Prescription Prescription ProcessingProcessing

7.07.0 Steve BowmanInformation Systems Consultant

One stop One stop shoppingshopping

All Rx filling activities now happen from the Prescription Processing screens

• List manager Format

• First see and can edit patient information

• Next taken to Medication screens that list and allow manipulation of meds

• After completing one Rx will be asked if there are more until you say no

• Print labels after completing all new and refilled orders

Menu Path

Or PSOM – PSO2 (Manager & Techs Menus)

PDM Pharmacy Data Management ...PIHS IHS-Specific Pharmacy Options ...PSO1 Pharmacist Menu ...PSOM Outpatient Pharmacy Manager ...TIUC Progress Notes/Discharge Summary [TIU] ...Select IHS Core Option:PSO1

RX Rx (Prescriptions) ...RXIN Pharmacy Intervention Menu ... Bingo Board User ... Change Label Printer Change Suspense Date DUE Supervisor ... Enter/Edit Clinic Sort Groups Medication Profile Print from Suspense File Process Drug/Drug Interactions Pull Early from Suspense Release Medication Return Medication to Stock Update Patient Record Verification ...Select Pharmacist Menu Option: RX (Prescriptions)

PrxP Patient Prescription ProcessingEDRX Edit Prescriptions Barcode Rx Menu ... Complete Orders from OERR Discontinue Prescription(s) List One Patient's Archived Rx's Reprint an Outpatient Rx Label View PrescriptionsSelect Rx (Prescriptions) Option: PrxP

Select PATIENT NAME: DEMO,PATIENT

PATIENT UPDATE SCREENS

MEDICATION PROFILE SCREENS

Displays pharmacy related patient data•Allergies/ADRs•Special instructions•Pending appointments

Allows entry of Allergies should answer no to document NKA

Allows entry of pharmacy data items

CAP: MAIL:MAIL STATUS EXPIRATION DATE: DIALYSIS PATIENT:NARRATIVE: PATIENT STATUS: OUTPATIENT//COMMUNITY NURSING HOME: NURSING HOME CONTRACT:LAST DATE OF CONTRACT: RESPITE PATIENT START DATE:RESPITE PATIENT END DATE: OTHER LANGUAGE PREFERENCE:PMI LANGUAGE PREFERENCE:

Goes back to Select Patient Name:Accepting default takes you

to Medication Profile pages

Pt has a documented Allergy/ADR

The Money pages•New Rx’s•Refills

Selects existing med for RF Can just enter the #s of the ones to RF w/o typing SO first

Creates a new Prescription

Med returned to stock

Other Actions Select Action: Next Screen// ?? The following actions are also available:RP Reprint (OP) DN Down a Line LS Last ScreenRN Renew (OP) RD Re Display Screen FS First ScreenDC Discontinue (OP) PT Print List GO Go to PageRL Release (OP) PS Print Screen + Next ScreenRF Refill (OP) > Shift View to Right - Previous ScreenPP Pull Rx (OP) < Shift View to Left ADPL Auto Display(On/Off)IP Inpat. Profile (OP) SL Search List UP Up a LineOTH Other OP Actions QU Quit

New Orders Select Action: Next Screen// NO  DRUG: ZITHRO Lookup: DRUG SYNONYM 1 ZITHROMAX AZITHROMYCIN 250MG TABLET AM200 -27462.5 00069-3060-50 DENNEHOTSO 2 ZITHROMAX AZITHROMYCIN 200MG/5ML SUSPENSION AM200 -1041.5 00069-3120-19

DENNEHOTSOCHOOSE 1-2: 1 AZITHROMYCIN 250MG TABLET AM200 -27462.5Now doing order checks. Please wait... VERB: TAKE Varies according to the dose form associated with the drug Can’t change here must wait till

end then edit after saying no to this OK Pick field 5.Choose one listed or a different, free text dosage may be entered.Available Dosage(s) 1. 250MG 2. 500MGSelect from list of Available Dosages, Enter Free Text Dose?: 2 500MGYou entered 500MG is this correct? Yes// YESVERB: TAKEDISPENSE UNITS PER DOSE(TABLETS): 2// 2Dosage Ordered: 500MGNOUN: TABLETS

ROUTE: PO//

The software checks the medication selected for any interactions or allergies noted in the patient’s record . The next prompts shown will be the new fields used to build the Sig.

Can use Quick Codes

The list of available possible dosages shown. Choose one listed or a different, free text dosage may be entered.

For numeric dosages, the Dispense Units Per Dose value is calculated based on the strength of the dosage ordered divided by the strength of the medication ordered. The 500 mg dosage ordered will require two 250 mg capsules. The Dosage Ordered is re-displayed after the Dispense Units to allow the entry to be double-checked.

If a Route has not been associated with the Dispense Drug, the default Route of PO or Oral will be displayed. A different Route can be entered or it can be deleted at this point if needed. The Route is not required to complete a prescription. If the abbreviation entered is in the stored list of possible routes, the entry will be expanded in the Sig.

New Orders SCHEDULE: QD//

LIMITED DURATION (IN DAYS, HOURS OR MINUTES): 1D (DAY)

CONJUNCTION: THEN

VERB: TAKEAvailable Dosage(s) 1. 250MG 2. 500MGSelect from list of Available Dosages, Enter Free Text Doseor Enter a Question Mark (?) to view list: 1 250MGYou entered 250MG is this correct? Yes// YESVERB: TAKEDISPENSE UNITS PER DOSE(TABLET): 1// 1Dosage Ordered: 250MGNOUN: TABLETSchedule: QD// (EVERY DAY)LIMITED DURATION (IN DAYS, HOURS OR MINUTES):CONJUNCTION:PATIENT INSTRUCTIONS: TAT FINF// UNTIL ALL GONE FOR INFECTION(TAKE TWO TABLETS BY MOUTH EVERY DAY FOR 2 DAYS, THEN TAKE ONE TABLET EVERY DAY UNTIL ALL GONE FOR INFECTION)A default value for Days Supply based on patient status is displayed. A default quantity is calculated when possible.DAYS SUPPLY: (1-365): 30//QTY ( TAB ) : 32// ^DAYSDAYS SUPPLY: (1-365): 30// 5 Quantity has been changed from 32 to 7

A default schedule associated with the drug ordered is displayed. The default can be accepted or a different free text schedule can be entered. Free text entries cannot contain more than two spaces or be more than twenty characters long. Entries will be compared against a list of common abbreviations and expanded if the entry matches. Any entry not found in the list of common abbreviations will be displayed in the Sig as entered.  

Used only when a medication should be taken for a limited period of time. Days are assumed for numeric entries. Follow the number with an “H” to specify hours or an “M” to specify minutes.

For complex Rx’s to join dosing sequences Can use only THEN, AND, or EXCEPT

Any entry in the PATIENT INSTRUCTIONS field will first be checked to see if it contains any abbreviations that can be expanded. The entry will be added to the end of the Sig, after the dosing information, and the entire Sig will be displayed.