Newfoundland and Labrador Drug Information System Integration
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1 Newfoundland and Labrador Drug Information System Integration McKesson Canada December 19, 2014
2 Introduction The Prescription Drug Act in many provinces now require Pharmacies to submit all dispenses on behalf of provincial residents to the Drug Information System (DIS). This process will capture information on all prescription drug dispenses, clinical information, and related processes to ensure the patient s Electronic Health Record (EHR) is complete. The Newfoundland and Labrador Pharmacy Network (NLPN) is a provincial drug information system. It provides vital clinical information necessary for the appropriate and timely care of patients. The Pharmacy Network will connect pharmacists, physicians, nurse practitioners, and other authorized health professionals with comprehensive electronic medication profiles for all patients. It will also provide a drug information database that will assist health professionals to identify potential adverse drug interactions and events. McKesson Canada values the importance of this exchange of patient information to ensure the best health care is provided for the residents of Newfoundland and Labrador. The implementation of security access within the PharmaClik Rx application is necessary to ensure only appropriate staff are viewing this data. 2
3 The following slides will outline quick previews of the various ways the PharmaClik Rx application has been modified to meet the NLCHI DIS requirements. This will not replace training and the user reference guide but it will provide a quick overview of the implementations of the Drug Information System. 3
4 DIS Preferences Interaction with the Pharmacy Network is set by McKesson when it is determined your Pharmacy is DIS Enabled. However if there are communication issues or the DIS is not available, Pharmacies can operate in a Down Mode. 1. Select More > Newfoundland > DIS Preferences. 2. Select Yes for DIS Availability. 4
5 Patient Search When searching for a patient, you can select one of the following buttons: Local Searches within PharmaClik Rx Search Searches within PharmaClik Rx and the Client Registry When a patient search is returned, PharmaClik Rx will indicate whether the patient is: Local Patient exists in PharmaClik Rx Sync Patient exists in PharmaClik Rx and has been synchronized with the Client Registry. NOTE: Prior to any DIS interaction, the patient must be synchronized with the Client Registry. 5
6 Client Registry Search Criteria When searching for a patient, it is ideal to use their MCP (referred to as PHN in PharmaClik Rx). If the patient does not know their PHN, the recommended search criteria when searching for a patient on the Client Registry is: Last Name First Name Gender Birth Date NOTE: In PharmaClik Rx you must have at least 2 characters in both the Last Name and First fields. 6
7 Client Registry Search Results Every individual who has an MCP will have a record in the Client Registry. Individuals who do not have an MCP may also be in the Client Registry. In either instance, you must always check the Client Registry before adding a new patient record. It is imperative to always exhaust all search options before adding a patient new to the Client Registry. 7
8 Compare Window Information currently in PharmaClik Rx. Information currently in the Client Registry (patient s Electronic Health Record). When a field is highlighted, these directional arrows can be selected to update the information from the EHR to PharmaClik Rx, or from PharmaClik Rx to the EHR. If there is a discrepancy in the information you have and what the Client Registry has you can opt to NOT import the information to your local system. 8
9 Patient Demographic Information Add Patient demographic information. Add Third Party Provider info. The Pharmacy Network is not affiliated with Third Party billing. Add Observations, Allergies, and Medical Conditions. View previous prescriptions and query the patient s EHR Profile. View any changes made to a patient s EHR. Add Professional Services and Immunizations. Add patient preferences (i.e. label preferences, dosett patient etc.) Notes Tab (not Displayed )- Add Patient Notes. The demographic information from the Client Registry will automatically update your local system. Any additional information you have (i.e. allergies, medical condition and notes) can be added to the Pharmacy Network for other health care professionals to view. 9
10 Viewing a Patient s EHR Profile Click here to view the patient s Pharmacy Network Profile (EHR). EHR All - Displays both Clinical and Prescription information EHR Rx - Displays Prescription information only. From the patient s Profile tab, select Rx > Profile > EHR All or EHR Rx. 10
11 Customizing the Information Returned The Pharmacy Network profile search can be customized for what you would like to see. View information based on the following: Type: All, Prescriptions, Device Prescriptions, Other Medications Source: DIS, Local Only, Combined The history can be adjusted for how far back you would like to view the profile. Select More > Newfoundland > DIS Preferences > # of Days to Retrieve. 11
12 Non-Local Medications The Local column indicates if the prescription is: Local Only DIS Only Local and DIS 12 If the prescription is on the DIS only, this indicates that the Rx was NOT filled at your pharmacy. NOTE: A prescription will be Local Only if it was filled, but not transmitted to the DIS due to the DIS being down, or the pharmacy choosing to defer the Rx to the DIS temporarily. In either scenario, the prescription still must be submitted to the DIS.
13 Viewing Details for Non-Local Rx Highlighting a non-local prescription and selecting the Detail button will display more information (i.e. where the Rx was filled, when, and by whom etc.). The EHR Rx Details window is broken down into two sections: Create Rx Info Dispense Info The deselected Local checkbox indicates that Rx is non-local and dispensed at another pharmacy. The Dispense Info provides more information about the Pharmacy that dispensed the Rx. 13
14 Non-Local Allergy When viewing the patient s EHR Profile, highlight the non-local allergy and select the Detail button. The local checkbox is deselected, indicating that the allergy was recorded by another pharmacy and transmitted to the patient s EHR Profile. Pharmacies connecting to the DIS have the ability to download the non-local allergy to the Patient Folder in PharmaClik Rx. 14
15 Non-Local Medical Condition When viewing the patient s EHR Profile, highlight the non-local medical condition and select the Detail button. The local checkbox is deselected, indicating that the medical condition was recorded by another pharmacy and transmitted to the patient s EHR Profile. Pharmacies connecting to the DIS have the ability to download the non-local medical condition to the Patient Folder in PharmaClik Rx. 15
16 Non-Local Immunization When viewing the patient s EHR Profile, highlight the nonlocal Immunization and select the Detail button. The local checkbox is deselected, indicating that the medical condition was recorded by another pharmacy and transmitted to the patient s EHR Profile. Immunizations added to the Pharmacy Network will be available for other healthcare providers to view only. 16
17 Non-Local Note When viewing the patient s EHR Profile, highlight the nonlocal note and select the Detail button. The local checkbox is deselected, indicating that the note was recorded by another pharmacy and transmitted to the patient s EHR Profile. Notes added to the Pharmacy Network will be available for other healthcare providers to view only. 17
18 Filling a Prescription The filling process remains the same. Once an Rx is submitted for adjudication, the EHR tab will display the Create and Dispense Info. The EHR tab is where all information related to the Electronic Health Record submission can be found. There will be no changes to the Third Party adjudications for claim submission. 18
19 Transaction Processing Message When a transaction is processing, a blue window will appear that indicates Processing Claim. Once the claim has been successfully transmitted to the DIS, the blue window disappears and the claim is placed in the Completed tab. If any issues need to be presented to the user, they will be provided in a form of a Detected Issue. 19
20 Detected Issues / Issue Management The DIS will present any DUR or information warnings or rejections to the user in form of a Detected Issues. In instances where applicable, the Pharmacist will have the ability to add an Issue Management and submit the claim. If the Add button is greyed out, adding an issue management is not possible for the Detected Issue. 20
21 Patient s EHR Profile The Rx filled at your pharmacy can now be viewed by other health care professionals as it is visible on the patient s EHR Profile. Any viewing of the patient s EHR is tracked as to who has viewed this information. Only users with DIS access (Pharmacists and Technicians) are permitted to view this data. Other health care providers are able to view this information through HEALTHeNL (a view only portal). 21
22 Pick Up Function Every prescription is required to be marked as picked up once the patient has received it. This indicates to other health care providers that the patient has the medication and it is not still at the pharmacy. Prescriptions can be marked Picked Up either automatically once the Rx is filled, or manually once the patient picks up. This preference can be set in the DIS Preferences window. 22 Pharmacies with POS Systems, will be set up for POS integration so at the time of scanning at the register, the pickup message will be sent.
23 Manual Pick Up Function To manually change the prescription to Picked Up, right-click the coloured icon next to the prescription and select Change to Picked Up The user should manage their completed tab daily to ensure only prescriptions waiting in the draw are not flagged for pickup. 23
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