Nutrition prescriptions
calculated to the milligram.

MyTotalMix walks a hospital pharmacy through the whole process of preparing a parenteral nutrition (PN/TPN) admixture, in four steps, from the physician's prescription to a finished bag.

A physician writes the prescription for a neonate, child, or adult, picking the ward and a patient from the list. A pharmacist checks it across three tabs: prescription, verification, summary. Exceeded dose limits, validated against ESPGHAN, are highlighted right away. Once accepted, the order becomes 3-in-1 or 2-in-1 bags. Labels and reports print on thermal printers, and the compounder loads the order after scanning the barcode on the label, with no retyping. Each label shows the composition, expiry date, and batch number. The report goes straight into the patient's record.

It is built for clinical pharmacists and hospital pharmacy managers, and for the physicians who order parenteral nutrition: neonatologists, pediatricians, intensivists, and oncologists who decide on macro- and micronutrient dosing every day.

It pays off most in large multi-specialty hospitals, oncology centers, and pediatric and neonatal units. Those places prepare a dozen to several dozen individual PN admixtures a day, and recalculating g/kg/day doses against ESPGHAN by hand gets slow and risky. With automatic validations and limits set per organization, the team handles more orders without more risk of error, while staying inside ward procedures and audit requirements. Hospital IT teams live in it too, keeping the organizational structure, integrations, and user accounts in order. As a side effect, mixture naming lines up across wards, so physicians and pharmacists spend less time clarifying what was meant.

Patient safety rests on three things: automatic requirement calculation, ESPGHAN-based validations, and a full audit trail on every change to a prescription.

Dose limits (g/kg/day) for energy, protein, fat, carbohydrates, and electrolytes, set per organization and per patient type, are compared against what was entered in the formula. Any overflow lights up in the pharmacist's verification tab before the order reaches production. Osmolarity and ingredient compatibility get checked too. The compounder pulls data straight from the system after a barcode scan, so nobody retypes values by hand. Every prescription version (V1, V2, V3) is signed and timestamped, so you can reconstruct the history of clinical decisions during a review or a safety incident. The protein limit for a preterm infant differs from a full-term one, and the system picks the right threshold itself, from the patient's data.

Nothing is deleted. Every record is archived instead, so the pharmacy keeps a complete, tamper-evident history.

Each formula keeps a version history, say V1 → V2 → V3, and every change carries a signature and a timestamp: who and when. The same goes for accounts, permission groups, and organizational units. Only authorized users can open the archive, and every read is logged. Database backups run on a regular cycle.

MyTotalMix connects to thermal printers for labels and reports and to the compounder over barcode. The system runs fully standalone. You always enter the order directly in MyTotalMix, with no dependency on other systems.

The compounder scans the barcode on the bag label and loads the whole order itself, so the production operator never retypes the composition. Thermal printers connect through printing services authenticated with OAuth, and you set access at the ward or central-pharmacy level. Master data, meaning modified milks, ready-made mixtures, and single ingredients, moves through CSV files. Import and export make rollout migration and catalog updates easier. Integration with the hospital HIS is possible over an API. Scope and approach are worked out individually as part of the rollout. You configure all of it from the admin panel.

Access follows a users → groups → permissions model. A group gets precise permissions (create, read, update, delete) for each function separately: issuing prescriptions, approving bags, managing dictionaries.

Permissions are inherited down the hierarchy: from the whole hospital, through wards, to cost centers. An admin sets access once, at the top, and lower units inherit it, with the option to narrow it for a given ward. Sign-in recognizes the organization from the email domain and routes the user to the right identity provider, with no picking a hospital from a list. Revoke a permission on a group and it hits everyone who inherits it at once. The whole structure shows up in the panel as an org tree.

We have been developing MyTotalMix for 15 years, building the system on experience gathered around parenteral nutrition in hospital pharmacies. The current version is a full rewrite of the codebase on a modern stack: the same domain scope and the same clinical rules, without the weight of older technology choices.

The foundation, meaning the prescription → verification → compounder cycle, ESPGHAN dose limits, and a full audit trail, rests on what we learned over those years working with clinical pharmacists, neonatologists, and pediatricians.