An Introduction To Patient Medication Records

so who am I um a pharmacist independent prescriber uh sadly no I can't give you any coding at the moment um and sadly no I don't want to look at the rash you've got from Thailand I'm sure they were very nice and good company but no that that needs professional help uh I am Star Wars nerd uh I do probably guessed already I do have a weird sense of humor Just Go With It uh I'm also very old and I remember Ms Doss that they gave out on a it's a magazine it was like oh my God so disclaimer all the all the information here is over 10 years old uh I had previous permission from the owner

uh he's since sold uh and would I lie about that hopefully not uh if anyone watching the ing is at home at home is employed by proscript then skip to the end this is very old information and uh my name is not Darren leis it's something else uh and no patients were harmed possibly inconvenienced in the making of This PowerPoint presentation so when you log in to I mean I'm dealing mainly with prescript there are a different there a couple number systems this is the one I'm more familiar with I've used it for probably about two decades now we have a small problem when you log in you need a username and a password this is audience participation

now and it's like oh no no one said anything about that I'm just here to listen to talks don't pick on me would anyone Hazard a guess of what the username and the passwords could be proscript proscript good one admin admin just blank yeah well I'm really sorry I'm also a practical joker cuz I played a trick on you so you don't actually need a password because if you go and use that file called PS Global and where it says require a login yes you just change it to a no whoops and we're in so what so there's not much to do or see if you know the person's name you can access their records but you need they

need to have been to your Pharmacy been to the place initially so you can't look up Kim Kardashian to see if she really did have any Botox on the NHS you can't look at any of that kind of stuff um and either bigan doesn't work I think the most exciting one we had was Pizza Hut which this is a pizza themed talk uh and that's it that's the end of the talk so thanks very much for attending thank you uh that was good wasn't it hang on I signed up for quarter of an hour good so let's have a look at the file structure so most of the stuff is it's built on dbf files which I think is

basically just glorified database file and each one has a corresponding CDX file uh edit the dbf file at your peril I mean I'm just saying just for argument sakes that if you edit the dbf file and don't do anything with the CDX file it may cause the system to crash backups are your friend I haven't tried this much um as we can see most of the stuff is You've Got Dat databases of doctors dosages side effects flavors drug alerts illnesses the whole works so from this file structure the most exciting one there is T table PMR which basically is every single prescription that that Pharmacy has dispensed so the one I was working at has dispensed 181,000

689 entries Christ no wonder I don't no wonder I look been tired all the time doing all those work and then you've got a patient one this one's got every single patient ever entered onto the records this case there's eight near just under 9,000 and that's got names addresses phone numbers date of births all the kind of stuff the program I used was um dbf file viewer you can export it to good old Excel I mean who doesn't use and love Excel so I've got some real world examples so these are U Back In 2006 we dispensed 56 Don 11 which is Don episil for Alzheimer's you've got 30 Dez 13s which is desler aadin antihistamine

so it's you can get a little bit of information but it's cross you need to cross reference each database so the number is basically the patient number date obvious drug drug code doctor is so doctor 8 would be a GP in the pool area um one of the local ones you can normally tell the lower the number the more likely they are to be fairly close by uh there's a type which I haven't got on that form because most of them were blank most of them are NHS uh there's a p if it's private and exemption status now as I've said before this information is old so we've got um AB c d uh F there's an e in there as well

that's all been simplified but essentially C is your over 60s uh D is maternity so in our example from 2006 same person and they've hold all that and they're over 60 so it's quite useful except I've just put what use is that so you need to use multiple database files to cross reference so um if you want the patient number you've got to look at the DBL patient if you want the drugs it's England because that's all the English drugs there's doctors and the exemptions look on the back of a prescription some of these files are edited and updated every month so if I were to change five drugs in the England database next month I'd have to do

exactly the same because it's updated remotely uh other dbfs can be edited lines deleted which is fairly pointless so if we took our previous example if we deleted some entries from 2006 all we're doing is just deleting an entry they've still had the drugs I've still been PID paid for them thanks very much um but you know deleting a Don episil what what's the point fairly little so these are s real life examples now this is where pharmacists go bad sounds like a very bad Sky one documentary doesn't it uh so patient 11368 under 16 using the drug code mc41 using the England database you can figure out that mc41 is Micron which is used for period control

contraception has she told her parents if she's under 16 she as long as she's Frasier Ang gilic competent and has mental capacity she doesn't have to if she's mature enough to make her own decisions which is just right for blackmail which is a bit wrong but then I've put on there it's like it is black mail material but how much money would a 14-year-old actually have so you look at return of investment you're not getting very much at all although you could actually bribe her for some other things like oh need access to your father's Maserati and just take that for a joy ride example number two this is patient 781 he is over 60 he's using Sil 42

which is Sil denifer fil it's used for hydraulic maintenance I know it's a performance issue two types of men they the men that go have you got any Viagra and there's the other type of man that's like I want the 100 milligram I want a ham A Nails in it's sad it's true um does his wife know I've actually had a case where a wife came in to pick up her medication and was given the husband's medication of which he was not using it with her whoops they were soon divorced and now instead of a nice big mansion there's two smaller little bedsits they both like sleeping so sorry keep touching that um this is going to have a much better

payout than the last person they're going to be more established they're going to be wealthy you can just milk them for anything can if you're that way inclined these are my favorites now you see because I I don't do blackmail a lot of hassle lot of problems you need to keep track of how much you're you know asking for so you can change the PS Global inii entries cuz that's not updated so we've got emergency supply text equals emergency supply password whole saer screen equals no and no dose text is us as directed by the prescribed so these are just some of mine I've not done this just for the benefit of the recording so the emergency supply one to

say you change it to you're a needs to order earlier especially Christmas people seriously don't make my life harder wholesaler screen let's just change that to yes then no one can order anything whoops and users directed by the prescriber to be used rectly with no lube and that would go on every single one you print with no label with no directions uh you can see why they're my favorites can't you so it's not all gloom and doom it's not all blackmail so proscript has evolved which is good each pharmacy now uses a separate login password they've moved to my SQL or SQL let's see if we can divide the room 50/50 by pronouncing it incorrectly

all the information is now 10 years old at least I mean you've seen 2006 the contraceptive patient's Now 26 and the Viagra patient sadly was born in 1922 so God Rest his soul he had he had fun on the way out he hammered those Nails in literally on the outside as well which is actually quite impressive any questions is this ah and now I'm not going to talk about the rash and that's it thank you for

listening thanks Darren um any questions we've got time for two so who'd like to go first don't have to ask a question if you don't want to no one thank oh got someone over there

so so it's good to hear that they've um improved things to some degree so do you know do they actually encrypt all this data in the database now yes so most of it now is offsite so the Legacy stuff from I think 2011 is still you can download it but I mean it's chunky files and it's not really relevant I mean anything that somebody had 20 years ago you know things have moved on on either it's dropped off or got better so but most of it now is SQL encrypted remote server remote backups passwords are changed uh it's just this is a quite an interesting fun Remnant it's an interesting thing with old data because for chronic conditions

it would still be relevant probably some of it yes thank you I uh it's a very interesting presentation thank you uh my question uh is U this kind of medical record system would it actually be linked to medical devices in a hospital setting so this one wouldn't be because each Pharmacy has their own separate system so if I went uh if I worked for boots or uh Rolland or super drug they're not linked so I could take my Viagra prescription into four different pharmacies and they wouldn't know I'm getting Viagra so it's not it's not linked yet the GP systems are linked and they've got far better security they're all remote access and a big disclaimer comes up

with misuse of computer act which I don't want to get fired thank you Darren Round of Applause yes