Download - Preparing for Outpatient Pharmacy v7.0 & Inpatient v5.0 SPEAKER: Bob Adams DATE: January 11, 2005
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Preparing for Outpatient Pharmacy v7.0 &
Inpatient v5.0
SPEAKER: Bob AdamsDATE: January 11, 2005
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Reading assignment
• Pharmacy Ordering Enhancements (POE) Pharmacy Data Management (PDM V.1.0) Pre-Release Implementation Guide
• This can be found on www.ihs.gov/ehr
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Prior to this training:
• Inactivate drugs that aren’t being used• Make sure that non-formulary
designation is correct• Trade name synonyms entered & marked
as trade name• Correct NDC #s entered in 5-4-2 format• Standardize drug names
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Correct NDC #s in the Drug File
• Use the FPN Report • Outpatient Pharmacy Manager
Menu Supervisor Functions FPN
• This will make NDF matching easier
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Enter Trade Name Synonyms
• Use Drug Enter/Edit or Synonym Enter/Edit options (on PDM menu)
• This will help providers when they order drugs through EHR
• If this isn’t finished before you create orderable items, you’ll need to Edit Orderable Items and enter the synonyms there instead of in the Drug File
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Standardize Drug Names
• Try to stick with the format of: Generic Name_Strength_Dosage Form
IBUPROFEN 400MG TAB
ENOXAPARIN 30MG/0.3ML INJ
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National Drug File
• Automatic match Verify Merge • Print NOCL and MANC Reports• Rematch / Match Single Drugs Verify Merge• Print the NOCL and MANC Reports
again• You won’t be able to match compounded
drugs or drugs not found in the NDF
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Make sure of the following before you proceed:
• Pharmacy Data Management (PSS) patch 1 has been installed at your facility
• Your site manager has assigned you the APSPSS security key
• The site manager may have to create the key. Instructions on how to do this are at the end of the patch installation instructions.
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Creating Orderable Items in Pharmacy Data Management
• Use Drug Enter/Edit to inactivate drugs that aren’t matched to the NDF (see NOCL & MANC reports for a list of these drugs)
• Create Pharmacy Orderable Items. Select
• Reactivate the drugs that you just inactivated• Manually Match Dispense Drugs so all active
drugs are linked with an Orderable Item
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Nouns Enter/Edit Option
• Pharmacy Data Management Ordering Enhancements Pre-Release Instructions/Nouns Nouns Enter/Edit
• Delete nouns for these dosage forms:*DROPS,ORAL *ENEMA *ENEMA,RTL*LIQUID,AEROSOL *SOLN,RTL*SUPP,RTL *SUPP,VAG*SUPPOSITORY *SUSP,RTL
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Select Instructions/Nouns Option: Select Instructions/Nouns Option: NOUNS Enter/Edit
Select DOSAGE FORM NAME: Select DOSAGE FORM NAME: ENEMA
Dosage Form => ENEMADosage Form => ENEMA
Select NOUN: Select NOUN: CONTENTS
NOUN:CONTENTS// NOUN:CONTENTS// @ Do you want to delete ‘CONTENTS’ ? No// Do you want to delete ‘CONTENTS’ ? No// Y
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Auto Create Dosages
• Pharmacy Data Management Ordering Enhancements Pre-Release
Dosages Auto Create Dosages
• This must be finished before you proceed. Use the Conversion Tracker option to see if the Auto Creation has finished.
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Print the Review Dosages Report
• Pharmacy Data Management Ordering Enhancements Pre-Release Dosages Review Dosages Report
• This is a “LONG” report. You can print it in segments, a few letters at a time.
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Dosage report for drugs from A through C Outpatient Expansion PAGE: 1
-----------------------------------------------------------------------------------------------------
(84534) ABSORBASE Inactive Date: Strength: Units: Application Package: OU Possible Dosages: (None) Local Possible Dosages: SMALL AMOUNT Package: O
(85177) ACEBUTOLOL 200MG CAP *N/F* Inactive Date: SPECIAL ORDER Strength: 200 Units: MG Application Package: OU Possible Dosages: Dispense Units Per Dose: 1 Dose: 200MG Package: IO
1 CAPSULE Dispense Units Per Dose: 2 Dose: 400MG Package: IO
2 CAPSULES Local Possible Dosages: (None)
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Dosages Enter/Edit Option
• Pharmacy Data Management Ordering Enhancements Pre-Release Dosages Dosages Enter/Edit
• Using the Review Dosages Report, you can add, edit, or delete Possible Dosages and Local Possible Dosages
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Things to keep in mind
• Possible dosages were created for single entity tablets and capsules
• Possible dosages for OUTPATIENT use need to be created for combination tablets and capsules, oral liquids, and injections
I=Inpatient O=Outpatient
IO=Both
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More things to keep in mind
• Possible dosages were not created for combination drugs, drugs with % soln strength, eye drops, inhalers, topicals, drugs not matched with the NDF
• Local possible dosages were created for the above drugs if there was an associated noun:
TIMOLOL 10% SOLN,OTI 1 DROP 2 DROPS
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Select Dosages Option: ENTER/Edit Dosages
Select Drug: CAPTOPRIL 1 CAPTOPRIL 25MG CV800 59772-7046-03 2 CAPTOPRIL 25MG UD CV800 51079-0864-20CHOOSE 1-2: 1 CAPTOPRIL 25MG CV800 59772-7046-03 This entry is marked for the following PHARMACY packages:OutpatientUnit DoseNon-VA Med
CAPTOPRIL 25MG Inactive Date:
Strength from National Drug File match => 25 MGStrength currently in the Drug File => 25 MG
Edit Strength? N// <ENTER> NO
Strength => 25 Unit => MG
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Select DISPENSE UNITS PER DOSE: ? Answer with POSSIBLE DOSAGES DISPENSE UNITS PER DOSE Choose from: 1 25 IO 2 50 IO
You may enter a new POSSIBLE DOSAGES, if you wish Type a Number between 0 and 99999999, 4 Decimal Digits
Select DISPENSE UNITS PER DOSE: .5 Are you adding '.5' as a new POSSIBLE DOSAGES (the 3RD for this DRUG)? No// Y (Yes) Dosage = 12.5MG POSSIBLE DOSAGES DOSE: 12.5// (No Editing)
DISPENSE UNITS PER DOSE: .5// <ENTER> PACKAGE: IOBCMA UNITS PER DOSE: 1
Strength => 25 Unit => MG
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Editing Dosages Tips
• The Review Dosages Report can be run multiple times. Make sure it is 132 columns or it won’t be useful.
• The Auto Create Dosages can also be rerun, with 2 different options – start over from scratch or build on Dosages already created.
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Med Instruction Frequency
• Pharmacy Data Management Ordering Enhancements Pre-Release Med Instruction/Frequency Medication Instruction Frequency Report
• Frequency is used to help calculate days supply & quantity defaults. If frequency isn’t in the Administration Schedule file, the software looks in the Medication Instruction File
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Medication Routes
• Review all of the medication routes• Make sure routes you plan to use are
marked for ALL package use and have an outpatient expansion
• Include a preposition as part of the route. You will need to delete prepositions from Dosage Form file after Pharmacy v7 is installed at your site
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Standard Schedules
• Edit any JCAHO “forbidden” schedules
• Make sure that frequency is correct – this will affect the days supply/quantity calculation
• Check to make sure that the expansion is entered for outpatient use
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Standard Schedules (cont.)• Make sure that you include Day of the
Week schedules in the correct format & that they’re marked as D.
• Enter the first 2 letters of the day of the week. This is the only way that RPMS will recognize the schedule.
• Use a hyphen for multiple days of the week, e.g., MO-WE-FR, TU-TH-SA.
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Medication Instructions
• Ordering Enhancements Pre-release Med Instruction/Frequency Med
Instruction Report• Use this report to identify med instructions
that could be used as schedules• Enter frequency in minutes: Q2H = 120
Q3D = 4320
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Edit Orderable Items• PDM Orderable Item Management
Edit Orderable Items• Use this option to put in the appropriate
route of administration (blank=default of Oral.
• Enter the appropriate Schedule Type (blank=default of Continuous).
• You can enter a default Schedule from your Standard Schedules.
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Patient Instructions Enter/Edit
• PDM Ordering Enhancements Pre-Release Patient Instructions Enter/Edit
• Enter defaults that will automatically be appended to the Sig (indications for use, etc.)
• Can enter med. Instruction codes & the expansions will print
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Select Pharmacy Orderable Item: IBUPROFEN TAB
PATIENT INSTRUCTIONS: FPA - TAKE F/M
FOR PAIN - TAKE WITH FOOD OR MILK
•Remember to type a period or use a hyphen, or other delimiter, if you want to separate the patient instructions from the rest of the SIG. FAR *W/F*
FOR ARTHRITIS. *TAKE WITH FOOD*