Part I:  Policy and economic issues Part II:  Pharmaceutical management Part III:  Management support systems

Planning and administration

Organization and management
Information management
48  Monitoring and evaluation
49  Pharmaceutical management information systems
50  Computers in pharmaceutical management
Human resources management

chap ter 50
Computers in pharmaceutical management

Summary  50.2 illustrations
50.1 Uses of computers in pharmaceutical Figure 50-1 Summary of illustrative integrated pharmaceutical
management  50.3 supply management software requirements and
characteristics  50.10
50.2 When and how to computerize   50.3
Benefits and limitations of computerization  •  Starting the Table 50-1 Computer applications for pharmaceutical
computerization process  •  Computer software: options and management  50.3
guidelines  •  General-purpose software  •  Special-purpose Table 50-2 Computer hardware specifications   50.8
commercial software  •  Utility programs  •  Network Table 50-3 Select features of registration software   50.15
software  •  Custom software  •  Open source software  • 
b oxes
Computer hardware: options and guidelines  •  Geographic
information systems Box 50-1 Key steps in the computerization process   50.4
Box 50-2 Illustrative phases in computerization   50.4
50.3 Specialized software for pharmaceutical management Box 50-3 RxSolution  50.12
and control  50.9 Box 50-4 Standard reports for supply management
Quantification of pharmaceutical requirements  •  Basic software  50.13
data analysis and production of formulary manuals  •  Box 50-5 Developing a website or posting materials to the
Procurement and inventory management  •  Hospital Web  50.17
pharmacy management software  •  Accounting and Box 50-6 Lessons for successful computerization   50.18
financial management  •  Drug use reviews  • 
Pharmaceutical product registration c ountry studies
50.4 Electronic communications and medicine CS 50-1 Sample computerization experiences   50.5
information  50.14 CS 50-2 Using handheld computers in pharmaceutical
Electronic communications  •  Medicine information  •  management  50.9
Developing a website CS 50-3 Creating an Internet-based information system for
50.5 Maintenance and support requirements   50.16 HIV treatment in Haiti   50.14
Staff recruitment and training  •  Protecting data  • 
annex
Maintaining computers
Annex 50-1 Building a product master file in a
50.6 Lessons for successful computerization in database  50.22
pharmaceutical management  50.18
Assessment guide  50.19
References and further readings   50.19
Glossary  50.21

copyright © management sciences for health 2011

50.2 I n f ormation ma nageme n t

s u mm a r y
Users should first define what functions or tasks com- • Output and peripheral devices (monitor, printer,
puters will be used for, identify appropriate software for modem, network card, speakers)
those functions, and then select hardware that is capable
Software refers to instructions that can be understood
of using the software efficiently.
and executed by the computer. Categories include—
A computerization process is easier when—
• The operating system, which coordinates and directs
• Efficient manual procedures exist information for the microprocessor
• Staff members are capable of, and interested in, • General-purpose software, such as word processing,
learning to use computers spreadsheets, and database management software
• Funds have been allocated for training, mainte- • Special-purpose software, such as presentation
nance, and equipment upgrades graphics, project management, and accounting soft-
• A reliable power supply exists ware
• Utility programs, such as antivirus, file backup, and
Pharmaceutical management programs should usu-
data recovery programs
ally begin with basic word processing and spreadsheet
• Specialized pharmaceutical management software,
applications. Users can then gain experience and develop
often a custom-programmed database application
support systems for supplies, repairs, and security.
Specialized pharmaceutical management programs are When used effectively, computer systems save money,
often used for quantification of pharmaceutical require- promote efficiency, and improve the quality of services.
ments, procurement, inventory management, or However, poorly conceived or implemented computer
medicine-use analysis. systems waste money, decrease efficiency, and distract
attention from other management improvements.
Medicine information is increasingly available through
electronic communications systems. Most pharmaceuti- This chapter discusses the uses of computers in phar-
cal supply systems have access to Internet communica- maceutical management and examines special issues in
tions. Two main options are available: e-mail and World computerizing pharmaceutical management informa-
Wide Web browsers. Use of the Internet for international tion. It also includes specifications for computer applica-
communications has become increasingly important. tions in pharmaceutical management, considerations for
hardware selection, and requirements for maintaining
Central to most pharmaceutical management applications
and supporting computers. Preparing data for comput-
is a product master file, including product name, strength,
erization is discussed, along with coding systems and
dosage form, therapeutic category, route of administra-
definitions of units. This chapter focuses on personal
tion, and packaging. A coding system with a unique iden-
computers because they are the most widely used by
tifier for each drug product must be developed.
essential medicines programs. Instructing users in par-
Personal computers, or PCs, can be used in all aspects of ticular software programs or making recommendations
the pharmaceutical management cycle. Hardware refers for the purchase of a specific piece of hardware or soft-
to the computer’s electronic and mechanical parts, which ware is beyond the scope of this chapter.
include—
The question today is usually not whether but rather how
• A microprocessor chip and how much to computerize. Even more important,
• Memory chips (RAM, for random-access memory) however, is how to computerize efficiently. This chapter
• Input devices (keyboard, flash drive, mouse, scanner) provides guidelines to help decision makers computerize
• Storage devices (hard disk drive, CD-ROM, mag- their operations effectively.
netic tape)
 50  /  Computers in pharmaceutical management 50.3

50.1 Uses of computers in pharmaceutical Table 50-1 Computer applications for pharmaceutical
management management

Area of activity Uses

Computers can be used in all aspects of the pharmaceutical
management cycle, from selection to use. Using commu- Project planning • Workplans
• Simulation programs
nication devices, users can exchange or share information • Annual reports
with other computers at the same site through a local area
Selection • Preparation of essential medicines lists
network (LAN) or with computers anywhere in the world. • Literature searches
The term computers here also encompasses devices such as
Requirements planning • Quantification of pharmaceutical needs
personal digital assistants (PDAs) and handheld and pocket • ABC analysis
devices such as “smartphones.” Table 50-1 summarizes some • Weight and volume analysis of kits
of the many current computer applications for pharmaceuti- Financing • Budget management
cal management. • Pharmaceutical sales monitoring
• Accounting
• Financial analysis
50.2 When and how to computerize Procurement • Tender document preparation
• Tender monitoring
• Bid analysis
Computer technology changes quickly, with machines con- • Preparing purchase orders and
tinually becoming faster, more capable, and less expensive. receiving reports
The benefits of computers in managing pharmaceuticals • Monitoring of order status
depend on the choice of tools, the commitment to using the Inventory control • Monitoring of stock positions
tools, and the ability to overcome the hurdles involved in • Monitoring of expiry dates
incorporating computers into the organization. No standard • Prediction of reorder dates and
quantities
formula exists for successful computerization in pharma- • Invoicing
ceutical management, but rather a mix of elements applies;
Transport • Vehicle routing and scheduling
the right mix can yield great benefits. • Weight and volume calculation
• Transport voucher preparation
Benefits and limitations of computerization Pharmaceutical • Database of registration data
registration and control • Adverse reaction reporting
Some of the benefits of computerization are to— • Medicines recalls
Medicines information • Formulary preparation
• Simplify and speed up complex tasks • Literature searches
• Increase accuracy by checking spelling, calculations, • Data storage and transfer
• Pharmaceutical bulletin production
and data integrity
• Training material preparation
• Update and access information quickly
Rational use • Formulary
• Automate repetitive tasks
• Standard treatment schedule
• Provide management information for decision making • Calculation of WHO medicine-use
• Allow organizations to expand operations indicators
• Streamline administrative processes • Survey analysis
• Training (simulation games)
• Generate timely reports without repetition
Personnel management • Training software
• Personnel records
Nevertheless, computers do have limitations. They cannot
• Supervision monitoring
assume responsibilities, make decisions, define problems, set • Payroll calculations
objectives, improve the basic data available, or make a per-
Health statistics • Population data
son more organized. They cannot fulfill needs if appropri- • Morbidity data
ate hardware and software are not chosen, and they are not a • Mortality data
one-time expense: funds are required for upgrades, training, Use • Health care coverage calculations
and support over time for both hardware and software. • Medicine consumption analysis
Conditions in an organization that support computeriza- Presentation • Graphs and charts
tion include— • Overhead transparencies or slide shows
for training
• Efficient existing manual procedures Communication • Fax
• Other departments that have computerized success- • E-mail
• Mailing
fully
50.4 I n f ormation ma nageme n t

Box 50-1 Box 50-2

Key steps in the computerization process Illustrative phases in computerization
1. Identify the tasks or the system to be computerized Phase I: Convenience computing
with a detailed analysis of needs compared to cur-
rent systems. This phase includes tasks that could be done with a
typewriter and calculator but are easier on the com-
2. Survey the environment and consider integrating puter. If the computer “goes down” (temporarily stops
with other systems to the extent feasible. (What working), the work can still be done. Examples are—
software and hardware are being used by other
departments? Does an institutional computer pol- • Word processing
icy exist? What equipment is already available?) • Simple databases (for example, an address list)
• Simple budgets
3. Evaluate the staff situation (actual versus needed).
Phase II: Periodic analyses and special activities
4. Select software before hardware.
These tasks would be extremely difficult to do by hand
5. Identify whether the software needed is available
but could be delayed for a few days or weeks if the
in the local language and to which original version
computer were down. Examples are—
it is equivalent (non-English-language versions are
sometimes not as current as English versions). • Quantification exercises
• Complex project budgets
6. Ensure the availability of supplies and maintenance.
• Survey analysis
7. Select the hardware and software suppliers that pro-
vide the most support. Phase III: Essential daily activities
8. Plan progressive implementation (one step at a These tasks involve large volumes of data handled daily
time) and involve current and future users in the or almost daily. If the computer went down, the work
design and implementation process. would be seriously impaired. Examples are—
• Inventory control
• Accounting
• Staff capable of, and interested in, operating computers • Pharmaceutical registration
• A reliable power supply
• Adequate funds to support maintenance, training, and
equipment upgrades
shared? Will a network be necessary? The key steps are listed
Conditions that can impede computerization include— in Box 50-1.
In computerization, users should walk before they try to
• Hardware or software not suited to the task run. Trying to do everything at once increases failure rates,
• Not enough trained operators so organizations often computerize in phases (see Box 50-2).
• Lack of a maintenance plan This strategy enables computer operators to handle increas-
• Lack of reliable power (voltage surges ruin computers ingly demanding tasks, permits support systems for supplies
and databases) and repairs to develop, and allows security systems to be
• Inadequate supply of storage media, paper, or printer put in place to protect against electrical damage, computer
ink and toner viruses, theft, and other hazards.
• Unsuitable physical environment (exposure to dust, Perhaps most important, a phased approach to comput-
heat, or magnets, which can damage hardware and erization allows users to develop a clearer concept of what
software) computers can do, what kind of information they want
from the computerized system, and which modifications
Starting the computerization process they need to make in reporting and management systems to
obtain that information. Computerization must be planned
Begin with the basic questions: What will the computer be carefully so that implementation occurs smoothly, with a
used for? Who will use it? Where will it be used? What is the minimum of interruption and dislocation in the organiza-
budget for equipment, software, and maintenance? What tion’s work. Country Study 50-1 provides some examples of
special functions may be required? Will data need to be good and bad computerization experiences.
 50  /  Computers in pharmaceutical management 50.5

Computer software: options and guidelines General-purpose software

Software is always becoming more powerful, and upgraded General-purpose software programs (such as word pro-
versions appear regularly. Upgrades may mean that the cessing, desktop publishing, presentation management,
software packages require upgraded hardware resources spreadsheets, and commercial database programs) perform
(such as hard disk space, processor power, and memory) to routine daily activities or periodic analyses. Software suites
run effectively. This factor is the main argument for choos- that combine individual programs in one software package
ing software before hardware and for including hardware are designed to allow easy exchange of information among
upgrades in the budget. the different programs, such as linking spreadsheet figures
Computer magazines (and their websites, which are often in a text document. Standard suites usually contain a word
free) are a valuable source of comparison articles on software processor, spreadsheet, and presentation program, while
and hardware. “After-market” software books published by “professional” suites also contain a database program. The
companies such as Sybex or Que are often easier to use than most important factor in choosing general-purpose soft-
the manual provided by the software company. ware is access to local support. Some questions to consider
Three broad categories of computer software are useful in are: Which package is the most common locally? Is local
pharmaceutical management: general purpose, special pur- training available? What software is used in other local
pose, and utility programs. offices with which our office interacts?

Country Study 50-1

Sample computerization experiences
Poor planning. The central medical store (CMS) in a have computerized, and data collection and processing
sub-Saharan African country was computerized as part overlap because responsibilities have not been clearly
of a program to strengthen the computer capacity of the defined. In addition, incompatible software packages
Ministry of Health. Unfortunately, the firm chosen to have been used; coding of key data, such as locations and
do the work did not realize that two previous attempts at medicine names, has not been consistent; and data link-
computerization had failed because of internal organi- ing has been very difficult. Many of the problems could
zational issues that had little to do with computers. The have been avoided by clear definitions of responsibilities,
firm repeated many of the previous mistakes, because it a software policy, and a common coding system for key
believed that the introduction of technology could estab- data.
lish organizational systems and controls, and it did not
Well-planned computerization. A Southeast Asian
examine the organization’s existing structure.
country has undertaken the process of computerizing
An ambitious plan to computerize inventory and finan- slowly. Initially, data on medicine consumption, pro-
cial accounts within three months was devised. What curement, supply, and health statistics were collected
resulted was hardware that could not be serviced locally manually. Computers were first used to enter these
and inadequate training of staff. Only a few poorly data in a spreadsheet program. Although this system
attended meetings were held with CMS management, worked well initially, the amount of data to be processed
and for many reasons, the data entered into the software eventually overloaded the system, and the decision was
were never accurate or up-to-date. made to upgrade it. Appropriate software and a systems
developer were carefully selected. Training of local staff
After nine months, the main CMS computer was stolen.
by expatriate staff was very successful and is still impor-
No data backup had been made for more than three
tant for maintenance of the system. Computerization
months because no diskettes were available. The last four
has helped provide useful management data for con-
months of data were lost, and no one thought that the
sumption analysis, pharmaceutical procurement and
system should be revived. No maintenance budget had
supply, and reallocation of supplies among health facili-
been set aside for recurring costs, such as printer toner,
ties. A computerized registration system is planned.
diskettes, and systems maintenance, and the computers
Computerization has been relatively successful in this
were being used only for word processing.
country because a step-by-step approach was used, start-
Computer integration issues. In a rapidly develop- ing from manual systems and developing the system with
ing South Asian country, problems have occurred in end users to meet their information needs.
the integration and transfer of data. Many departments
50.6 I n f ormation ma nageme n t

Word processing. Word processing programs have In pharmaceutical management, databases are used
replaced the typewriter. For most offices, 80 percent of in data-intensive tasks, such as inventory control, pro-
computing time is spent on word processing. It is usually curement, tender management, detailed analyses of pre-
the easiest task to learn, because the input and output are scriptions, accounting, and drug product registration.
obvious even to a novice. These programs are mainly used Databases are superior to spreadsheets for this type of
for correspondence and for producing documents. Features application because they store more data in smaller files
such as graphics capabilities, spelling checkers, search-and- with less need for duplicating entries. A common field can
replace functions, and generators for tables of contents link separate records in the database, limiting the need for
makes producing documents easier. duplication of data entry and facilitating data retrieval and
Desktop publishing. This software has word processing reporting. The structure of databases permits easy data
features but is more powerful in handling graphics, large manipulation for access and reporting, and they can be
documents, and production of files to be used by a printer designed to check the data entered for consistency with
for newsletters, bulletins, training materials, or books. previously entered data. A relational database is partic-
Newsletters can also be produced using a word processing ularly useful in pharmaceutical management because it
program. allows multiple records for the same basic item (helpful
Spreadsheet. A spreadsheet is a worksheet made of hori- for inventory management, tender analysis, or medicine-
zontal and vertical lines that define a matrix of rows and use analysis).
columns. It is modeled after an accountant’s ledger, and data
are entered in cells identified by coordinates in the matrix. Special-purpose commercial software
Any type of data (text or numbers) can be entered in these
cells, and sophisticated calculations and analyses (such as Pharmaceutical management systems often need special-
those discussed in Chapter 40) can be performed. purpose commercial software packages, such as presenta-
A major advantage of spreadsheets is their ability to revise tion graphics, project management, statistical, accounting,
totals, percentages, and other calculations immediately after bibliographic, and communications programs.
any number or set of numbers is changed, allowing experi- Project management. Project management software
mentation with “what if ” alternatives. They can be linked to organizes and tracks project tasks to be accomplished
allow consolidation of accounts and can produce graphics according to a defined schedule and shows potential con-
and charts of the data entered. flicts in the use of resources. Budgeting information can
In pharmaceutical management, spreadsheets are used also be included.
for budgeting, financial analysis, quantification of pharma- Statistical. Although spreadsheets and databases have
ceutical requirements, ABC analysis, price comparisons, standard statistical functions, using a dedicated statisti-
pricing models, and creating or revising national essential cal package is sometimes preferable. Epi Info, developed
medicines lists, as discussed in other chapters. and distributed by the World Health Organization (WHO)
Presentation. A simple graph often has more visual impact and the U.S. Centers for Disease Control and Prevention
than a complex table, so presentation graphics packages can (CDC), integrates basic word processing, data entry, sta-
be useful for preparing effective and attractive reports, fund- tistical, and database functions. It is particularly useful
ing proposals, overhead transparencies, and presentations. for processing survey data and tabulating data stored in
Database. A database is like an electronic filing cabinet. standard database programs.
Data (characters, numbers, dates, formulas, or memos) are Accounting. Accounting programs are available with a
stored in fields. The combination of fields forms a record, wide range of capabilities. Basic bookkeeping can be done
the records together constitute a table, and a group of with spreadsheets, but a dedicated accounting package is
tables constitutes a database. Database software can store often more appropriate. Selection depends on local factors:
and manipulate large amounts of data quickly. Databases What can the bookkeeper use? What does a donor use?
are used in many business applications, allowing users to— What support is available? What bookkeeping technique
is used? Is the accounting format compatible with local
• Sort data in any order using multiple sorting keys regulations? Increasingly, reputable local accounting firms
• Establish relationships between databases and generate can advise which accounting programs are most suitable
sophisticated consolidated reports for an organization.
• Improve data consistency by allowing or requiring data Bibliographic. Bibliographic software greatly facili-
to be entered according to defined choices tates storing, searching for, retrieving, and manipulating
• Quickly retrieve data according to specific criteria bibliographic information on books, journals, training
• Develop complex applications using powerful pro- materials, and government and project documents. This
gramming languages kind of software requires staff to keep the database up-
• Import and export data to-date.
 50  /  Computers in pharmaceutical management 50.7

Utility programs of the system can connect to a server at the central level to
manage inventory distribution. Maintaining the informa-
Programs called utilities help manage and maintain com- tion in a central location allows users from all levels to easily
puters and stored data. Common utilities include anti- share data and coordinate work. Because the data are pooled
virus, file management, file backup, file exchange, data in one location, management reports are easier to produce
recovery, data compression, firewall, and network soft- and use in a timely fashion.
ware. Because operating systems now include many of
the commonly needed utilities, checking the capabilities Custom software
of a particular operating system is advised before buying
a separate utility. Development of custom-built software, such as an inventory
A current antivirus program is absolutely vital for com- program, is a complex and time-consuming task. Although
puter units that handle essential day-to-day functions, such the idea of custom-built software is attractive, purchasing
as inventory control, drug product registration, accounting, software that has already been written and tested by others
or maintenance of national health statistics. It is also essen- is usually preferable, unless a suitable program cannot be
tial for any system that receives data from outside sources, found. If new software does need to be developed, approach
including branch offices within the country. A firewall pro- this task in a step-by-step fashion—
gram is equally necessary for any computer that connects to
the Internet. The firewall protects the network from unau- • Define the system requirements.
thorized access. • Choose the software and tools for developing the cus-
tom program.
Network software • Design a system.
• Develop and program the system.
Establishing an office-based computer network may be use- • Test and debug the system.
ful. A LAN (local area network) connects the computers and • Implement the system through data entry and training.
printers in a single location. A wide area network (WAN) • Develop system documentation and a complete user’s
connects computers in separate locations. A LAN can be manual.
established with or without a server, although a server may • Provide system support, revision, and upgrades.
be required for certain purposes, such as running central-
ized inventory software. If the network has a server, it must Frequently, lack of time, money, or expertise results in
be protected in a secure, climate-controlled room and its the development of unusable software. Developing custom
data must be backed up regularly. software always takes longer than expected and often goes
A network is helpful if a number of computers in the over budget. Users should explore all alternatives carefully
office need to easily share resources, such as a printer or before choosing to develop software themselves. Annex 50-1
an Internet connection. A network is essential if multiple contains advice on developing a product master file in phar-
computer users need to simultaneously access the same soft- maceutical management database software.
ware program, such as an inventory program running on
the server. Installing the inventory program on the server Open source software
means that all of the program’s data is stored in one central
location (a secure server room) and that other computers on Open source software emerged when individuals invent-
the network can access the data from various locations, such ing programming code as part of the software develop-
as the accounts department or the warehouse, if the appro- ment process shared their inventions with other networked
priate permissions have been granted. users. Because any user could modify any part of this code
Although the cabling and configuration of the network and then again share it with the network, the phrase open
are often done by an outside firm, someone on the office source software became a natural way of describing it. Open
staff should know at least the basics of network trouble- source software differs from proprietary software because
shooting and maintenance so that downtime is minimized its programming code is available for inspection, modifi-
if system problems occur. If physically cabling the comput- cation, reuse, and distribution by others. Although open
ers together is problematic, a wireless network can also be source software can be free of charge, it can also be pur-
an option. chased; but once attained, it is freely modified. Today, open
Wireless networks can also be used to connect comput- source software is used by individuals and organizations
ers in separate locations over a WAN. Some countries have in the public and private sectors worldwide and is gain-
decentralized pharmaceutical operations such as distribu- ing popularity. Linux is one of the best examples of open
tion so that work is done at the provincial or district level source software—in this case, used to control the comput-
rather than the central level. Using a WAN, the lower levels er’s operation.
50.8 I n f ormation ma nageme n t

Table 50-2 Computer hardware specifications

Hardware Indicator Significance
Hard drive Gigabyte (GB) The number of gigabytes describes the storage capacity of the hard drive—how much data and
software it can contain.
Processor chip Chip type, with The chip type and speed determine how quickly the computer can make calculations, run
speed in gigahertz software, and function. Any chip sold today should be sufficient for most office uses. The type and
(GHz) speed are more important for computers that will be used as network servers.
RAM (random- Megabyte (MB) or The amount of RAM in a system determines how many tasks the computer can run at once and
access memory) gigabyte (GB) how complicated a program it can handle. A gigabyte is approximately 1,000 megabytes.
Monitor Size (inches or The LCD (liquid-crystal display) monitors sold today vary primarily in their physical size and can be
centimeters) selected on that basis and on price, unless they will be used for highly graphics-intensive work.
Printer Characters per Dot matrix printers are judged in CPS, and laser and inkjet printers in PPM. Both are important
second (CPS), pages when producing large amounts of output. Printer quality is measured in DPI and is important
per minute (PPM), when producing high-quality output.
dots per inch (DPI)
Modem Baud The baud rate is how much information a modem can send in a second and controls how long it
takes to send a file over a telephone line.
Ethernet card Speed The speed of the Ethernet card determines how quickly it can send and receive data on a network.
CD-ROM or Speed The speed of a CD-ROM or DVD-ROM drive describes how quickly it can access and read
DVD-ROM drive information from a CD-ROM or DVD-ROM.
CD-RW or Speed The speed of a CD-RW or DVD-RW drive describes how quickly it can write information to a
DVD-RW drive CD-ROM or DVD-ROM. These drives can also read information from CD-ROMs and DVD-ROMs.

Program decision makers need to evaluate a number of a month or two can mean a lower price or greater capabili-
issues when considering the use of open source software, ties for the same price. Table 50-2 describes different types
including— of computer hardware. In general, larger numbers are better
for the indicators listed.
• A definition of program needs The use of handheld computers called personal digital
• The types of open source applications available for the assistants (PDAs) is increasing in the health care field and in
needs pharmaceutical management, because they are a convenient
• A review of open source and proprietary software way both to access and record information while away from
alternatives, including differences in costs the office. Country Study 50-2 discusses different ways that
• The availability of resources to support the open source PDAs are being used by various country programs.
approach
• The functionality and usability of the open source Geographic information systems
application
• The availability of professional support skills A geographic information system (GIS) is a computer sys-
tem that captures, stores, analyzes, and displays information
A good resource on the use of open source software in that is identified according to a specific location. In other
developing countries is available (Dravis 2003). words, it provides an interface between all kinds of data
and a map. GIS allows data sets from different sources to
Computer hardware: options and guidelines be brought together in spatial context to reveal relationships
and patterns that are not necessarily obvious otherwise. In
The size and speed of computer hardware continue to change public health, for example, GIS technology can combine
so quickly that specific recommendations about what a user demographic, environmental, and health data with satellite
should buy are impossible to make. When purchasing com- maps to determine endemic or epidemic disease patterns.
puters and peripheral devices such as printers, the impor- A GIS can use digitized maps or coordinates from global
tant issues are processing, storage, memory, and output positioning system (GPS) receivers to determine spatial rela-
capacities. Always buy the most powerful equipment that tionships. In Tanzania and Uganda, Management Sciences
the budget will allow, especially if a new computer cannot for Health’s (MSH’s) East African Drug Seller Initiative is
be purchased for a few years. Hardware generally improves using GPS to map the locations of public- and private-sector
so rapidly that a computer should not be purchased until clinics and drug shops to determine gaps in health care cov-
shortly before it will be used. Delaying a purchase for even erage in remote areas.
 50  /  Computers in pharmaceutical management 50.9

Country Study 50-2

Using handheld computers in pharmaceutical management
The increased technological ability and convenience of Tanzania Food and Drugs Authority (TFDA) worked
handheld computers or personal digital assistants (PDAs) with Management Sciences for Health to introduce the
or smartphones have made them popular tools in the use of PDAs in data collection and management. The
health care field, including pharmaceutical management. TFDA inspectors collect data on a wide range of product-
Many information sources have been adapted for use and site-specific information, which previously had been
on PDAs, including the National Library of Medicine’s handwritten on paper forms, then transferred to a data-
MEDLINE database and pharmaceutical-specific base. The program’s PDAs include forms for port-of-entry
resources, such as the British National Formulary. Some of inspections, premises inspections, and postmarket sur-
these resources are free and others are subscription-based. veillance in a format that guides inspectors through the
data-gathering process. Collected data are sent monthly
In addition to providing easy access to health informa-
to TFDA by public mail/transport or by hand delivery to
tion, PDAs and smartphones are also being used to
the TFDA central office. Also, updated product references
collect, analyze, and report data more accurately and effi-
needed by the inspectors in the field are uploaded to the
ciently in a number of countries.
PDAs monthly. The new system makes analyzing data
Canada. In British Columbia, PDAs are being used as and creating reports easier, and it improves the accuracy
part of a quality-management program in a 285-bed hos- of inspection records through design controls and by
pital that requires the collection and analysis of quality increasing inspector accountability.
indicators for pharmacy services. An electronic form was
custom designed based on the pharmacists’ data needs Uganda. The Uganda Health Information Network is
for process and outcome indicators, including adverse using PDAs that are connected through the local GSM
drug reactions and medication cost savings. The resulting cellular telephone network to help expand access to
electronic patient care form was installed on four PDAs health and medical information and support data collec-
and each pharmacist received a two-week orientation tion and analysis. Health workers in the field use PDAs to
before switching from paper-based logs. The PDA data send and receive information and data via “jacks,” which
were downloaded daily to a single PC into a common are relay devices that contain a GSM cellular transceiver
database program, where it could be easily analyzed and and a data cache. The jack then communicates with a
used for reports. Users of the PDAs found that they were main server in Kampala. When users connect to the jack,
able to double the number of patients they counseled, information is both uploaded and downloaded. In the
and much less time was needed to collect, analyze, and pilot of this program, the PDA system was used primar-
report the data. ily for collecting and disseminating field data, such as
Source: Collins 2004. weekly disease surveillance reports and broadcasting
medical education material.
Tanzania. In an effort to improve the effectiveness of its
drug product and premises inspection programs, the Source: UHIN 2004.

WHO’s Public Health Mapping and GIS Programme pro- types of specialized software for various tasks and guidelines
vides resources on how to use GIS technology to improve to consider when evaluating alternatives. Examples of spe-
public-health decision making (http://www.who.int/health_ cific types of programs are given, and others are listed in the
mapping/about/en). references at the end of the chapter.

Quantification of pharmaceutical requirements

50.3 Specialized software for pharmaceutical
management and control Quantification of pharmaceutical requirements (see Chapter
20) is complex, and a computer can greatly speed up the
Pharmaceutical systems that successfully computerize usu- process. Spreadsheets can be used if too many data are not
ally begin with basic word processing and spreadsheet appli- involved. Worksheets can be set up to forecast requirements
cations and then seek specialized applications for inventory using consumption data; formulas can be entered into the
management, procurement, pharmaceutical regulation, or spreadsheet for estimates based on different scenarios.
medicine use analysis. This section provides an overview of Spreadsheets can be linked, or a single spreadsheet can be
50.10 I n f ormation ma nageme n t

Figure 50-1 Summary of illustrative integrated pharmaceutical supply management software and characteristics

Management component Uses

1. Accounting Accounting manages the financial aspects of pharmaceutical management activities.
1.1 Accounts Payable/Purchasing Tracks and processes bills and payments and provides complete checking account
management functions.
1.2 Accounts Receivable/Billing Tracks all customer histories and accounts.
1.3 Job Costing and Cost Accounting Job costing and cost accounting provide a method for collecting, analyzing, and reporting all
costs associated with a particular job.
1.4 General Ledger General ledger maintains the Chart of Accounts and provides the basis for all other financial
functions.
1.5 Financial Reporting
1.6 Accounting Standards
2. Distribution Distribution addresses selling and providing pharmaceuticals to other facilities.
2.1 Client Orders/Sales Orders Receives and processes client and sales orders.
2.2 Consumption Reporting Reports the distribution of items in stock.
2.3 Delivery Supports processes and methods of delivering ordered items to others.
2.4 Kit Management Addresses putting together and breaking apart stock items for distribution.
2.5 Push System Provides facilities with predetermined types and quantities of stock.
2.6 Repackage into Dispensable Units Addresses breaking apart large quantities of stock into smaller packages.
2.7 Reporting
3. Tender Management Tender management manages the competitive bid process.
4. Inventory Control Inventory control manages the stock and inventory.
4.1 Receiving Adds stock to the inventory database.
4.2 Supplier Performance Monitoring
4.3 Maintaining History of Transactions Stores and archives transactions for future reference.
4.4 Selling Inventory over the Internet E-commerce associated with selling inventory over the Internet.
4.5 Establish and Maintain Inventory Records
4.6 Reporting
4.7 Forecasting and Order Planning Forecasting and order planning supports methods and processes used to estimate the
quantities of pharmaceuticals needed for your organization.
5. Procurement Procurement manages the acquisition of pharmaceuticals.
5.1 Purchase Requisitions Collects and disseminates information about requested items.
5.2 Purchase Orders Creates and tracks information about a sales transaction.
5.3 Group Purchasing/Pooled Procurement Manages the procurement for a group with similar purchasing needs.
5.4 Perpetual Purchasing Manages the procurement of stock-based designated or calculated reorder points.
5.5 Scheduled Purchasing Manages the procurement of stock on a predetermined purchasing cycle.
5.6 Ordering Online over the Internet
5.7 Supplier Management Tracks supplier information.
5.8 Reporting
6. Vehicle and Equipment Management Vehicle and equipment management deals with tracking and monitoring the assets in your
organization.
6.1 Vehicle Management
6.2 Equipment Management
6.3 Cold-Chain Equipment Management
6.4 Load Building
6.5 Route Planning
6.6 Transport Personnel Management
6.7 Transport Personnel Assignments
6.8 Vehicle Allocation/Vehicle Tracking
6.9 Reporting
7. Warehouse Management Warehouse management deals with managing the physical stock, whether it is in-house or
located in another warehouse.
7.1 Bar Coding and Related Technologies
7.2 Managing Multiple Warehouses Manages multiple physical or virtual warehouses.
7.3 Stock Location Tracking Tracks the physical location of inventory items.
7.4 Reporting
7.5 Picking
 50  /  Computers in pharmaceutical management 50.11

Management component Uses

8. Transfunctional Transfunctional includes requirements that span the entire range of functions and includes
some miscellaneous requirements.
8.1 Currency Supports multiple currencies.
8.2 Languages Supports multiple languages.
8.3 Interface with WHO Drug Registration Imports drug registration data from a SIAMED export.
Software (SIAMED)
8.4 Master Drug File (from WHO) Imports the master drug file.
8.5 User Customization
8.6 Custom Reporting
8.7 Indicators Addresses custom thresholds and acceptable ranges for monitoring system.
9. Technical Technical requirements describe the architectural characteristics of the system.
9.1 Multitier Organizational Structure Operates in a three- and four-level organizational hierarchy.
9.2 Single-User Environment Operates in a single-user, single workstation environment.
9.3 Multiuser Environment Operates in a multiuser, networked environment.
9.4 Software Platform: Microsoft Windows
9.5 Security Addresses user authentication and data security.
9.6 System Maintenance Backs up and archives data.
9.7 Data Exchange Supports importing and exporting data with other applications.
9.8 System Architecture
10. User Support User support deals with technical support facilities you may require for this type of software.
10.1 Online Help
10.2 User’s Manual

divided into sections (one to record the morbidity profile, Formulary manuals. A word processing program can be
one to organize the standard treatments, and one to sum- used to develop a formulary manual with treatment guide-
marize pharmaceutical requirements within therapeutic lines (see Chapter 17). A desktop publishing program can
categories). Linking spreadsheets requires an advanced level produce documents ready for printing.
of proficiency with spreadsheets.
Quantimed is a database tool for forecasting that has Procurement and inventory management
been developed by MSH. Users enter consumption data
(past and forecasted use) and/or morbidity data (num- Spreadsheets can automate aspects of procurement and
ber of expected cases for each age range and for each inventory management, but they are not ideal for processing
health problem). When standard treatments are defined, large amounts of data. Database software is more appropri-
Quantimed generates a table that compares the medicines ate for this purpose. Using the same database program for
needed, using both consumption and morbidity methods procurement, inventory management, and accounting is
(see Chapter 20). Quantimed also produces a number of preferable, because these activities are interconnected.
other reports, including some that can help with budget- Inventory management is often part of a commercial
ing and to compare costs among different products and accounting software package, but such packages typically
treatment regimens. focus on accounting and lack features specific to pharma-
ceutical management, such as the ability to track multiple
Basic data analysis and production of products for the same code number, or to track items by lot
formulary manuals number and expiry date. The ability to track issues by lot
number is important for medicine recalls.
Basic commercial software can be used for many pharma- Database programs have been developed by MSH and
ceutical management purposes, such as data analysis and others specifically to manage procurement and inventory
publication of formulary and therapeutics manuals. control in public pharmaceutical systems (see References
Data analysis. Spreadsheets are ideal tools for develop- and Further Readings and Box 50-3). Figure 50-1 provides
ing a medicines list, because they allow easy manipulation a summary of pharmaceutical supply management software
of both text and numbers. Creating a spreadsheet that lists requirements and characteristics. Box 50-4 lists standard
medicines and data on price, consumption, lead time, and reports that should be produced by such software. Country
formulary category is very easy. Formulas can then be added Study 50-3 illustrates how software for inventory manage-
to perform various analyses, such as ABC analysis, price ment and procurement has been used to improve pharma-
comparison analysis, and therapeutic category analysis (see ceutical management for an HIV/AIDS treatment program
Chapter 40). in Haiti.
50.12 I n f ormation ma nageme n t

Box 50-3
RxSolution
RxSolution is an integrated computerized pharmaceutical • Staff in one South African hospital can now produce
management system. The system is used to manage inven- the monthly tracer list report for the provincial office
tory; process purchase orders; handle issues to wards, out/ with one click, rather than taking a day to count
inpatient pharmacy, and satellite clinics; dispense medi- stock and write up the information. They can also
cation to patients; and prepare repeat prescriptions for track expenditures to come in on budget, and easily
down-referral at the facility level (down-referral occurs determine the amount spent on antiretroviral medi-
when a higher-level health care facility such as a hospital cines, which they are required to report. Store man-
transfers all or part of a patient’s care to a lower-level facil- agement reports now include much more financial
ity that is more convenient for the patient). RxSolution information.
supports best practices for procurement, storage, distri- • The director of pharmacy services for a South
bution, and dispensing of pharmaceuticals and medical African city reports that RxSolution allows the staff
supplies, helping to ensure availability of critical products to better manage their system and cost centers,
at all times. Users record information on products, suppli- because they can more easily track budgets and
ers, clients, prescribers, dispensers, and patients. monitor clinics. The main depot receives 90 to 95
The program has modules for— facility orders each month and can complete all of
the orders within two weeks.
• Budgeting
• Procurement • Installing and using RxSolution in eleven hospitals
• Receipts and health centers in Swaziland met the Global
• Requisitions Fund’s requirements for a reliable antiretroviral
• Dispensing tracking system. These facilities use the system to
• Down-referrals produce regular stock, patient, and prescribing
reports for national-level managers. As a result of
Any or all of these modules may be used, depending the successful installation and use of RxSolution, the
on the needs of the site and user restrictions. The pro- Global Fund authorized funds for Swaziland to pur-
gram includes a wide range of clinical and management chase antiretrovirals.
reports, which help improve pharmaceutical use, stock
• The chief pharmacist at a South African hospital
availability, and financial and logistic accountability.
uses RxSolution to produce ABC analysis reports for
RxSolution is currently being used in more than 120 sites the wards and the hospital to support his pharmacy
in southern Africa. Examples of how facilities are using and therapeutics committee work.
the software include the following—

Hospital pharmacy management software • Laboratory value monitoring

• Outpatient prescriptions
Specialized hospital pharmacy software can support • Patient billing
various aspects of a hospital pharmacy (Chapter 45),
including— Accounting and financial management

• Patient medication profile Most public-sector supply systems must abide by govern-
• Records of intravenous therapy ment accounting regulations, which differ from country to
• Management of total parenteral nutrition country. Commercial accounting software is widely avail-
• Unit-dose management able, but it may require modification to correspond with
• Medication administration record local regulations. If a specialized pharmaceutical manage-
• Order entry and inventory management ment software program is used for inventory control, the
• Medication interaction checking inventory software and the accounting software should be
• Allergy checking modified to communicate with each other.
• Food and medicine interactions Learning how to perform basic spreadsheet analysis is
• Duplicate therapy checking now a must for the essential medicines program manager.
 50  /  Computers in pharmaceutical management 50.13

Box 50-4
Standard reports for supply management software
Supply management software should generate standard Functional lists/outputs printed by the system
reports to support decision making, such as the follow-
List of “picking tickets”
ing—
List of delivery notes/invoices
Inventory reports
Stock status report: lists all products in the product mas- List of stock count sheets
ter file, including product code and description, unit of Multilocation reports
measure, quantity in stock, quantity on order, quantity
reserved, quantity available. (If using a system that tracks stock in multiple locations)

Reorder report: lists all products that are below the Transfer advice report: a reorder advice report that
re­order level, with reorder quantity. lists products that are over the maximum or under the
reorder level. This report makes possible determining
Overstock report: lists all products exceeding the maxi- whether a product that is unavailable or understocked in
mum level. one location is available in another location.
Inventory valuation report: lists the current value of the Financial reports
inventory, based on the chosen valuation method (LIFO,
FIFO, average). (If linked to financial information)

Expired or soon-to-expire stock report: lists the products Credit hold orders report: lists orders that are on hold
that are presently expired or will expire within a defined because the customer is over the credit limit.
period. Debtors and creditors report: lists those who owe and are
Order reports owed money.

Open order report: lists orders from customers that have Tender reports
been entered and not yet shipped. Bid evaluation report: for each product in a tender, lists
Back order report: lists all unshipped back orders. all suppliers that offered bids, with information on the
supplier (country, delivery time) and on the quoted
Order history report: reports on all orders (shipped and product (unit cost, quoted unit price, bid converted to
nonshipped) on file. base currency, manufacturer, quality of sample, and any
Product reports other details).
Catalog report and price list: lists all products in the prod- Supplier performance report: lists, for a given supplier,
uct master file. Can contain pricing information and be details of all previous quotations, orders, and deliveries,
used as a price list. including both a comparison between date promised and
date delivered and the condition of products.
Product history report: lists by stock item total quantities
and sales values for each fiscal period. Product quotation record: for each product, lists previous
bids, with details of the supplier and the quoted prices. If
Sales analysis and forecasting reports
an order was made, this is indicated with supply timeli-
Customer analysis report: lists sales made to each cus- ness and quality information.
tomer in a specified period.
Database listings: lists suppliers and products. The sup-
Ranked customer analysis report: same as above, but plier listings can also be available as mailing labels and
ranked by sales volume, with cumulative percentages. for mail-merging into a word-processed letter.
50.14 I n f ormation ma nageme n t

Country Study 50-3

Creating an Internet-based information system for HIV treatment in Haiti
The daily administration of several different antiretro- Clinic staff members enter all clinical and medication
viral medicines as part of antiretroviral therapy (ART) data using a standardized Web-based patient form. To
requires that each patient is monitored for health status, facilitate data entry, the form has an electronic checklist
that results of laboratory tests are tracked and commu- of patient management items, including requests for
nicated to doctors, and that pharmaceutical supplies are laboratory tests, details of treatment regimens, and lists
reliably available at each treatment site. Zanmi Lasante, of standard ART medicines. Doctors can check the medi-
a non­governmental organization that operated a suc- cines, doses, and administration schedules. As the medi-
cessful ART site in Haiti’s central plateau, was funded cines are entered into the form, they are cross-checked
to scale up its program to five additional sites. In rural to the patient record for allergies, inappropriate doses,
Haiti, where doctors are few, roads are almost nonexis- and incompatible medicine combinations. The system
tent, and elec­tricity is spotty, creating and maintaining displays warnings about problems—for example, if zid-
such an information system among disparate sites would ovudine and stavudine are prescribed together. When
be challenging. the form is completed, the user can print out an order for
the pharmacy. As new patient information (for example,
On the basis of its experience, Zanmi Lasante decided that
laboratory results) is added that indicates additional
the cheapest and most flexible communication strategy
treatment, e-mails are automatically sent to all clinicians
would be to establish a small satellite connection to the
with links to the medical records of patients who require
Internet in each of the five new sites. Instead of placing
follow-up.
servers in each clinic, one shared server could be guaran-
teed a secure environment with stable power and a reliable Staff members also enter warehouse stock data into Web
data backup system. Using Web-based electronic records forms, and those figures are analyzed and monitored
allows data collection and review from the remote sites, against expected use patterns from the treatment regi-
and with one server, the most recent data are accessible to mens in the system.
all. The Web-based electronic medical record system in
Haiti is built with standard, open source software. Source: Fraser et al. 2004.

Spreadsheets can be used for both simple and sophisti- for pharmaceutical product registration, is available from
cated analyses of program finances. See Chapter 41 for WHO. Computers can greatly facilitate pharmaceutical
examples. registration by improving access to information, but they
do not provide the enforcement capacity needed to give
Drug use reviews registration meaningful impact. A legal framework for
pharmaceutical registration and a flexible and efficiently
Simple analyses of medicine-use patterns can be done functioning drug regulatory authority are prerequisites to
with spreadsheets and commercial database software. successful computerization of drug product registration.
Commercial software is available for analyzing data on med- Table 50-3 presents the features needed in pharmaceutical
icine use from large databases. These software programs are registration software.
usually fairly expensive (thousands of U.S. dollars [USD] per
installation).
50.4 Electronic communications and medicine
Pharmaceutical product registration information

Pharmaceutical product registration software can help the Communications and medicine information are discussed
drug regulatory authority track the hundreds or thousands together because medicine information is increasingly
of registered products. Registration data can be tracked in available through electronic communication systems. An
a manual card system, sorted by product name or com- enormous amount of reference information on medicines
pany, but retrieving data needed for specific purposes is is available on the Internet. In addition, many organizations
very time-consuming. Database programs can automate now create their own websites to share information inter-
this procedure, retrieving records meeting specific crite- nally or to show their progress and activities to the outside
ria almost instantaneously. SIAMED, a software program world.
 50  /  Computers in pharmaceutical management 50.15

Table 50-3 Select features of registration software

Names and Pharmacological International
identifications information information Quality assurance Administrative tracking
• Registration of • Pharmacopoeial • Country of origin • Certification by regulatory • Duration of license, dates
products by vendor and standards applicable agency in country of origin of approval and renewal (or
manufacturer to product (WHO certification scheme) denial)
• Identification • Dosage strength and • Product status and • Dates and results of quality • Dates of receipt and action
by International dosage form regulatory action in tests and assays on registration application
Nonproprietary Name other countries
(INN) and brand name
• Identification of • Quantities and • Variable handling • Summary of results of • Dates and results of agency
alternative generic functions of active of applications from clinical trials hearings and regulatory
names (U.S. Adopted and inactive suppliers based actions regarding products,
Name [USAN], British ingredients in the registering vendors, and manufacturers
Approved Name [BAN]) country
• Cross-indexing • Shelf life and storage • Results of good • Records of payments
between generic and conditions manufacturing practices or and dues regarding
brand names, active other inspections application and marketing
ingredients, and • Details of inspection authorization fees
authorized vendors and program based on user- • Variable length of
manufacturers defined criteria, such as authorization for marketing
• Records of imports geographical area, company • Records of price agreements
and foreign exchange activity, type of products, and price control categories
applications and characteristics of inspectors and decisions (as applicable)
authorizations related to • Registration and licensing
products, vendors, and of wholesale suppliers,
manufacturers licensed pharmacies,
and other licensed
pharmaceutical outlets
Source: WHO 2004.

Electronic communications In recent years, discussion groups have formed to

exchange information over the Internet. For example,
Computers are powerful and relatively cheap communi- E-Drug is a discussion group that uses regular e-mail to
cation tools. Computer-based communication is possible exchange information on essential medicines management
through electronic mail (e-mail), the World Wide Web, issues. PharmWeb is a website that offers information on
computer-to-computer modem connection, or fax. worldwide pharmacy and pharmaceutical management
If a good telephone line is available, computers equipped issues and organizations. PharmWeb links the user to vari-
with a fax-modem can send and receive fax messages or ous websites maintained by organizations active in the field.
complete documents in just a few seconds. Modern word See References and Further Readings for contact informa-
processing software can send fax messages directly from tion for E-Drug and PharmWeb. Web-based discussion
the computer. The transmission speed and quality depend groups can be helpful sources of information on a wide
on the quality of the telephone line, but error protection range of subjects, from computer problems to pharmaceuti-
protocols can help ensure the integrity of the transmitted cal information.
data.
The most comprehensive computer-based communica- Medicine information
tions medium is the Internet. Most countries have local con-
nections to the Internet, which can send any data (including Traditional sources of information on medicines are jour-
e-mail messages or computer files) for only a fraction of nals and textbooks, such as those listed in Chapter 34.
the cost of a telephone connection. Once the connection is Maintaining an up-to-date library of texts and journals
established, Internet use is relatively inexpensive, especially is costly, however, and information is not always easily
for universities and governments. Increasingly, Internet accessed by users in remote areas.
cafés provide access in many locations. Locations with Computers can greatly facilitate access to pharmaceuti-
in­adequate telephone-line infrastructure are having success cal information. For example, PubMed, a nonprofit service
with wireless Internet connections, which do not rely on of the U.S. National Library of Medicine, provides access to
traditional wires and cables. Other Internet connections are millions of articles from more than 4,800 medical journals
made through satellite and radio transmission. on the Web (http://www.ncbi.nlm.nih.gov/sites/entrez).
50.16 I n f ormation ma nageme n t

PubMed can also be accessed with a PDA. The more com- A website developer should consider the following crite-
monly used and readily available computer databases for ria when creating a site to ensure that it is useful and infor-
medicine information are listed and discussed in more mative (WHO 2001).
detail in Chapter 34. General criteria to consider for every site include—
CD-ROM is relatively inexpensive technology that can
store about 680 megabytes of data on one compact disc. • User-friendliness: The first impression should include
DVD-ROMs are similar to CD-ROMs, but they hold about an attractive design and logical organization of infor-
four gigabytes of data. Many products are now available on mation.
DVD. It is important that new computers be able to read • Site map: The site map indicates logical links and
DVD products. organization of the site and explains how to navigate
Through powerful indexing routines and huge storage through the content.
capacity, CD-ROMs and DVDs permit very fast access to • Navigability: This characteristic allows the user to find
medicine information. Books such as the British National information easily.
Formulary and USP Drug Information are available in • Speed: The pages should be displayed within four to
CD-ROM format. CD-ROMs with medication information five seconds.
or advice for poisoning treatment are used in many phar- • Search function: The site should have its own search
macies and medicine information centers in industrialized engine.
countries, and use is spreading quickly around the world as • Update: The website should include its creation date
computers become more widely available. and when the pages were updated. Information should
Plenty of websites offer biased information on and ques- be updated regularly.
tionable sales of medical products, including medications,
but reliable, independent information on the quality, regu- Specific criteria to consider for an organization or pro-
lation, and rational use of pharmaceutical products is lack- gram site may include—
ing. Learning to evaluate website content for accuracy, bias,
and timeliness is an important skill. Chapter 34 has more • Mission statement
information. See also the list of references in this chapter for • Contact information
some useful websites. • Organizational structure (or management hierarchy)
• Services offered
Developing a website • News, events, and meetings
• Forms to download
If an organization has information that it needs to commu- • Hyperlinks to other useful resources
nicate, it may wish to consider developing its own website. • Publications
Websites can be used to disseminate information to the pub-
lic or can be designed specifically for an organization’s inter- Answering the questions in Box 50-5 can help in mak-
nal use (intranet). Although the design and development of ing a decision about whether and how to develop a new
the site can be contracted out if staff members do not have website.
the necessary skills, staff should be involved in the review
and approval of material for the site, because it represents
the organization. Many Internet service providers (ISPs) 50.5 Maintenance and support requirements
offer hosting services for websites and can house the nec-
essary files on their servers to make them available on the Using computers, like using any electronic tool, requires
Internet. access to reputable repair services and supplies. Even more
An organization can use an intranet to share information important, however, is a reliable, adequately trained staff.
and data if a WAN cannot be established. For example, users
can access an intranet to view or submit inventory data for Staff recruitment and training
procurement or distribution purposes. An intranet can also
be used to share files or disseminate organizational informa- Discussions about computerization often focus only on
tion, such as standard policies and procedures. The intranet software and hardware, but computers are useless without
site can be maintained at the central level of the system but competent staff to run them. Recruitment and training are
accessed by other levels in the system as long as the other key in maintaining good computer services, particularly
levels have Internet access and the proper permissions. The when day-to-day operations such as inventory manage-
intranet allows pooling and sharing of information in a sys- ment and accounting are computerized. Investing in train-
tem without requiring a direct connection among the differ- ing staff members to use computers effectively is quite
ent levels of the system. (See Country Study 50-3.) worthwhile.
 50  /  Computers in pharmaceutical management 50.17

Experienced typists interested in learning new skills or job changes will not bring the computer unit to a halt.
can be recruited for word processing and data entry tasks. Additional training may be necessary from the vendor if
Computer courses are available in many countries. The personnel leave the unit.
cost of courses should be built into computerization bud- A highly computerized operation that uses software to
gets, along with sufficient funds each year to train new staff support critical operations, such as procurement or inven-
and retrain existing staff in new software. Online courses tory management, should have the support of an infor-
are also available through an Internet connection. For mation technologist on-site, if at all possible. If computer
example, Microsoft offers free, self-paced courses for most hardware or software is disabled by a problem that inter-
of its Office products at http://office.microsoft.com/en-us/ feres with the daily business operations of an organization,
training/default.aspx. the problem needs to be resolved as soon as possible. An
When specialized pharmaceutical management pro- information technology support unit serves to ensure that
grams are installed by an outside organization, the vendor the organization’s hardware and software remain functional
must provide adequate training that is spread out over time through proper maintenance and prompt attention to errors.
so that staff members can raise their own questions as they
become familiar with the new system. Protecting data
Provisions need to be made for staff changes. At least
two people need to be familiar with each specific com- Data in a computer are stored on magnetic media, such as
puter program and operation so that sickness, annual leave, a hard disk, CD-ROM, DVD, or flash drive. Unfortunately,

Box 50-5
Developing a website or posting materials to the Web
Here are some questions that will be useful to think about • What new content needs to be written?
to effectively plan for, develop, and maintain a website. • How often will content be updated?
• In what languages will content be presented?
I. Vision
• Is any of the content proprietary, or is use restricted
• What is the purpose for developing a website or for by any parties?
posting materials to the Web? • Do any donors or partners need to approve posting
• What do you hope to achieve? of content?
• What are the intermediate and long-term goals or
objectives? IV. Functionality
• Do you see this activity as part of an existing website • What tasks do you want users to perform when they
or something new? come to the site?
• Is it important for this site to have a unique URL or • What specific functions would you like to include
Web address? on the website (for example, information database,
II. Audience online message boards)?

• Who are your primary and secondary audiences? V. Marketing

• What is the anticipated size of your audiences? • How will your reach your audience?
• Where are your audiences located?
• What are the information and/or learning needs of VI. Evaluation
your audiences? • How will you know when you have achieved your
• What is the audience’s level of comfort and experi- goals?
ence using Internet? • What evaluation methods will you use (for example,
• What is the audience’s level of Internet access? e-mail survey, phone interviews)?
• What is the audience’s level of computer proficiency?
• Do you anticipate this site being public or private/ VII. Roles
restricted? • Who will develop content?
III. Content • Who will update content over time?
• Who will market the site?
• What type of content do you anticipate for this site? • Who will provide technical support to users?
• What content currently exists?
50.18 I n f ormation ma nageme n t

magnetic storage media can lose data, so other precautions

must be taken. The computer, along with all data on the hard Box 50-6
drive, might be stolen or could be harmed by dust or high- Lessons for successful computerization
voltage electrical spikes.
Data can also be damaged by a computer virus when pro- • Assess what software is needed before choosing
grams or data are exchanged between computers or when hardware.
an infected e-mail attachment is opened. This risk increases • Ensure software and hardware compatibility.
when illegally copied (pirated) software is used. A virus • Secure local support for hardware and software.
can result in anything from harmless messages appearing • Have a well-functioning manual system.
unexpectedly on the computer screen to complete loss or
theft of data on the hard drive. To avoid getting a computer • Provide adequate staff training and involve staff in
virus, accept files only from users who take precautions the computerization process.
against viruses, do not open unknown attachment files from • Computerize in phases, allowing sufficient time for
e-mail senders, use virus-checker software that automati- each step.
cally scans the computer’s hard drive every day, and check • Establish and enforce strict procedures for data and
any media, such as flash drives or CD-ROMs, used to share equipment protection, using backups, virus check-
data . Regular updates of virus checker programs are needed ers, restricted access, surge suppressors, and so on.
because new viruses are created continually. • Set aside adequate funds in each year’s budget for
CD-ROMs and DVDs can be damaged by magnetic fields hardware and software maintenance, supplies, and
(from loudspeakers, telephones, and metal detectors), and staff training.
by moisture, particles, and scratches. Thus, having only one
copy of data is risky, and the importance of making backup • Plan and budget for timely hardware and software
copies cannot be overemphasized. Basic rules for maintain- upgrades.
ing backups are—

• Make at least one backup copy of all important work

when it is created. • Protect the computer room with air-conditioning—if
• Back up routine work daily with separate sets of CDs, possible—against excess heat, humidity, and dust.
DVDs, or external drives used in rotation for extra • Do not eat or drink near the computer or smoke in the
security, especially for large databases such as inven- computing room.
tory control systems. • Protect keyboard, monitor, and computer with covers.
• Ideally, store backups off-site to guard them from fire • Always use spike/surge protectors (for computer,
or theft. Consider saving and archiving an entire set of printer, monitor, and fax) and an uninterruptible
data at the end of each month or quarter. power supply. Car batteries with an inverter or a sepa-
rate fuel generator may also provide safe electrical
Access to computers should be restricted to authorized power.
staff; most computer operating systems and software can be • Move the computer only when it is switched off.
protected with passwords, which are required to enter the • Use reliable maintenance and repair services.
system (and which allow managers to track use of the com-
puter).
50.6 Lessons for successful computerization in
Maintaining computers pharmaceutical management

Computers are adversely affected by humidity, static elec- Successful computerization in pharmaceutical manage-
tricity, power surges, extreme temperatures, dust, ciga- ment can greatly increase an organization’s efficiency, pro-
rette smoke, and food or liquid spilled on the keyboards. ductivity, and capabilities, but it must be carefully planned.
Computers are also vulnerable to frequent switching on and Expensive mistakes are easy to make through a lack of
off, sudden physical movements while the hard disk is run- knowledge or forethought, hindering rather than helping a
ning, misuse by untrained staff, and unprofessional repair project. Following the list in Box 50-6 and considering the
attempts. To protect computers— issues raised earlier in this chapter will help a manager to
avoid or prevent such mistakes. The information presented
• Make sure that a reliable firm (or department) is under in this chapter should enable a manager to ask the right
contract to support hardware and software. questions and effectively plan the computerization of an
• Train all operators in proper computer handling. organization. n
 50  /  Computers in pharmaceutical management 50.19

a s s e s s ment g u ide

Use of computers in pharmaceutical management management, and special functions such as presen-
• In which phases of pharmaceutical management will tation graphics, project management, accounting, or
computerization be most useful: medicine selection electronic communications?
and formulary development, registration, quanti- • Is training available for each software package? Are
fication of pharmaceutical requirements, procure- manuals or other instruction books available?
ment, inventory control, prescription analysis, • Have hardware specifications been defined in terms
other areas? of operating system, microprocessor speed, available
• Does a product master file exist? Has a coding sys- RAM, storage capacity, monitor, printer, modem,
tem been developed to uniquely identify pharma- uninterruptible power supply? Is this hardware
ceutical products? Is the ICD or other coding system capable of running the software identified?
used to identify health problems? • Has the computerization process been planned in
phases, so that experience with computer applica-
Readiness for computerization or expansion tions will develop in parallel with broad systems
• Are computers currently used for producing cor- development?
respondence, newsletters, reports? Preparation of • Have procedures been developed for data and equip-
tables, graphs, charts? Budgets and other spread- ment protection, such as restricted access, use of an
sheet applications? Electronic communications? uninterruptible power supply and surge suppressors,
• Do good manual systems exist for pharmaceutical virus checking, backing up data files, and storing
management functions? backups off-site?
• Are staff members capable of and interested in learn-
Hardware and software support and maintenance
ing to operate computers?
• Are resources available for staff training? Supplies • Is there a firm in the country or area that sells soft-
such as CDs and DVDs, paper, and printer ink and ware and provide support? Does this firm provide
toner? Computer support and periodic upgrades, as training in use of the software?
needed? • Is there a firm in the country or area that sells and
Computerization planning maintains computer hardware?
• Is there a government agency or department that can
• Have needs been identified and the specific tasks, provide support services to the supply system?
functions, and systems to be computerized carefully • Has someone on the staff been trained, at minimum,
analyzed? in the basics of computer troubleshooting?
• Has appropriate software been identified, for exam-
ple, for word processing, spreadsheets, database

References and further readings Medical Record to Support HIV Treatment in Rural Haiti. BMJ
329:1142–6.
Gookin, D. 2007. PCs for Dummies. 11th ed. Hoboken, N.J.: John Wiley
General & Sons.
Harindranath, H., W. G. Wojtkowski, J. Zupancic, D. Rosenberg,
Camara, G., and F. Fonseca. 2007. Information Policies and Open W. Wojtkowski, S. Wrycza, and J. A. A. Sillince, eds. 2002. New
Source Software in Developing Countries. Journal of The American Perspectives on Information Systems Development: Theory, Methods,
Society for Information Science and Technology 58(1):121–32. and Practice. New York: Springer.
Collins, M. F. 2004. Measuring Performance Indicators in Clinical Healthlink Worldwide, AfriAfya, and the Institute for Sustainable
Pharmacy Services with a Personal Digital Assistant. American Health Education and Development. 2006. Improving Health,
Journal of Health-System Pharmacy 61(5):498–501. Connecting People: The Role of ICTs in the Health Sector of Developing
Dravis, P. 2003. Open Source Software: Perspectives for Development. Countries. Working Paper No. 7. Washington, D.C.: infoDev. <www.
Washington, D.C.: Dravis Group, infoDev, and World Bank Group. infodev.org/en/Document.84.pdf>
<http://www.infodev.org/en/Publication.21.html > Keplar, K. E., and C. J. Urbanski. 2003. Personal Digital Assistant
Enders, S. J., J. M. Enders, and S. G. Holstad. 2002. Drug-Information Applications for the Healthcare Provider. Annals of Pharmacotherapy
Software for Palm Operating System Personal Digital Assistants: 37:287–96.
Breadth, Clinical Dependability and Ease of Use. Pharmacotherapy McFadyen, J. 2003. Pharmaceutical Management Logistics Software
22(8):1036–40. Evaluation Report. Prepared for the Strategies for Enhancing Access
Fraser, H. S. F., D. Jazayeri, P. Nevil, Y. Karacaoglu, P. E. Farmer, E. to Medicines Program. Arlington, Va.: Management Sciences for
Lyon, M. K. Fawzi, et al. 2004. An Information System and Health.
50.20 I n f ormation ma nageme n t

Miller, M. 2009. Absolute Beginner’s Guide to Computer Basics. 5th ed. Logistics Support System (WHO/PAHO Supply Management System).
Indianapolis, Ind.: Que Corp. Supply management project software for use in disaster relief efforts.
MSH (Management Sciences for Health). 2000. E-Learning for PAHO. <http://www.lssweb.net>
Program Managers through Global Information Resources. The The Medical Letter. Adverse Drug Interactions Program. (Updated reg-
Manager 9:(1&2). <http://erc.msh.org/TheManager/English/V9_ ularly.) Available for Windows-based PCs, PDAs, and in CD-ROM
N1/V9_N1_En_Issue.pdf> format. The Medical Letter also has a number of other software
UHIN (Uganda Health Information Network). 2004. Technical Report: products. <http://www.medicalletter.com/html/software_desc2.
September 2003ñOctober 2004. Prepared for The International htm>
Development Research Centre. (Available at http://pda.healthnet. PubMed provides access to citations from biomedical literature,
org.) including MEDLINE, the U.S. National Library of Medicine’s biblio-
WHO (World Health Organization). 2004. Setting up a Computerized graphic database covering the fields of medicine, nursing, dentistry,
Drug Registration and Allied Information System. Geneva: WHO. veterinary medicine, the health care system, and the preclinical sci-
<http://whqlibdoc.who.int/publications/2004/9290610646.pdf> ences. PubMed is accessible online through the National Library of
————. 2001. Improving the Quality and Usefulness of Drug Medicine Database via Datastar, Dialog, or NLM. CD-ROM version
Regulatory Authority Websites. WHO Drug Information through Silver Platter. Contact the PubMed help desk at custserv@
15(3&4):163–7. nlm.nih.gov or 888-346-3656. <http://www.ncbi.nlm.nih.gov/
entrez/query.fcgi?db=PubMed>
Quantimed is a quantification database tool that facilitates the gen-
Coding systems eration of realistic estimates of pharmaceutical needs at the facil-
ity, regional, or national level, using morbidity and/or consumption
AHFS (American Hospital Formulary Service) Drug Information. data. Contact [email protected] for more information.
(Online updates.) Bethesda, Md.: American Society of Health- RxSolution is designed to manage pharmaceuticals and medical sup-
System Pharmacists. <http://www.ahfsdruginformation.com> plies, from procurement to dispensing to patients. Contact cpm@
WHO (World Health Organization). 2010. International msh.org for more information.
Nonproprietary Names (INN) for Pharmaceutical Substances. SIAMED: Model System for Computer-Assisted Medicine
(Updated regularly.) Geneva: WHO. <http://www.who.int/ Registration. <http://www.who.int/medicines/areas/quality_safety/
medicines/publications/druginformation/innlists/RL63.pdf> regulation_legislation/siamed/en/index.html>
————. 2007. International Classification of Diseases (ICD-10-CM). WHO Model Web Site for Medicines Regulatory Agencies. A tool to
Geneva: WHO. <http://www.who.int/classifications/icd/en> help the drug regulatory agencies in WHO member states to develop
————. No date. “INN Stems.” (Updated regularly.) <http://www.who. or review their own websites. <http://www.who.int/medicines/
int/medicines/services/inn/stembook/en/index.html> areas/quality_safety/regulation_legislation/model_site/en/index.
WHO Collaborating Centre for Drug Statistics Methodology. ATC/ html>
DDD Index 2010. (Updated annually.) Oslo: WHO Collaborating Vigibase Services is a unique collection of international drug safety
Centre for Drug Statistics Methodology/Norwegian Institute of data available through WHO’s Uppsala Monitoring Centre. <http://
Public Health. <http://www.whocc.no/atcddd> www.umc-products.com/DynPage.aspx?id=4910&mn=1107>

PDA-specific applications and resources

Pharmaceutical-related computer applications
Dalhousie University College of Pharmacy. “Drug- and Pharmacy-
British Medical Association and Royal Pharmaceutical Society of Related Mobile Technology” <http://dir.pharmacy.dal.ca/pda.php>
Great Britain. British National Formulary (BNF). (Updated every six Johns Hopkins Point of Care Information Technology (POC-IT).
months; website updated more frequently.) Paperback, CD-ROM, <http://www.hopkinsmedicine.org/poc-it>
or online. <http://www.bnf.org> University of Kansas Medical Center. Dykes Library. Mobile Resources.
The Electronic Dispensing Tool is a software application for managing <http://library.kumc.edu/m/index.html>
essential medicines stock and monitoring details on dispensing to
individual patients. The tool was designed to be used by a dispensing
pharmacist. Contact [email protected] for more information. Internet resources
Epi Info is a series of microcomputer programs for word processing,
data management, and epidemiological analysis, designed for public E-Drug (Essential Drugs English) and other global discussion groups
health professionals. The software can be downloaded free from a in various languages on pharmaceutical issues. See http://www.
number of websites, including the following: <http://www.cdc.gov/ healthnet.org for information on subscribing to any e-mail forum.
epiinfo> Eldis is an Internet-based information service presenting develop-
INRUD (International Network for Rational Use of Drugs). Medicines ment information through the Web and e-mail. The Eldis ICT
Use Bibliography. (Updated regularly.) <http://www.inrud.org> for Development Resource Guide has information and resources
The Inventory Management Assessment Tool (IMAT) is a user- specific to using information technology in developing countries.
friendly, Excel-based instrument designed to collect and calculate <http://www.eldis.org/go/topics/resource-guides/ict-for-develop-
indicators of effective pharmaceutical inventory management. ment>
<http://erc.msh.org/toolkit> The Information and Communication Technology (ICT) for
The Inventory Tracking Tool aids in managing ARV stocks at higher Development Gateway shares information and promotes ideas on
levels than the facility (program, district, or national). The tool how information and communication technologies can be used to
monitors aggregated medicine consumption and compares it with address socioeconomic needs in developing countries, with a special
projected consumption. Contact [email protected] for more informa- focus on achieving the Millennium Development Goals. <http://ict.
tion. zunia.org>
 50  /  Computers in pharmaceutical management 50.21

The Information for Development (infoDev) Program works to pro- CPU (central processing unit): The “brain” of the computer,
mote better understanding, and effective use, of information and which directs and processes input and output.
communication technologies as tools of poverty reduction and Data: Numerical or verbal representations of facts that are pro-
broad-based, sustainable development. <http://www.infodev.org> cessed to produce information.
InterConnection works to make Internet technology accessible to
Database: A collection of related data that can be retrieved and
nonprofit organizations in developing countries. <http://www.inter
manipulated by a computer.
connection.org>
Management Sciences for Health (MSH), Center for Pharmaceutical Debug: To go through a software program to remove mistakes.
Management (CPM). View the website at http://www.msh.org/cpm. Density (double, high): Describes how much information can be
To send an e-mail message, write to [email protected]. MSH freely stored on a storage medium.
makes available electronic products for the practice of international Disk: A round piece of magnetic-coated material used to store
health at the Manager’s Electronic Resource Center. <http://erc. data.
msh.org> Disk drive: Part of a computer that reads data from, or writes data
The Open Source Initiative is an organization that promotes the use to, a disk.
and distribution of open source software. <http://www.opensource. Dot matrix printer: A printer that produces lower-quality output
org>
than a laser printer. This type of printer is the best for printing on
PharmWeb is a website with pharmacy-related information and links
multiple kinds of paper.
to other sites maintained by organizations active in pharmaceutical
management. PharmWeb sponsors a number of discussion groups Downtime: Any period when a computer is not available or not
and pharmaceutical information mailing lists. View the website and working.
find instructions for subscribing to the lists. <http://www.pharmweb DVD (digital video [or versatile] disc): A medium for storing
.net> large amounts of data that can be accessed quickly and selectively
SATELLIFE is a nonprofit telecommunications organization dedicated by using a DVD drive. DVDs hold more data than CD-ROMs.
to providing health care workers around the world with affordable Field: In a database, the basic column unit, in which the same type
access to critical health information through the HealthNet network of information appears.
and other communications services. <http://www.healthnet.org> File: An organized collection of bytes stored on disk, maintained
The World Health Organization’s (WHO’s) Essential Medicines and
by the operating system, and referenced by name.
Pharmaceutical Policies (EMP) website provides information on
Hard disk: A fast-spinning, rigid piece of equipment made of
EMP’s political and administrative components, including its man-
date, management approach, and worldwide projects, and on its stainless steel with a magnetic layer, which stores huge amounts
technical components and services. These include national medi- of data inside a computer.
cine policies, indicators, medicine information and documentation, Hardware: The physical equipment of a computer system, such as
rational medicine use, training courses, and publications. Selected the computer, monitor, and printer. Useless without software.
documents and publications can easily be downloaded from the Inkjet printer: A type of printer with print quality between that of
EMP website. <http://www.who.int/medicines> a dot matrix printer and a laser printer.
The WHO Medicine Information System Web page lists a number of Laptop/notebook/netbook: Small computer that incorporates the
resources related to pharmaceutical-related information systems. CPU, monitor, and keyboard in one unit and can run on batteries.
<http://www.who.int/medicines/services/medicines_etools/en/
A notebook computer is smaller than a laptop, and a netbook is
index.html#ED>
smaller than either.
Laser printer: A type of printer that uses laser technology to pro-
duce very high print quality.
Glossary Mainframe: Big, powerful, expensive computer, usually used by
universities and the military. Usually not necessary for managing
Apple: Company that made one of the first desktop computers. pharmaceutical supplies.
It now makes the Mac line of computers and iPhones (smart- Memory: Circuitry and devices that hold the bits the computer can
phones). access. Examples are RAM (random-access memory) and ROM
Backup: An extra copy of software or data, normally kept on file in (read-only memory).
case the original program is damaged or lost. Minicomputer: Smaller than a mainframe but still too big or costly
Baud: A measure of the speed at which data travels (normally for an individual; may be useful for storing large amounts of data
between a computer and a peripheral). in a central medical store.
Bit: A binary digit (1 or 0). Modem: An electronic device that allows computer equipment to
Bug: A flaw or problem in a software program. send and receive information through telephone lines.
Byte: A sequence of bits that represents a single character. In most Monitor: A TV-like display used with most computers to show the
small computers, a byte is eight bits. information being input and output.
CD-ROM (compact disc read-only memory): A medium for stor- Motherboard: The board containing the computer’s circuitry, onto
ing large amounts of data that can be accessed quickly and selec- which all other parts of the CPU are attached.
tively using a CD-ROM drive. CD-ROMs are less vulnerable to Mouse: A small, mobile manual device that controls movement of
damage than diskettes, which are seldom used anymore. the cursor and selection of the function on a computer display.
Chip: A generic term for an integrated circuit, a single package Network: An interconnected system of computers. The compo-
holding thousands of microscopic electronic components. The nents do not have to be physically close to one another—they can
processor of a computer is one. be connected by telephone, data lines, or without wires.
50.22 I n f ormation ma nageme n t

Annex 50-1 Building a product master file in a database

This section describes essential concepts for building the main Arguments exist favoring each of these coding options, as well
reference file (that is, the product master file) in pharmaceutical as others. Data entry errors are reduced with more complex
management database software. coding schemes, but the time required to enter data may be
greater. An information-bearing coding scheme takes more
Product master file time to develop and maintain than a simple numeric code for
Common to nearly all forms of database management is products. Note that a separate coding scheme will be needed
a master file, which includes features for pharmaceutical for therapeutic categories. Several international coding systems
management, such as product name, strength, dosage for medicine categories are discussed in Chapter 41.
form, and therapeutic category. For procurement and Health problem coding
inventory control systems, the product master file usually has
supplementary information on cost and pack size. The full Health problem information must be coded for diagnosis-
description of a product can be split into database fields to sort specific medicine use analysis and morbidity quantification
and classify the data. of pharmaceutical requirements. The accepted standard is
the WHO International Classification of Diseases (ICD-10), a
The following table briefly describes the information commonly hierarchical classification based on major and minor disease
contained in a basic product master file. The development categories, which is available online, on CD-ROM, and for PDAs
of this file should be carefully planned around several issues, and smartphones. Most information systems are now based
including product coding systems, definition of units, and on the ICD system, although local adaptations often result in
identification of supplier-specific products. different groupings of individual health problems.
Product master file code Definition of units
A computer program must be able to identify each product When computerizing medicines systems, considerable
quickly and without confusion. After a coding system has been confusion can arise over the definition of units. For example,
chosen, it must be maintained without ambiguity, or duplication in the preliminary quantification exercise for a large essential
will occur. Many options exist for coding systems. The simplest medicines project, requirements for benzyl benzoate (a topical
system is the “dummy” code, which has no intrinsic meaning— preparation for skin infestations) were calculated in milliliters,
for example, 12345 is assigned to the first item entered in the whereas the essential medicines list specified liters. This
list, 12346 for the second, and so on. With this system, the only discrepancy led to a 1,000-fold error that increased estimated
question is how many digits are needed; the key point is that pharmaceutical requirements by USD 1 million.
the code should be unique. In most systems, a five-digit code
is sufficient for many years. If a large number of different items Defining the basic unit, issue unit, defined daily dose unit, pack
exist, a six-digit code might be prudent. size, and minimum order can help avoid major mistakes.
Basic or comparison unit. The basic unit is the smallest unit
A more complex option is an “information-bearing” code, in
in which a drug product can be conveniently dispensed or
which each digit has significance—for example, ampicillin 500
administered. It is also used to compare prices of different sized
mg capsules might be coded as AMP500C. In some countries,
bottles or vials. The total number of basic or comparison units is
formal information-bearing codes have been developed at the
equal to one issue unit. For example, 100 tablets make up one
national level for pharmaceutical products. An example is the
bottle, with the tablet as the basic unit and the bottle as the
nine-digit National Drug Code in the United States, in which
issue unit.
the first four digits signify the manufacturer or labeler, the
next three digits show the product, and the last two show the Issue unit. The issue unit is used to count and distribute the
package size. stock. It allows the comparison of items of different pack sizes

Operating system: Software that oversees the overall operation Power spikes/surges: Major fluctuations in electrical current that
of a computer system. It enables other software to communicate can disrupt the computer’s internal operation and damage hard-
with the hardware and must be present for the computer to func- ware.
tion. An example is Windows, used by PCs and OS X, used by Printer: A device to produce hard-copy output.
Macs. RAM (random-access memory): The main type of memory used
PC (personal computer): Any general-purpose computer for indi- in computers, also known as read/write memory because data in
vidual use. Microsoft and Intel dominate the PC operating sys- RAM can be easily changed.
tem market. Today’s PCs evolved from PCs standardized by IBM Record: One entry, or row, in a database.
in the 1980s, except for Apple Corporation products, which are ROM (read-only memory): Memory where information is perma-
not considered to be PCs. nently stored and cannot be altered. This form of memory is also
Peripherals: Equipment (usually hardware) that is external to the random access.
computer itself. Examples are tape drives and speakers. Scanner: A piece of hardware that reads information from text or
Personal digital assistant (PDA): Handheld computing device images and converts it into digital form for a computer to use.
that can record and store data to synchronize with a desktop Server: The main computer on a network; provides storage and
computer. processing capabilities for client computers.
 50  /  Computers in pharmaceutical management 50.23

but the same issue unit. The total number of issue units per pack differently, but managers of pharmaceutical programs
is equal to one pack size. must be thoroughly familiar with the problems of defining
pharmaceutical units. Unambiguous local definitions must
Pack size. In procurement, the pack size is used to request bids.
be established, and everyone involved in recording, entering,
Suppliers usually give the product cost for a pack size.
verifying, or using the computer data must be trained to use
See the table on the following page for more examples of units. these definitions.
Individual computer systems may handle these concepts

Standard information in a master product data file

Description Example Explanation
Product code AMP250C Each entry in the product data file must have a unique code. (See text for discussion of
coding options.)
Generic name Ampicillin The official International Nonproprietary Name (INN) is generally preferred. The WHO
Model List of Essential Medicines, which is regularly updated, uses the INN.
Strength 250 mg The International System of Units (SI), with related SI abbreviations, should be used.
“Strength” can be split into “strength number” (250, for example) and “strength unit” (such
as mg), but this method often creates unnecessary confusion and coding difficulties.
Route of administration PO Standard abbreviations should be used. For example, PO = per os (oral), IV = intravenous,
TOP = topical.
Dosage form CAP Standard abbreviations should be used. For example, CAP = capsule, TAB = tablet.
Issue unit CAP The issue unit is the smallest unit by which a drug product can be conveniently distributed.
(See text for further explanation.)
Defined daily dosage (DDD) 4 The DDD represents the usual total daily therapeutic dosage for an adult. In computer
systems, it is best defined in terms of issue unit per DDD.
DDD unit g The unit in which the DDD is measured.
National essential medicines Y Is the medicine listed in the national EML or formulary? Y = yes, N = no.
list (EML)/formulary status
Therapeutic class 44:29 Categorizing medicines by therapeutic or pharmacologic class can be useful. Several
systems exist, including the ATC, BNF, AFHS, and PAHO systems, and that used for the WHO
Model List of Essential Medicines. (See Chapter 41 for further discussion of therapeutic
category systems.)
Prescription status POM Status for retail sales. For example, POM = prescription-only medicine, OTC = over-the-
counter.
Level of care A National EMLs may categorize medicines according to level of care. For example, A = all
levels, B = all levels except dispensary, and so forth.
ABC classification A Classification of a product as A, B, or C according to the volume consumed and unit cost.
(See Chapter 41 for discussion of ABC analysis.)
VEN classification V Classification of a product as V, E, or N, according to its therapeutic value as vital, essential,
or nonessential. (See Chapter 41 for discussion of the VEN system.)
WHO status M Is the medicine on the WHO Model List of Essential Medicines? This entry can be listed as
Y (yes) or N (no). It can also be listed as M (main), C (complementary), E (therapeutically
equivalent), or N (not on the list).

Smartphone: A mobile phone that offers more advanced com- Spreadsheet: A program for calculating and linking numbers.
puting ability and connectivity than a basic mobile phone. Virus: An undesirable program that displays bizarre messages or
Smartphones allow the user to install and run more advanced destroys data on the computer. Transferred mainly by sharing
applications and transmit data easily. files without testing them first with antivirus software or opening
Software: Programs or segments of programs. infected attachments to e-mail messages.
Annex 50-1 Building a product master file in a database (continued)

Units in pharmaceutical management

Issue unit Pack size Miniumum order
Pack size
Comparison Issue units units per Pack Cost per
units per Comparison per pack minimum size Minimum Cost per comparison
Code Description Strength Form issue unit unit size Issue unit order Pack size cost order cost issue unit unit
AMP250T Ampicillin 250 mg Tablet 1 Tab 1,000 Tablet 5 Bottle 34.00 170.00 0.0340 0.0340
per tab per tab
PIL2OD Pilocarpine 2% Drops 15 mL 12 Dropper 1 Box 17.52 17.52 1.4600 per 0.0973
dropper per mL
BNT0T Bacitracin + USP Ointment 3.5 g 100 Tube 1 Box 100.00 100.00 1.0000 0.2857
neomycin per tube per g
50.24 I n f ormation ma nageme n t

NACL09I Sodium 0.9% Injection 1,000 mL 12 Vial 10 Box 1.56 15.60 0.1300 0.0001
chloride per vial per mL
AMP500I Ampicillin 500 mg Injection 1 Vial 100 Vial 1 Box 30.00 30.00 0.3000 0.3000
per vial per vial
PEN5MI Penicillin 2 MU Injection 1 Vial 12 Vial 6 Box 6.00 36.00 0.5000 0.5000
per vial per vial
COD0S Codeine USP Syrup 500 mL 1 Bottle 6 Box 7.00 42.00 7.0000 0.0140
per bottle per mL
SAL200S Salbutamol 100 mcg Inhaler 200 Doses 1 Inhaler 100 Box 2.70 270.00 2.7000 0.0135
per dose per inhaler per dose
COND0L Condom — Disp 1 Condom 100 Condom 10 Box 1.50 15.00 0.0150 per 0.0150 per
condom condom
BIS10S Bisacodyl 10 mg Suppository 1 Suppository 12 Suppository 10 Box 10.00 100.00 0.8333 0.8333
per supp per supp
AL90L Alcohol 95% Liquid 1 Liter 210 Liter 1 Drum 100.00 100.00 0.4762 0.4762
per liter per liter
JEL0J Jelly, BP Gel 142 g 12 Tubes 1 Box 100.00 100.00 8.3333 per 0.0587
lubricating tube per g
GLOV7D Glove 7 Disp 2 Glove 50 Pair 1 Box 100.00 100.00 2.0000 1.0000
per pair per glove
NED21G Needle 21 g Disp 1 Needle 100 Needle 10 Box 10.00 100.00 0.1000 0.1000
per needle per needle