Module guide · Clinical

Pharmacy

Everything a hospital pharmacy runs on: the drug formulary, lot-tracked inventory, purchasing from vendors, e-prescribing with automatic safety checks, dispensing, bedside administration, DEA controlled-substance compliance, medication reconciliation at transitions of care, and a retail point-of-sale counter.

Overview Dashboard Drug catalog Inventory & batches Purchasing Prescriptions Dispensing MAR Controlled substances Med reconciliation POS & sale history Good practices

What this module is for

A drug's life in the system: it's added to the catalog, received into inventory as a lot/batch, sold over the counter or prescribed and dispensed against a chart, and — for scheduled drugs — tracked movement by movement for DEA compliance.

Who uses it

Pharmacists and pharmacy staff run the catalog, inventory, purchasing, dispensing, and controlled-substance compliance screens. Physicians and nurses prescribe, request dispensing, and record administration (MAR). Directors and compliance staff review DUR alert trends and DEA reporting.

Where to find it

Open Pharmacy from the sidebar. Eleven screens, several of them (Inventory, Purchasing, Controlled Substances) restricted to pharmacy management roles.

1
Stock it
Add a drug to the catalog once; receive it repeatedly into inventory as lot-tracked batches.
2
Prescribe or sell
A physician writes an e-prescription (automatically screened for drug-safety issues), or a walk-in buys an OTC item at the POS counter.
3
Dispense & administer
Pharmacy dispenses against the prescription using FEFO batch logic; nursing records the actual dose given on the MAR.
4
Reconcile & comply
Medication reconciliation catches conflicts at admission/transfer/discharge; controlled substances get an auditable, DEA-compliant paper trail end to end.

A few terms you'll see throughout

FEFO (First-Expiry-First-Out) means the system always pulls from the batch expiring soonest. DUR (Drug Utilization Review) is the automatic safety check run on every new prescription, flagging interactions, duplications, or contraindications. A drug's DEA Schedule (CII–CV) marks it as a federally controlled substance requiring extra tracking. NDC is the National Drug Code identifying the exact product.

Pharmacy dashboard

Three tabs summarizing stock health, drug-safety alert trends, and finances, plus one-click links into every other screen.

Operational tab — stat tiles

Field	What it means
Low Stock Alerts / Expiring Soon	Drugs at or below their reorder point, and batches expiring within 90 days.
Active Recalls	Batches currently under an active FDA-style recall.
Dispensed Today / Active Prescriptions
On Hold / Pending Prior Auth	Prescriptions paused, or awaiting insurance prior authorization.
Incomplete Med Rec	Medication reconciliations not yet verified by a pharmacist.

The Clinical tab (date-range filtered) shows DUR alert volume, override rate, and a breakdown by alert type and severity. The Financial tab shows total/active drug counts, batch counts, and estimated inventory value. A red banner appears for active recalls, an amber one for low stock.

Drug catalog

The hospital's formulary: every drug the pharmacy can stock and dispense, with its identifiers, safety flags, and current stock.

List and filters

Field	What it means
Filter chips	All, Controlled (DEA), High-Alert, or LASA (look-alike/sound-alike name).
Export / Import	Export the catalog or current inventory as CSV; import a bulk NDC catalog file (.txt/.tsv/.csv).

Each row flags low stock (red) and near-expiry batches (amber), plus a DEA schedule badge and a High-Alert badge where they apply. Clicking a row opens its detail, including a FEFO-ordered list of every batch on hand.

"Add / Edit Drug" form

Field	What it means
NDC Code	Optional — leave blank if the drug has no formal code. Only editable when creating.
Generic Name*	Locked once the drug is created; it can't be renamed later.
Brand Names	Add multiple names as removable chips.
Category, Dosage Form, Strength, Unit*	Dosage Form, Strength, and Unit lock after creation.
Routes of Administration / Storage Conditions	Multi-select chip lists, e.g. PO/IV/IM… and Room Temp/Refrigerated/Frozen…
Tall-Man Lettering	e.g. "DOBUTamine" — visually distinguishes look-alike/sound-alike drug names.
Controlled Substance / DEA Schedule	Controlled Substance is set only at creation; if checked, a DEA Schedule (CII–CV) becomes required.
Requires Prior Auth / High-Alert / OTC / Requires Rx	Checkboxes; the last three are locked once the drug is created.
AWP Unit Cost / Retail Selling Price	Wholesale cost for accounting, and the price charged at the POS counter.

Most fields lock after creation

Name, dosage form, strength, unit, and the controlled/Rx/OTC flags can't be changed once saved, only descriptive fields like brand names, pricing, and safety flags can be edited later. Activate / Deactivate (with a required reason) is how a drug is retired without deleting its record.

Inventory & batches

Lot-level stock control: receiving, quarantine/release, temperature logging, quantity adjustments, and recalls, all following First-Expiry-First-Out.

Filter tabs

Field	What it means
Pending Release	Batches sitting in quarantine, awaiting a pharmacist to release them.
Expiring Soon / Low Stock / Recalled

"Receive New Batch" form

Field	What it means
Drug, Lot Number, Manufacturer ID*
Quantity Received, Unit, Expiration Date, Storage Location, Storage Condition*
Unit Cost, Vendor*
Reorder Point	Quantity threshold that triggers the Low Stock flag.

Every new batch starts in quarantine

Whether received here or from a Purchase Order delivery, a batch is not usable stock until a pharmacist explicitly clicks Release. Newly created batches cannot be dispensed while in quarantine.

Per-batch actions

Field	What it means
Release / Quarantine	Moves a batch into or out of usable stock.
Adjust	Waste, Cycle Count, Breakage, Diversion, Correction, or Return, with a signed quantity (negative to remove) and reason. A witness is required for adjustments on controlled-substance batches.
Temp	Logs a cold-chain temperature reading for the batch's storage device.
Process Recall	Applies an FDA-style recall to every batch of a drug at once, matched by NDC — the drug must have an NDC on file first.

Quarantine — received, not yet released for use

Active / Released — usable stock

Recalled — pulled under an active recall

Expired / Depleted / Destroyed — no longer available

Purchasing

Drug-specific purchase orders to vendors, from draft through approval, sending, and receiving goods.

Alert banners flag overdue POs and supplier payments due within 7 days. A New Purchase Order needs a vendor, order date, and one or more drug line items (each a drug, quantity, and unit cost).

Draft → Pending Approval → Approved — working its way to being sent

Sent to Vendor → Acknowledged — with the supplier

Partial / Fully Received — goods have started or finished arriving

Invoiced → Paid — financial close-out

Cancelled / Disputed — called off or contested

Each status shows only the next action available: Submit for Approval, Approve/Reject, Send to Vendor, Mark Acknowledged. Receive Goods is available from Approved through Partial Received (a PO can be received more than once for split shipments); every line needs a lot number and expiry date to be received, and — same rule as manual receiving — the resulting batches land in quarantine.

Prescriptions

Electronic prescribing with automatic drug-safety screening (DUR), prior-authorization tracking, and patient medication-history lookup.

"New Prescription" form

Field	What it means
Patient, Prescriber*
Order Type	Inpatient, Outpatient, Discharge, Emergency, Controlled Substance, Compounded, or Investigational. Defaults Outpatient.
Dispense As Written (DAW)	Checkbox — blocks generic substitution when checked.
Medication lines*	One or more: drug, dose, dose unit, route, frequency, sig (patient instructions), quantity, refills (0–12), days supply.

Overriding a drug-safety alert requires a written reason

Saving a prescription automatically runs a DUR check for interactions, duplications, and contraindications, color-coded Contraindicated/Major (red), Moderate (amber), Minor (grey). Choosing to override a pending alert prompts for a typed justification, an empty reason cancels the override.

Active — current, can be dispensed

On Hold — paused, can be re-Activated

Cancelled — called off, cannot be undone

Completed / Discontinued / Expired — closed out

The Patient Lookup tab searches one patient's active prescriptions and can export their medication history as a FHIR bundle.

Dispensing

Where pharmacy staff hand out medication against an active prescription, using FEFO batch selection.

The Pending Queue lists prescriptions awaiting dispensing. Opening one shows each medication line with the prescribed quantity and refill usage, and an editable dispense quantity, leave a line at zero to skip it (e.g. out of stock) rather than dispensing partially. The system automatically pulls from the soonest-expiring batch; staff don't choose which lot. A Pharmacist DEA field appears for controlled substances. Patient History and Statistics tabs cover lookup and reporting.

MAR — Medication Administration Record

The nursing record of what was actually given to a patient, when, and by whom, including refusals, holds, and controlled-substance waste.

"Record Administration" form

Field	What it means
Patient, Active Medication*	Only that patient's active medication orders are offered; picking one auto-fills dose and route.
Dose, Dose Unit, Route*
Outcome	Administered, Refused, or Held. Refused/Held each require a reason.
Waste Tracking	Appears only for a controlled substance: wasted amount and a named witness.

Unwitnessed controlled-substance waste is flagged

A dedicated tab lists every controlled-substance waste event recorded without a witness, this is exactly the list compliance reviews to close the gap.

Controlled substances

DEA-compliance workspace (21 CFR §1304/1306): a full transaction ledger, diversion-flag investigation, biennial inventory, physical counts, and DEA number validation.

Transaction Ledger & Balances

Every controlled-substance movement, filterable by schedule or drug, with a running per-batch balance. Flagged (possible diversion) rows are highlighted red; an Investigate action requires documented notes to close a flag.

Physical Counts & Biennial

Start a Daily/Weekly/Monthly/Biennial count (pre-populated from released batches at a location), then Complete it, the system reports discrepancies automatically. The Biennial tab compiles the DEA-required Schedule II inventory.

A DEA Validate tab checks whether a DEA registration number is properly formatted and valid. Waste by Staff filters the ledger to one staff member's waste transactions.

Medication reconciliation

Documents comparing a patient's medications at admission, transfer, or discharge, catching duplicates, omissions, or dangerous interactions across the transition. Satisfies Joint Commission NPSG.03.06.01.

"New Reconciliation" form

Field	What it means
Patient, Performed By*
Encounter	Optional, scoped to the patient.
Transition Type	Admission, Transfer, or Discharge. Defaults Admission.
Medication lines*	Name (can be a home medication not in the formulary), dose, frequency, route, and an Action: Continue, Discontinue, Modify, or New. Modify reveals New Dose / New Frequency fields.

Two-person sign-off is required

A reconciliation starts as Pending. It only becomes Complete once a pharmacist separately Verifies it with their NPI on the Pending Review tab, whoever documents the history isn't the one who signs off on it.

POS & sale history

A retail checkout counter for selling medication directly to a patient or walk-in customer, plus the sale history and daily cash summary.

Checkout

Field	What it means
Registered Patient / Walk-in Customer	A registered patient can link an active prescription (unlocking non-OTC items); a walk-in only needs a name and can only buy OTC medication.
Cart	Add drugs by search; quantity and unit price are editable per line.
Payment Method	Cash, Mobile Money, or Card/Bank. Defaults Cash.

After checkout, download a PDF receipt or start the next sale. Sale History lets staff search, filter, and reprint past sales, and pull a Z-Report, an end-of-day revenue summary broken down by payment method.

Good practices

Release quarantined batches promptly

Nothing received, whether by manual entry or PO delivery, can be dispensed until it's released, an easy step to forget after a busy delivery.

Never override a DUR alert without a real reason

The justification you type is a permanent record explaining why a flagged interaction, duplication, or contraindication was allowed to proceed.

Controlled-substance waste needs a witness, every time

Skipping the witness field is exactly what lands a transaction on the Unwitnessed CS Waste list for compliance review.

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