Recipes & Blends, Prescriptions, and Product Schedules

Overview

The video included below will give you an overview of the product section.  In this article we are going to focus in on the three advanced portions of the product section:

1. Recipes and Blends
2. Prescriptions
3. Product Schedules

Product Recipes & Blend

It’s important to first clarify the distinction between recipes and blends.  A recipe is simply a set of instructions that record how much of what substances should be mixed together to create a final product.  It’s a guide, it is not the end result.  A blend, on the other hand, is the end result.   It is what you get when you follow a recipe and combine the ingredients.  So a blend is a physical tangible item, while a recipe is just words and measurements on paper.

Here are a few rules of recipes and blends to keep in mind:

1. In order to create a blend, you must first create a recipe.
2. A recipe does not need to be followed exactly, every time.  You have the freedom to vary quantities, and ingredients, while keeping the original recipe intact.
3. Ingredient inventory will not be deducted unless you finalize the recipe, which means that you actually create the blend.

With that said, in this section we are going to explain how to chart the creation of a blend for a patient, ingredient by ingredient.

Create and save a recipe

First thing to do is to add a product section to your chart.  If you are not certain how to do this, read this article first, and then continue here.  Once your product section has been added, click on the ‘BLEND’ box in the product section.  This will open up the blend editor.

Click +BLEND to open the blend editor

Creating Tinctures with the Tincture Calculator

If you intend to create a tincture, we have a helpful tincture calculator will be of assistance.  The Tincture Calculator will help calculate the suggested daily intake of each substance by converting your recommended dosages for that substance based on the reference ratio vs your stock ratio.  So for example, if substance A is recommded as 1 tp 2 mL/day in a 1:4 ratio, but you actually have a 1:8 ratio in stock, then the calculator will display the recommended dose of 4mL/day at the 1:8 ratio concentration.

Blend Editor with Tincture Calculator turned on

In the Blend Editor, the ‘Hide/Show Tincture calculator’ will turn on or off the columns of the blending table related to tincture.   When turned on, it adds a number of columns to the Blend Editor.  Here is an explanation of what all the columns in the Blend Editor are for when the tincture calculator is turned on:

1. Ingredient: This is where you will select your ingredient.  Note the dispensary selected at the top of the product section.  This is the dispensary from which you are going to be selecting your ingredients.  If you create a new ingredient, that is the dispensary where the ingredient is going to be saved. An ingredient will show up in your dispensary just like any other product.
2. Rec. Dose (x-y in mL/d): This is a tincture calculator column.  This is where you will be entering the recommended dosage range, in mL/d.  This most likely comes from your reference material.
3. Ref. (1:n): This is a tincture calculator column.  This is the dilution ratio, again from your reference material, to show the dilution ratio to which the previous column’s reference recommended dose refers.
4. Stock (1:n): This is a tincture calculator column.  This is the dilution ratio of the substance that you actually have in stock.  For example, the reference material may indicate a ratio of 1:4, but what you have in stock is a 1:6.
5. Adj. Dose (x-y in mL/d): This is a tincture calculator column.  This column will look at the previous columns and calculate the adjusted recommended dose for that substance based on the data you entered.
6. Suggested Daily Intake (mL/d): This is a tincture calculator column. This is where you will specify the dosage that you are going to recommend to your patient, based on what the calculator is showing you is the Adjusted Recommended Dosage.
7. %: The percent column is going to show you the percentage ratios of all the ingredients you have selected based on your Suggested Daily Intake for each.
8. Adj. % (opt): This column allow you to further refine your recommendation by allowing you to override your Suggested Daily Intake based on the percentages you see in the previous % column.  For example, if your Suggested Daily Intake recommendation results in a 49% to 51% split between 2 ingredients, you may simply want to override that and make it 50/50.
9. Quantity: This column will tell you exactly how much of each ingredient you will need to create your blend.  It’s important to note that you need to first enter the total quantity at the bottom.  For example, if you plan on dispensing a 250mL bottle of the tincture, enter 250 in the Quantity total column.  Then the quantities of each ingredient will be calculated automatically.
10. $/unit: This column will show you what you have entered into the system as the cost per unit of the substance.  When working with tincture, it is helpful to add in the cost per mL as the unit cost for a tincture ingredient in the dispensary, rather than entering the cost of a bottle of that ingredient.  Putting in the cost per mL will allow the tincture calculate to calculate the exact cost to you of the blend you are making.
11. Subtotal: This column will itemize the total costs per ingredient, by taking the unit cost and multiplying it by the value in the Quantity column.  Then the subtotal is further totaled at the bottom to show you the total cost for your tincture.

You do not have to use the tincture calculator if you do not want to – if you already know your tincture recipes, or you are creating a simple blend of ingredients and not a tincture, then you can turn off the tincture calculator and just enter your ingredients and final quantities of each.

Creating a simple recipe

A simple recipe is just a recipe created without the help of the tincture calculator.  You could be blending teas, making powdered blends, or even making tinctures but without the use of the calculator because you already know the proper recipe.  In these cases, you can use the Blend editor with the Tincture Calculator turned off.

Simple Blend Editor, ie Tincture Calculator turned off.

Here is an explanation of the columns in the Simple Blend Editor:

1. Ingredient: This is where you will select your ingredient.  Note the dispensary selected at the top of the product section.  This is the dispensary from which you are going to be selecting your ingredients.  If you create a new ingredient, that is the dispensary where the ingredient is going to be saved. An ingredient will show up in your dispensary just like any other product.
2. Quantity: You can enter the quantity of each ingredient in your recipe here.  Note the unit of measure.
3. $/unit: This column will show you what you have entered into the system as the cost per unit of the substance.  When working with tincture, it is helpful to add in the cost per mL as the unit cost for a tincture ingredient in the dispensary, rather than entering the cost of a bottle of that ingredient.  Putting in the cost per mL will allow the tincture calculate to calculate the exact cost to you of the blend you are making.
4. Subtotal: This column will itemize the total costs per ingredient, by taking the unit cost and multiplying it by the value in the Quantity column.  Then the subtotal is further totaled at the bottom to show you the total cost for your tincture.

Units, and cost per unit

You will notice in the Blend Editor that you can click on the unit of measure, and the cost per unit for each ingredient.  This allows you to permanently modify properties for your ingredients.  If the word ‘unit’ is displayed as the unit of measure for your ingredient, it means that no units have been entered into the system for that ingredient.  So you can enter them right now.  Click on ‘unit’ and it will allow you to change the unit of measure for that ingredient.

For the cost per unit, you want to enter your cost (what you pay to your suppliers) for every unit.  So if you buy your ingredient by the 1L bottle, but your unit of measure is mL, then take your per bottle cost and divide it by 1000 to get your cost per mL.  This is the cost per unit.  If you enter these correctly, the Blend Editor will be able to tell you the exact cost for each blend you make.  This will help you set the price, if needed, for that specific blend.

Recipe creation best practices

• When creating recipes, it is best for all ingredients to be entered with the same units of measure.  This will ensure that inventory is properly managed when you are when you are finalizing the blend.  When a blend is finalized, inventory is deducted from the ingredients, and added to the blend.  So 50g of substance A and 50g of substance B, when blended together, will deduct 50g from each of the ingredient’s inventory, and add 100g to the blend inventory.
• Do not create one-off recipes.  There is no need.  When you create a recipe, it can be modified to suit the individual needs of your patients.  So do not create a recipe for each patient.  Instead create one master recipe, and vary it per patient.  The only time you should create a new recipe is if the recipe serves a different purpose.  For example, do not create a ‘energy booster’ tincture with varying ingredients and quantities for each patient.  Instead, create one master recipe for your ‘energy booster tincture’, and then modify that recipe as needed when you add to to a specific patient’s chart.  A good master recipe will be the most general recipe you can make, that will reduce the amount of variations you need to make for each patient.  If you find that you are having to constantly modify the master recipe in a very specific way, then it might be time for a new master recipe.
• Ingredient units should be set to the smallest unit of measure that you use in your blends.  If you purchase your ingredients in 1L bottles, but you create blends in mL, then your unit should be set to mL, not L.  Your cost for that ingredient should also be recorded in terms of the smallest unit used in blending.

Saving, Updating, and Finalizing recipes

When you are done with your recipe, you must click on ‘Save as New Recipe’ only if you are creating a new recipe.  If you are modifying an existing recipe as a one-off modification, do not create a new recipe – there is no point.  If it’s a one-off, then you’ve already added it to the chart, and you will not need it again for other patients.  If this same patient comes to see you for a follow-up, you can just load that one-off recipe from their previous chart.

If you load a recipe and want to modify it permanently, either by changing quantities, or changing ingredients, then you can click on ‘Update Recipe’ after you make your changes.  This will change the master recipe, but it will have no retroactive effect on your charts.  All your previous charts using this recipe will not be changed when you update a recipe.

If you want OutSmart to calculate inventories on an ingredient level, or if you want to allow for this blend to show up as a billable item in the Express Checkout Dashboard Card to make it easier for your admin staff to bill for the blend, then you can click on ‘Finalize and Produce Blend’.  This basically means that you are actually creating the blend now – it will deduct inventories from the ingredients, and add inventory to the resulting blend.

Creating a Prescription

Although the prescription area of the products section is most often used for pharmaceutical prescriptions, you can actually use it anytime you want to create a more structured product recommendation for your patience, and also create a more structured product label.

First thing to do is to add a product section to your chart.  If you are not certain how to do this, read this article first, and then continue here.  Once your product section has been added, you will need to select a product from the product section drop down.  First check to ensure that you have the correct dispensary selected, and then select your product from the product drop down list.  If your product is not there, then you can create a new product.

Search for a product.

Once you have selected or create a new product, then click on the ‘PRESCRIPTION’ box in the center of the product section.  This will open up the prescriptions editor.

Once your dispensary and product are selected, click on the +PRESCRIPTION box.

The Prescription Editor

The prescription editor is a structured interface to ensure that you get all the pertinent information about the prescription entered correctly.  Here is a list of the sections, and how you should use them:

1. Start: This is the date that you want the patient to start taking the prescription.
2. Duration: This is the length of time that you want your patient to be taking the prescription.
3. Form: This is the form of the substance you are prescription, for example, cream, gelcaps, tablets, spray, etc.
4. Quantity: This is the total quantity that you want to dispensary, or you want the pharmacist to dispense.
5. Dosage: This is your recommended dosage of the prescribed product.
6. Frequency: This is a standard frequency list, describing when the patient is to take the specified dosage in the previous box.
7. Route: This describes by what means to take the prescribed product, for example, orally, topically, etc.
8. Refills: This specified how many refills you are authorizing.
9. Note to Pharmacist / Staff: This will display on printed Rx’s as a note to the pharmacist or your staff.
10. Dosage Instruction: This is an additional line of instructions to follow the above information, for example, ‘Take with water’.

Beyond the above 10 areas, you can also add additional information to the ‘Dosage and Instructions’ and the ‘Description’ areas of the product section.  While these will not show up on the printed Rx, they will show up on the patient’s treatment plan.

Printing your prescription or prescription label

A prescription or the prescription label can be printed from a number of areas:

• From the SOAP chart prescription box: Print buttons located within the prescription box.
• From the Express Checkout Dashboard Card: Print buttons located directly to the left of the product listing in the Express Checkout card.
• From the Client Workspace: Print buttons located directly to the left of the product listing in the Medical Summary.

When you click on Print Rx, you will get a print view which will include every single prescription from SOAP chart that the prescription was added to.  So if you had 5 different prescriptions within that chart, all 5 will show up in the print view.  You can then choose whether to print out all 5, or select exactly which ones to print.

Print Rx view. You can print all the RX’s from your chart, or only selected ones.

If you choose to print a label, you must have a thermal label printer like a Dymo printer in order to print the label.  OutSmart does not currently support printing labels on regular printers with multiple label sheets.

Sample label generated for a prescription.

Creating Product Schedules

A product schedule is a set of product dosages scheduled at specific intervals over the course of the day or the week.  For example, a product schedule could indicate a recommendation to take Fish Oil every morning with breakfast, or to take Adrenal supplements upon waking and before going to bed every day.  Creating a specific schedule for your product recommendations can help your patients to better organize their supplement intake for the day – which is a key element in increasing patient compliance with your recommendations.

OutSmart helps you accomplish this with our automated Active Product Schedule.  The Active Product Schedule will display all your active product recommendations in an easy to understand daily schedule that the patient can print out and stick on their fridge, so that they have a clear understanding of your recommendations.  Here is how you can create that schedule, and maintain it.

Adding A Product To The Schedule

You easily add a recommended product to a schedule from your SOAP / Medical  chart.  Start off by adding a Product Section to your chart, and the select or create a product or blend within that section.

Add a product section to your chart.

Once you have added a Product Section to your chart, ensure that the dispensary you have selected is the correct dispensary where the product information is stored, and then select the product you want to recommend from the product drop down list. (Note: You can also create a new blend or create a new product as well if you prefer.)

Search for a product.

Once you have selected a product from the list, click on the +Schedule bar to open up the Product Schedule Builder.  The Product Schedule Builder will allow you to start adding scheduled dosages for this product.

Add a scheduled dosage.

Once the builder is open, use the +Add Scheduled Dosage button to add individual dosages for each time of the day that you want your patient to take the product.  You can also add additional dosage notes or product descriptions as required.  All this information will be made part of the Active Product Schedule.

Set up the scheduled dosage.

When you are done adding the specific product dosage information, scroll down your chart a bit until you see the Active Product Schedule, and click on the “Refresh” button in order to see your product added to the schedule.  Note that the schedule view that you have in your charts does not match exactly the printout that will display for the patient.  The Patient’s Active Product Schedule view will have more specific information about the dosages within the schedule.  To see what the patient will see on their print-out, you can click on the “Print” button for the schedule.  You can then actually print out the schedule immediately if it is done, and provide that to your patient.

Preview the results in the product schedule.

Using Product Protocols To Speed Up Schedule Creation

When you populate the Product Section with information about a product, blend, prescription, or schedule, you have the option of saving all that information as a Protocol, which is essentially a template of all the data you entered into that section.  This includes the scheduling information.  You can read this section of the article for more information on creating Product Protocols, but essentially you are typing in a name the Protocol Save Box and then clicking on “Save”.

Save as a product protocol.

Once you have saved a protocol, you can recall is from the product drop-down menu at any time.  Loading a protocol will update all data within the Product Section, so you should always load a protocol FIRST, before then making changes and adjustments to it.

For example, if you wanted to use the newly created “Ferro-C Morning + Night Schedule” Protocol for another product like Vitamin C because you want to re-use the same product schedule, then start by selecting the “Ferro-C Morning + Night Schedule” from the product selection box, and then once that protocol is loaded, change the product to the new product you want.  So always select the protocol first, because it will replace all data in the Product Section.  Then, follow with any changes required.  This will allow you to use pre-saved protocols to speed up the scheduling process for products with a similar schedule.  You may also want to save the newly customized product section as a protocol itself, if you recommend it often.

Select a saved product protocol