• Patient Booking and Payment Confirmation: 

Patients initiate the consultation process by booking appointments through the clinic's online platform. Once a booking is made, the system confirms payment for the consultation. 

(Operational)

• Invoice generated in XERO

Confirmed and paid practitioner appointment is sent to XERO by Zapier generating a paid invoice and adding patient contact details to XERO. 

(Operational) 

TO discuss 3rd January 2024

• This step is working OK only for NEW patients. For existing patients, before creating a new record in Xero, we need to check if the patient information from the ECWID Booking is already present in Xero. Information to be checked include the patient’s full name, address, phone number and email address to avoid duplicates.

• If potential duplicates occur (eg. Patient name exists in Xero with the same email address and phone number but different address) flag a message and do not update Xero.

• Allow for a manual review of the flagged record to decide if there is a duplicate or not.

• Request for Patient Medical History (PMH): 

At the time of booking, patients are prompted to fill out their medical history via an online form or questionnaire. This step streamlines the consultation process, providing practitioners with essential background information before the appointment. 

(Operational)

• Completed Patient Medical History (PMH): 

Patients submit their completed medical history forms, which are then stored securely for the practitioner's review prior to the consultation.

• Welcome Email to Patients: 

Following the confirmed booking and submission of the medical history, an automated welcome email is sent to patients. This email reiterates the appointment details, including date, time, and any other essential information they need to know.

(Completed)

• Reminder Emails: 

To ensure patients don't miss their appointments, automated reminder emails are sent 4 hours and 1 hour before the scheduled consultation. This helps minimise no-shows and ensures patients are prepared.

(Operational)

• Creation of Patient Folder in Google Drive: 

Upon booking confirmation, a dedicated folder for each patient is created in Google Drive. This folder serves as a centralised repository for all relevant patient-related documents and records.

TO discuss 3rd January 2024

• If an existing patient, do not create a new patient folder. If in doubt whether a patient is new or not, flag a message, provide option for MOCA Admin team to review.

• Practitioner Medical Notes (PMN): 

Within each patient folder, a separate document titled Practitioner Medical Notes (PMN) is established. This document is where practitioners record their observations, diagnosis, treatment plans, and other essential information during the consultation. 

• Archiving Patient Medical History (PMH): 

The patient's completed medical history form, converted into a PDF or Google Pages document, is securely stored within their respective Google Drive folder.

TO discuss 3rd January 2024

Step to be performed for new patients ONLY.

Request Patient Medical History (PMH) if non present

Completed - If there is no Patient Medical History (PMH) from the patient, send periodic emails requesting a completed form.

Existing Patients pre clinic preparation 

For pre-existing patients, no additional information is required at time of booking.

• Management of Patient Master Booking Spreadsheet (MBS): 

A central spreadsheet (MBS) is maintained to oversee all patient bookings, both existing and new. It serves as a master record containing essential patient information and appointment details.

• Addition of New Patient Details: 

Whenever new patients book consultations, their details are promptly added to the Patient Master Booking Spreadsheet (MBS) for comprehensive record-keeping and management.

• Linking Practitioner Medical Notes (PMN) to MBS: 

The Practitioner Medical Notes (PMN) document within each patient's folder is linked or cross-referenced to the corresponding entry in the Master Booking Spreadsheet (MBS). This allows for easy retrieval and association of patient records during follow-up visits or consultations.

TO discuss 3rd January 2024

Not currently placing links to existing patients

1. When a new row is created in the PMS, if it’s an existing patient it is required to have a link to the Practitioner Medical Notes; a link to the existing questionnaire; and the DOB. The DOB comes from the booking - not all raws creates in the PMS have the DOB. This must be there for both existing and returning patients. 

See example screenshot incorrect date format 

See screen shot missing date of birth - present in booking 

2. All Medical Notes are currently created with the following permit - Public access- Anyone on the internet can find and view the document - Viewer permit. Completely REMOVE Public access and limit access to Medicinal Organic Cannabis Australia (MOCA)
   
   Integration of Patient Medical History (PMH) into MBS: 

The information gathered from the Patient Medical History forms is incorporated into the Master Booking Spreadsheet (MBS). This integration provides practitioners with a comprehensive overview of each patient's medical background before consultations.

Generate Prescription

Generate Repeat Medication Database and interface

Generate Medication Invoice to Patient 

Generate Medication Purchase Order 

Generation of Daily Clinic Spreadsheet (DCS): 

The Daily Clinic Spreadsheet (DCS) is automatically generated from the Master Booking Spreadsheet (MBS) to facilitate the day's clinic sessions for each practitioner. It provides a concise summary of scheduled appointments and necessary patient details.

On this spreadsheet, the practitioner will access the Patient Medical History (PMH) and the Practitioner Medical Notes (PMN) where they will record the consult. 

TO discuss 3rd January 2024

Location of Daily Clinic Spreadsheet

https://drive.google.com/drive/folders/1rMjArKFVgDcklpLYLLTR6gg3j8A3dimH?usp=drive_link

Do we need to make a patient folder for 2024 or by practitioner?

Example naming convention  for Daily Clinic Spreadsheet 

DD-MM-YY Practitioner NAME and SURNAME - Medical Consultations e.g:- 

30-11-23 Victoria Thomas - Medical Consultations

On this spreadsheet the practitioner will arrange the next step of the treatment plan, they will prescribe medications from drop down menu options, including the number of repeat prescriptions and include when they want to see the patient again for follow up as per the Daily Clinic Spreadsheet (DCS).

The medications in the drop down menus will populate from column A of our MOCA Product Range (MPR). 

The MOCA Product Range (MPR) database will enable us to add and remove products from one central place. Additionally there is more information which we will need in the subsequent steps where, we will generate invoices and purchase orders from the prescribed medicines.

During the consultation, the practitioner will choose from the dropdown box for each medication (maximum of 10 medications) , quantities and repeats.

General overview of Consultations and Prescription Generation: 

During consultations, practitioners utilise the provided patient information and their medical expertise to diagnose, prescribe medications, and outline treatment plans. This process may include generating prescriptions for medications as deemed necessary.

Selecting the various combinations of menu options, they will tailor a treatment plan. They will also indicate when they wants to see the patient for a follow up appointment, see drop down menu example.

From this information will be generated the prescription(s). Each medication prescribed requires a prescription to be generated.

The practitioner establishes when a follow up consultation (NUMBER OF DAYS FROM DATE OF CONSULTATION) by selecting a date from the drop down menu Daily Clinic Spreadsheet (DCS). 

This number is added to Master Booking Spreadsheet (MBS). 

The prescriptions will take the following formats and information they will also have a component that is in the handwriting of the practitioner for selected medications (you can see an example of a prescription with handwritten component on this link. In due course we will create a database of practitioners and there relevant information. 

The information for which prescriptions require a handwritten component shall be contained in the MOCA Product Range (MPR) and will reference .jpgs of the handwritten component. 

In the 2 example prescriptions, the section in blue represents variables that the practitioner will include including medication name and repeats and dosage guide.

The naming convention for each prescription shall be - (Patient first and last name) (Medication Prescribed) (Date of Prescription).

A copy of each prescription is then saved in .pdf format in the Patient folder (for each patient) and in the Master Patient Prescriptions folder (folder to be created).

From the information updated by the practitioner during the consultation for each patient, one or more prescriptions are generated (one per medication prescribed) ready for checking by the practitioner. 

The prescription is populated by information on the Daily Clinic Spreadsheet (DCS), and the MOCA Product Range 2024, will supply the titration guide (column I) and side effects (column J) for each prescription. 

Draft prescriptions are embargoed pending review form practitioner. Once a practitioner checks and confirms the prescription(s), a copy of the prescription(s) is sent to the Patient Folder and made available to the dispensing pharmacy. (this step will come in the next phase, during generating a purchase order for the medication from the compounding pharmacy).

Prescription that have a handwritten element are added to a seperate folder and at the end of each month are printed and sent to the pharmacy for archiving. 

The insertion of the handwritten component is created by inserting the .jpg for each version of the written component of the prescription. Below we have created (3) versions of each for Colada and Gorilla Glue and (3) versions of Mimosa in the 2 x 15 grams and (2) versions of the Mimosa in the 1 x 15 grams. We want to alternate between the versions of the handwritten version so that the exact same version is not used every time. 

On the  MOCA Product Range (MPR) spreadsheet, I have added the location of each of the images below in the corresponding rows for each product. Let me know if you prefer me to upload the images to Google Drive folder.

The medical practitioner signature is at the end of this section and we have (2) versions of the signature to use and alternate on all prescriptions (not just the ones that need the handwritten medication).

Sample Prescription 

Sample Prescription with handwritten THC Flower

Once the patient has completed the consultation, at the end of the clinic each day, send an email update with what the next steps are in the process. The draft email is located here. 

It is our intention to keep the patient informed at all times of the processes in the treatment. 

Automated Invoice Creation: 

Upon prescription generation, automated systems create invoices for the prescribed medications. These invoices are itemised and designed to ensure accuracy and transparency in billing.

Communicating with patient details of treatment plan. 

An email with details of treatment plan is sent to patient advising that an invoice will follow shortly for payment and detailing the n ext steps in dispensing.

To Do - Prepare email for sending from wellness@mocahealth.com.au to the patient with a summary of what has been prescribed, confirmation that application(s) is with the TGA, and that an invoice will be sent to them shortly.

Information from the Practitioner Medical Notes (PMN) about medications prescribed for each patient used to  generate an invoice in Xero to the patient for medication. 

Once generated, embargo invoice until review by practice manager or duty manager.
(MANUAL PROCESS BY PRACTICE MANAGER)

Once approved by the practice manager or duty manager, send an XERO invoice to the patient. 

To Do - When a patient completes payment into the MOCA Health Commonwealth Bank account, update Xero to status paid.

General Overview of Confirmation of Received Payments

Once payments for the prescribed medications are received, the system updates and confirms payment status for the respective invoices, ensuring proper tracking of financial transactions.

Payment are received into bank account and the XERO software is updated by the Practice Manager from 'Awaiting Payment' to 'Paid'. 

As a result of the update, an email is generated to the patient with confirmation of payment received

Operational

Once the patient has been prescribed medicine, sent an invoice and paid for the medication (the email confirming and acknowledging payment if medication sent), then we will send a letter of attestation to the patient. 

A draft of the letter is on this link.

It is very important that this letter is ONLY sent to the patient AFTER the medication has been paid for. The letter can be sent to patients numerous times and always after they have paid for medications.

It is proof that they are patients of the clinic for employers and in the event that the patient is stopped by the police. 

A draft email for the Letter of Attestation can be found on this link.

Compounding Pharmacies

1.  To Do - When a patient pays for medication (money is received into the MOCA Health CommBank account), create Purchase Order(s) (PO) in Xero add new Purchase Order Number (PON) to compounding pharmacy spreadsheet for compounding and dispensing (YSCP and or DUKASA  spreadsheet).

2. Compounding pharmacy to update spreadsheet with dispensing date, invoice number and tracking number. (MANUAL PROCESS BY PHARMACY)

PATIENT UPDATE - MEDICATION DISPENSED AND TRACKING NUMBER 

When the Compounding Pharmacies update the spreadsheet with the tracking number - generate an email to the patient with the tracking number details and note from MOCA Health (to be supplied) advising that the medication is now dispensed and being collected by the courier company for delivery.

Operational

LINK TO MESSAGE FORMAT

• Patient Booking:

  • Patients book appointments online via the clinic's booking platform.

• Consultation and Prescription:

  • Practitioner contacts the patient at the appointed time and prescribes medications and repeats using the clinic's spreadsheet.

• Confirmation and Invoicing:

  • MOCA Health team receives confirmation of prescribed medications and generates an invoice using Zero accounting software.

• Embargoed Invoice and Shipping Preparation:

  • Invoices are embargoed and prepared for shipping to the patient.

• Follow-up Consultation and Reminders:

  • Practitioner sets a follow-up consultation date and, two weeks before its expiry, sends an email to the patient, suggesting booking an appointment.

• Repeat Prescription Management:

  • Patients can request repeat prescriptions between consultations, which the practitioner often includes during the initial consultation. Typically, the practitioner offers three repeat prescriptions.

Proposed Clear Process for Developing a Medical Cannabis Repeat Prescription Management System:

• Data Collection and Storage:

  • Replace the use of Google Sheets with a secure database to capture patient information, prescribed medications, and repeat prescription details.

• System Development:

  • Develop a custom software solution, moving away from Google Sheets, to manage patient records, prescribed medications, and repeat prescriptions.

  • Design a user-friendly Graphic User Interface (GUI) for both practitioners and patients.

• Features of the System:

  • Patient Dashboard: Allow patients to log in, view available repeat prescriptions, and place orders.

  • Practitioner Interface: Enable practitioners to input prescription details, set repeat prescription quantities, and manage patient records.

  • Automated Notifications: Implement a notification system for patients to receive reminders for follow-up appointments and prescription refills.

  • Secure Database: Ensure data security and compliance with regulations regarding patient health information.

• Integration with Accounting Software:

  • Integrate the prescription system with Zero accounting software to generate invoices seamlessly.

• Testing and Quality Assurance:

  • Conduct thorough testing to ensure the system's functionality, data accuracy, and user interface.

• Launch and User Training:

  • Roll out the system to practitioners and patients after comprehensive testing.

  • Provide training sessions for clinic staff and patients on using the new system.

• Continuous Improvement and Support:

  • Collect feedback from practitioners and patients to improve the system continuously.

  • Offer ongoing technical support and updates for system maintenance and enhancements.

By following these steps and leveraging a custom software solution instead of Google Sheets, your clinic can effectively manage repeat prescriptions for medical cannabis while enhancing patient experience and streamlining the clinic's operations.

Absolutely, transitioning from Google Sheets to a more robust and specialised system for managing medical cannabis prescriptions involves several key steps and considerations:

Suitable Alternatives to Google Sheets:

• Database Management Systems:

  • Consider using specialized database management systems such as:

    • Microsoft SQL Server: Robust, scalable, and suitable for handling large amounts of data securely.

    • MySQL or PostgreSQL: Open-source alternatives with strong community support and capabilities to manage healthcare-related data effectively.

    • MongoDB: If flexibility and handling unstructured data like patient records or prescriptions are crucial, MongoDB is a NoSQL database that could be considered.

• Electronic Health Record (EHR) or Practice Management Software:

  • Look into dedicated healthcare software systems that manage patient records, prescriptions, and clinic operations, such as:

    • Cerner: A comprehensive EHR system with modules for prescription management and patient records.

    • Epic Systems: Offers integrated software solutions for medical records, patient engagement, and prescription management.

    • Practice Fusion: A cloud-based EHR system that includes prescription management functionalities.

Integration with Current Processes:

• Data Migration:

  • Export existing data from Google Sheets into a suitable format for the chosen database management system or EHR software.

  • Import this data into the new system, ensuring accuracy and proper structuring.

• Custom Software Development:

  • If a specific software solution doesn't fully align with your clinic's needs, consider developing a custom application.

  • Engage software engineers or a development team to create a bespoke solution tailored to the clinic's prescription management processes.

• Integrating Prescription Management System:

  • Ensure the new system integrates seamlessly with your current processes, such as:

    • Allowing practitioners to input prescription details and set repeat prescriptions within the new software interface.

    • Enabling patients to access their profiles, view available repeat prescriptions, and place orders through the patient dashboard.

• Accounting Software Integration:

  • Set up integration between the prescription management system and Zero accounting software for generating invoices automatically based on prescribed medications.

• User Training and Adaptation:

  • Conduct training sessions for clinic staff to adapt to the new system.

  • Provide resources and guidance to patients for navigating the patient dashboard and managing their repeat prescriptions.

• Continuous Improvement:

  • Gather feedback from practitioners, clinic staff, and patients to refine the system continuously.

  • Collaborate with the development team to implement updates and enhancements to improve user experience and efficiency.

By choosing a suitable alternative system and following a systematic integration process, your clinic can streamline prescription management, ensure data accuracy, and improve overall operational efficiency while catering to the needs of practitioners and patients.

Current spreadsheets

Practitioner Medical Notes (PMN) 

Master Booking Spreadsheet (MBS)

Daily Clinic Spreadsheet (DCS).

MOCA Product Range (MPR). 

1. Booking Database:

• Function: To manage appointment bookings and scheduling.

• Features:

  • Records patient appointments, dates, and times.

  • Tracks appointment availability and practitioner schedules.

  • Integrates with the clinic's online platform for patient bookings.

2. Patient Management Database:
Master Booking Spreadsheet (MBS)

• Function: To store and manage patient information securely.

• Features:

  • Contains patient demographics (name, contact details, DOB, etc.).

  • Archives patient medical histories and treatment plans.

  • Links patient records to practitioner consultations and medical notes.

3. Invoicing Database:
(XERO)

• Function: Manages billing and invoicing for consultations and medications.

• Features:

  • Generates and stores invoices for consultations and prescribed medications.

  • Tracks payment status (paid, pending, overdue).

  • Integrates with accounting software for financial management.

4. Repeat Prescriptions Database:

• Function: Monitors and tracks repeat prescriptions for patients.

• Features:

  • Records prescribed medications, dosages, and number of repeats.

  • Tracks intervals between repeat prescriptions.

  • Notifies when patients are due for repeat medication.

5. Compounding Pharmacies Database:

• Function: Handles medication orders from compounding pharmacies.

• Features:

  • Stores compounding pharmacy details (contact, locations, etc.).

  • Tracks medication orders, deliveries, and associated tracking numbers.

  • Manages communication and documentation related to orders.

6. Stock Management Database:

• Function: Manages inventory and stock levels of medications.

• Features:

  • Tracks medication inventory, quantities, and expiry dates.

  • Generates alerts for low stock levels or expiring medications.

  • Records received and dispensed medications for stock reconciliation.

Integration and Interconnectivity:

• Data Exchange: Ensure seamless data exchange and synchronization between databases to avoid discrepancies or duplications.

• Automation Tools: Integrate automation tools (like Zapier) to streamline processes and trigger actions across databases based on specific events or criteria.

• Secure Access: Implement security measures and access controls to protect patient data and ensure compliance with privacy regulations.

These databases work in conjunction to facilitate efficient clinic operations, streamline patient care, manage medications, handle billing, and maintain accurate records for MOCA Health Cannabis Clinic. Integrating these databases and ensuring their efficient interoperability is crucial for smooth clinic functioning.

Email communications to patients

Welcome email sent to patients 

Reminder email for consultation

Reminder email 1 hour prior to consultation 

Post Consultation email - 2 hours after medication prescribed 

Possible side effects email -  4 hours after medication prescribed.

Patient Update - Payment received for medications - upon updating Xero invoice to paid

Patient Update - Medication dispensed and tracking number to be sent at the time that the tracking number is added by the dispensing pharmacy.

Letter of Attestation  to be sent 8 hours after tracking number is added  by pharmacy.

Follow up appointment with practitioner to be sent to the patient 5 days prior to when the practitioner has requested a new appointment (i.e) patient visits practitioner on 1st January 2024, requests follow up 30 days after appointment -  letter sent on 26th January)

Take expired dates offline once clinic finishes.

Preparation for appointment with medical practitioner

Patient Master Booking Spreadsheet (MBS)

Daily Clinic Spreadsheet (DCS)

Consultation 

Generating Prescriptions

Generating Patient Invoice

Post Consultation 

Repeat Prescriptions

Inventory Management 

Monthly reconciliation from Compounding pharmacies 

Fortnightly reconciliation practitioner invoices 

1. Compounding pharmacy to update spreadsheet with number of repeat prescriptions remaining. (MANUAL PROCESS BY PHARMACY)

2.  To Do - Stock levels on CBD isolate to be automatically reduced by each prescription and have a running total of balance. (STOCK LEVELS LIST TO BE CREATED)

3.  To Do - Stock levels of THC flowers to be adjusted based on dispensed medication (STOCK LEVELS LIST TO BE CREATED).