about 2,000 charts to initially transfer all his patients to the system. Thereafter he will use about 250 charts monthly. It was found in practice to be faster to make a chart for each patient, even the one-prescription, onetimers rather than to have two systems. The complete system can be installed for less than $175, including 5,000 labels. Costs are-Chaij
charts, $35.00/M (5M @ $30.00/M, 10M @ $25.00/M); Daily Log-$7.50 each (records 7,000 prescriptions); Patient Receipts-$15.00/M, in quantities of 5M and year end income tax statements $10.00/M. The duplicating labels, depending on size and style, cost about $100 for 5,000 (pressure sensitive, on rolls).
Any portion of the system may be ordered separately in the above quantities, or write for free sample package to Chaij, 1812 Monterey , Berkeley, CA 94707.
Medic Presently under development by CCCC (4-C) System Development, the Medic prescription record system is an EDP software program which will eventually be offered for sale andjor lease to computer operators. The computer operator will then service pharmacies in his area, providing the Medic Patient Profile to the pharmacy along with a number of additional pertinent reports. Medic utilizes a "total systems" approach to the pharmacy recordkeeping problem. Besides the computer software portion of the system, the inpharmacy procedures have been kept in mind. Functionally, there is very little change in the present methods of the pharmacist user. Instead of typing the prescription label on a regular typewriter, the pharmacist does this on a standard Model 33 ASR Teletype machine. The only modifications to the teletype that are desirable, are a 12-character per inch typeline (same as "elite" typewriter) available from Teletype, and some minor modifications to the platen pressure rollers to accommodate narrow labels. It has been found that a label with a backing that retains the typed impression is very desirable in order to have a visual back-up for future possible reference after the original label is peeled off and placed on the dispensed prescription. The Teletype produces a computer-ready punched paper tape output as a direct result of the label typing process. No change in label format is required. Presently the order in which the information is typed on the label is-prescription number, prescriber's name, patient's name and address, dosage instructions, medication and strength, quantity, number of renewals authorized, cost and/or price information, date 668
oml••"""'""
I
oouoo...,NSEoa.,REN
lou..,T\ I
....
AllOUSS
CITY StAtE UP DUPIICIUNQS.
su:nnYina, ALI.ZICliS,ITC.
Original Medic patient record form was printed on ledger stock while revised form is produced on regular stock tabulating paper, double copies.
of dispensing and pharmacist's initials. Paper tape is picked up from the pharmacy as ready, at prearranged intervals, usually completed profiles and other reports from previous pick-ups are returned at the same time. The patient profile is individual rather than family-oriented. The original form of the profile (smaller example) anticipated a new profile being printed each time a new or renewal prescription was dispensed; the renewal would be listed each time dispensed, and the complete profile containing all prescriptions dispensed for the preceding year, or until a page was filled, would be produced every time any activity occurred. It is now thought that a somewhat larger form may be more efficient and practical, with renewals being listed on the same line as the original dispensing over a four-month period. A new profile will be produced each time activity occurs, as with the original form
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
OOOAG<
I I
I I
I
.....""·'.. ::!
PUSC1Jaca IWCS IY IIUIIID. 110.1
tvrAL PUSCilPTI~ • 1'tD TOTAl.l«DtCALtaiJOC'TAIU•T!D
design, and retention of the profiles will be up to the individual pharmacy for whatever period of time required or desired. The profile format is such that it will not be necessary to refer to the original prescription order each time a renewal is dispensed. For renewals where a new label is not required, the pharmacist need only type, (other than on a label), the prescription number, and patient's name and address, preceded by the word "refill." Other reports the software will furnish will be-drug utilization, peer review, accounts receivable, accounts payable, inventory and third-party payments, among others under consideration. The cost to the average pharmacy is estimated to be in the $300 per month range, not including the Teletype. This unit is purchased, either by the pharmacy or by the computer operator, who may then rent it to the pharmacy. At present the cost of the Teletype as used is only a little
Standard Teletype Model 33 ASR (automatic send-receive) unit installed at the Medical Center Pharmacy in Lompoc, California.
more than a full-size electric typewriter, such as an IBM Selectric. The Teletype and paper tape method of input is not mandatory for the software system. Other methods andjor equipment such as
a typing unit that will produce a magnetic tape cassette can be used depending on the computer operator's input equipment. The Teletype was originally selected because of cost and availability. It was the
best and least expensive that could be obtained at the time of the start of Medic development. At this time no firm date is available for the readiness of the software system. It is felt that Medic will be ready for distribution in approximately six months to one year. Present plans are that necessary modifications to the software will be made by 4-C upon receipt of an order for the software to fit the hardware system of the computer operator. Additionally, certain modifications can be ordered by a computer operator to suit the particular needs of the pharmacies in the area he is serving, or more plainly put, 4-C will tailor each software package ordered, if required.
CCCC (4-C) System Development, P. 0. Box 902, Lompoc, CA 93436. Louis B. Olsen, Manager.
Record-A-Scrip and the Comprehensive Profile System· Pictorial Packaging of Aurora, Illinois, markets Record-A-Scrip which was mentioned in the July issue of this Journal as being available also from Dallas Label and Box Company (page 369) and Samuels Products, Inc. (page 370). Similar to Quik Chek (page 367) and Safeguard (pages 369-370), Record-AScrip consists of 50 single-form, carbon-backed receipts affixed to the day-log sheet underneath. A posting board holds the receipts in position until the last one is torn off, while a log binder holds the completed day-log sheets. The family ledger card (printed two sides to record 40 prescription orders) lines up under the appropriate receipt so that one writing completes the receipt, family ledger card and day-log. An all-steel file tray holds 2,000 family ledger cards, with metal tab index dividers or the new instant retrieval card system. Counter brochures promoting the Record-A-Scrip service are also available. One complete Record-A-Scrip System (including posting board, log binder, file tray, index cards, 1M brochures, 1M ledgers and 1M stock receipt sheets) is $96.70. Pictorial Packaging introduced the Comprehensive Profile System in March 1973, consisting of a Patient Information File and Patient I nformation File Sheet. The 12" X 8 1/2" Patient Information File provides for patient name and address, home telephone number, date of birth , sex, weight, third party 1.0. number,
- - - - - -'
_ _ _.ZIP_
=~P:T~c:::H-EMICA-LE-XPOS-URESEX_WEIGHT_THIROPARTYI.D. NUMBER
HOMETELEPHONE• - - -' _ _ _ _ _ _ __
DRUG SENSITIVITIES AND ALLERGIES _ _ _ _ _ _ _ _ _ _ _ _ _ __
FOOD SENSITIVITIES AND ALLERGIES_ _ _ _ _ _ _ _ _ _ _ _ _ __
OTH EA PHYstCI ANSIDENTISTS:
Complete Profile System Patient Information File available from Pictorial Packaging of Aurora, Illinois.
GENERAL PRACTITIONER _ _ _ _ _ _ _ _ __
PHYSICALH.I.N DICAP / APPLIANCEUSE _ _ _ _ _ _ _~-------
"occupation/chemical exposure," family history, alcohol use, "smoking (amount)," "drugs abused," immunizations, medical history, current diagnosis, drug and food sensitivities, antibiotic exposure, home remedies used, names and telephone numbers of physicians (general practitioner, internist, dermatologist), dentist, psychiatrist and other, physical handicap/appliance use and caution. The inside portion of the Patient I nformation File includes space for 36 prescription orders, with drug name and strength, dosage and frequency, method of administration and quantity, number, order date, physician, 12 renewals and fee. The Patient Information Sheet requests similar data contained on the front of the Patient Information
File, and the sheet is to be updated by patient "once every 6 months" and "must inform the pharmacist on all over-the-counter purchases" and all prescription medication dispensed elsewhere. "This system is not for every patient, only one or two patients in ten. Patients on long-term drug therapy, heart, diabetic, hypertensive patients require this service," reports Pharmacist Frank Petrancosta, vice president of sales. Prices for the Patient Information File are $9.95/ 100 or $42.00/500; while prices for the Patient Information File Sheets are $8.25/100 and $14.00/M.
Pictorial Packaging, 232 South Lake Street, Aurora, IL 60507. Frank Petrancosta, Jr., Vice President of Sales. Vol. NS13, No. 12, December 1973
669
Cha~
No m• A dd .
John ri S mith Jr 1214 Main S treet Ca 94121 Ph. 6$$-1234
w,
Oakland
Dob
1-1-40
Fomily
John R S mith S r Paid Bx
Med #
•I
6.S.5:::!!J2.L
MD Brian Jones Ad d _!UZ..L.6.__sj;r.e..e..t.,_Qakl.and, Ca St• __G_2.3!l_ INDD
#
A
J
)234$6
:d--=====-------_--_-_-_ St # _ _ _ BND D _ _ _ _ _ _
ld io1ync:/ Med . Remoth
Allerg in Pen G, Aspirin Cronic illness= ulcer OTC =Mil ~ of Ma:z
The Chaij System is a time-saving system. · It has been in use on an experimental basis for about oneand-a-half years. Experience has shown that it is about 30 percent faster than the conventional method of dispensing prescriptions. In addition, it creates its own patient profiles. The system, developed by pharmacists Neil Maxwell and Jerry Beisner of Oakland, California, utilizes the patient chart as the prescription order. The 6" by 81/2" chart is designed to receive all the patient and prescriber information in the heading, and has spaces for 10 prescriptions in the body. The information legally required on a prescription heading is name and address of patient; and name, address, BNDD and/or state license number of the prescriber. In addition, the Chaij heading has spaces for information required andjor useful on a patient profile-patient's birthdate, telephone number, family affiliation, third-party billing information and idiosyncrasies/medical remarks. When the heading is filled in, the chart is numbered with any consecutive numbering system. The prescription number then becomes a combination of the chart number, plus the number of the line on which the prescription occurs, i.e., 7905-1. The rest of the information required on a prescription includes date and pharmacist's initials; name, strength, manufacturer if needed, quantity, and directions
''P, ;- ; ·. , ,:
11
~
!jglajds
Thyroid gr, 1 #100 One ta blet daily,
'")B ..U. I 7'12 il "'
The Chaij System utilizes duplicate label, the lower portion of -:-,..-. which is affixed to the Patient Medication Record Chart .
for use of the drug dispensed; renewal instructions, and prescriber, as indicated by his position in the heading. The back of the chart is divided into columns and numbered from 1 to 10 to receive renewal information. The system utilizes a duplicating label (Professional Tape Co., Inc., 144 Tower Dr., Burr Ridge, I L 60521) to facilitate transfer of the prescription information to the chart and reduce the time required for its completion. Also time-saving is the fact that all the patient and prescriber information need only be entered once for each 10 prescriptions dispensed for that patient. When a prescription order is received by telephone, all that is necessary is the typing of the duplicating label, (in California the name,
_L';"
---1!-,.,----------- ·- - - - - - · - - T ·· ;;-
strength, quantity and manufacturer if a generic, is required on the label) and entering the required information in the date, renewal, and "Dr.#" spaces on the chart, and the profile and the prescription file is completed. A written prescription is handled in the same manner except that the original (3" by 4") is filed according to law and maintained in a separate file, but it is never referred to again. Since the chart is actually the prescription order, each individual must have a separate chart. When a patient fills one page-i.e., 10 prescriptions-his chart number and heading information are transferred to a second page, and his next prescription number will be 7905-11. Each patient's chart is perpetual, Vol. NS13, No. 12, December 1973
667
regardless of the number of prescriptions he receives. The heading information must be transferred, however, to comply with the legal requirements of a prescription order. The charts are filed alphabetically to facilitate retrieval of lost numbers, and can be notched or color-coded according to their alphabetical position. The system also includes a daily log and a multi-line patient receipt, both on NCR paper and an income tax statement which can be mailed
automatically each year. A pharmacist dispensing 100 prescriptions daily will use about 2,000 charts to initially transfer all his patients to the system. Thereafter he will use about 250 charts monthly. It was found in practice to be faster to make a chart for each patient, even the one-prescription, onetimers rather than to have two systems. The complete system can be installed for less than $175, including 5,000 labels. Costs are-Chaij
charts, $35.00/M (5M @ $30.00/M, 10M @ $25.00/M); Daily Log-$7.50 each (records 7,000 prescriptions); Patient Receipts-$15.00/M, in quantities of 5M and year end income tax statements $10.00/M. The duplicating labels, depending on size and style, cost about $100 for 5,000 (pressure sensitive, on rolls).
Any portion of the system may be ordered separately in the above quantities, or write for free sample package to Chaij, 1812 Monterey , Berkeley, CA 94707.
Medic Presently under development by CCCC (4-C) System Development, the Medic prescription record system is an EDP software program which will eventually be offered for sale andjor lease to computer operators. The computer operator will then service pharmacies in his area, providing the Medic Patient Profile to the pharmacy along with a number of additional pertinent reports. Medic utilizes a "total systems" approach to the pharmacy recordkeeping problem. Besides the computer software portion of the system, the inpharmacy procedures have been kept in mind. Functionally, there is very little change in the present methods of the pharmacist user. Instead of typing the prescription label on a regular typewriter, the pharmacist does this on a standard Model 33 ASR Teletype machine. The only modifications to the teletype that are desirable, are a 12-character per inch typeline (same as "elite" typewriter) available from Teletype, and some minor modifications to the platen pressure rollers to accommodate narrow labels. It has been found that a label with a backing that retains the typed impression is very desirable in order to have a visual back-up for future possible reference after the original label is peeled off and placed on the dispensed prescription. The Teletype produces a computer-ready punched paper tape output as a direct result of the label typing process. No change in label format is required. Presently the order in which the information is typed on the label is-prescription number, prescriber's name, patient's name and address, dosage instructions, medication and strength, quantity, number of renewals authorized, cost and/or price information, date 668
oml••"""'""
I
oouoo...,NSEoa.,REN
lou..,T\ I
....
AllOUSS
CITY StAtE UP DUPIICIUNQS.
su:nnYina, ALI.ZICliS,ITC.
Original Medic patient record form was printed on ledger stock while revised form is produced on regular stock tabulating paper, double copies.
of dispensing and pharmacist's initials. Paper tape is picked up from the pharmacy as ready, at prearranged intervals, usually completed profiles and other reports from previous pick-ups are returned at the same time. The patient profile is individual rather than family-oriented. The original form of the profile (smaller example) anticipated a new profile being printed each time a new or renewal prescription was dispensed; the renewal would be listed each time dispensed, and the complete profile containing all prescriptions dispensed for the preceding year, or until a page was filled, would be produced every time any activity occurred. It is now thought that a somewhat larger form may be more efficient and practical, with renewals being listed on the same line as the original dispensing over a four-month period. A new profile will be produced each time activity occurs, as with the original form
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
OOOAG<
I I
I I
I
.....""·'.. ::!
PUSC1Jaca IWCS IY IIUIIID. 110.1
tvrAL PUSCilPTI~ • 1'tD TOTAl.l«DtCALtaiJOC'TAIU•T!D
design, and retention of the profiles will be up to the individual pharmacy for whatever period of time required or desired. The profile format is such that it will not be necessary to refer to the original prescription order each time a renewal is dispensed. For renewals where a new label is not required, the pharmacist need only type, (other than on a label), the prescription number, and patient's name and address, preceded by the word "refill." Other reports the software will furnish will be-drug utilization, peer review, accounts receivable, accounts payable, inventory and third-party payments, among others under consideration. The cost to the average pharmacy is estimated to be in the $300 per month range, not including the Teletype. This unit is purchased, either by the pharmacy or by the computer operator, who may then rent it to the pharmacy. At present the cost of the Teletype as used is only a little
Standard Teletype Model 33 ASR (automatic send-receive) unit installed at the Medical Center Pharmacy in Lompoc, California.
more than a full-size electric typewriter, such as an IBM Selectric. The Teletype and paper tape method of input is not mandatory for the software system. Other methods andjor equipment such as
a typing unit that will produce a magnetic tape cassette can be used depending on the computer operator's input equipment. The Teletype was originally selected because of cost and availability. It was the
best and least expensive that could be obtained at the time of the start of Medic development. At this time no firm date is available for the readiness of the software system. It is felt that Medic will be ready for distribution in approximately six months to one year. Present plans are that necessary modifications to the software will be made by 4-C upon receipt of an order for the software to fit the hardware system of the computer operator. Additionally, certain modifications can be ordered by a computer operator to suit the particular needs of the pharmacies in the area he is serving, or more plainly put, 4-C will tailor each software package ordered, if required.
CCCC (4-C) System Development, P. 0. Box 902, Lompoc, CA 93436. Louis B. Olsen, Manager.
Record-A-Scrip and the Comprehensive Profile System· Pictorial Packaging of Aurora, Illinois, markets Record-A-Scrip which was mentioned in the July issue of this Journal as being available also from Dallas Label and Box Company (page 369) and Samuels Products, Inc. (page 370). Similar to Quik Chek (page 367) and Safeguard (pages 369-370), Record-AScrip consists of 50 single-form, carbon-backed receipts affixed to the day-log sheet underneath. A posting board holds the receipts in position until the last one is torn off, while a log binder holds the completed day-log sheets. The family ledger card (printed two sides to record 40 prescription orders) lines up under the appropriate receipt so that one writing completes the receipt, family ledger card and day-log. An all-steel file tray holds 2,000 family ledger cards, with metal tab index dividers or the new instant retrieval card system. Counter brochures promoting the Record-A-Scrip service are also available. One complete Record-A-Scrip System (including posting board, log binder, file tray, index cards, 1M brochures, 1M ledgers and 1M stock receipt sheets) is $96.70. Pictorial Packaging introduced the Comprehensive Profile System in March 1973, consisting of a Patient Information File and Patient I nformation File Sheet. The 12" X 8 1/2" Patient Information File provides for patient name and address, home telephone number, date of birth , sex, weight, third party 1.0. number,
- - - - - -'
_ _ _.ZIP_
=~P:T~c:::H-EMICA-LE-XPOS-URESEX_WEIGHT_THIROPARTYI.D. NUMBER
HOMETELEPHONE• - - -' _ _ _ _ _ _ __
DRUG SENSITIVITIES AND ALLERGIES _ _ _ _ _ _ _ _ _ _ _ _ _ __
FOOD SENSITIVITIES AND ALLERGIES_ _ _ _ _ _ _ _ _ _ _ _ _ __
OTH EA PHYstCI ANSIDENTISTS:
Complete Profile System Patient Information File available from Pictorial Packaging of Aurora, Illinois.
GENERAL PRACTITIONER _ _ _ _ _ _ _ _ __
PHYSICALH.I.N DICAP / APPLIANCEUSE _ _ _ _ _ _ _~-------
"occupation/chemical exposure," family history, alcohol use, "smoking (amount)," "drugs abused," immunizations, medical history, current diagnosis, drug and food sensitivities, antibiotic exposure, home remedies used, names and telephone numbers of physicians (general practitioner, internist, dermatologist), dentist, psychiatrist and other, physical handicap/appliance use and caution. The inside portion of the Patient I nformation File includes space for 36 prescription orders, with drug name and strength, dosage and frequency, method of administration and quantity, number, order date, physician, 12 renewals and fee. The Patient Information Sheet requests similar data contained on the front of the Patient Information
File, and the sheet is to be updated by patient "once every 6 months" and "must inform the pharmacist on all over-the-counter purchases" and all prescription medication dispensed elsewhere. "This system is not for every patient, only one or two patients in ten. Patients on long-term drug therapy, heart, diabetic, hypertensive patients require this service," reports Pharmacist Frank Petrancosta, vice president of sales. Prices for the Patient Information File are $9.95/ 100 or $42.00/500; while prices for the Patient Information File Sheets are $8.25/100 and $14.00/M.
Pictorial Packaging, 232 South Lake Street, Aurora, IL 60507. Frank Petrancosta, Jr., Vice President of Sales. Vol. NS13, No. 12, December 1973
669