Be the Difference. Creating and Generating Prescriptions in UHCare This Job Aid provides step-by-step instructions for creating and generating prescriptions in UHCare. Working with Prescriptions Prescriptions are created directly from home and visit medications during the Discharge Reconciliation process. New prescriptions can also be created for your patient during discharge rec. Prescriptions are created using Prescription Writer. Prescription Writer provides a set of tools to manage your patient s medications. Using Prescription Writer you can: Create and maintain outpatient prescriptions Electronically transmit new prescriptions and renewals to pharmacies using eprescribe View and update primary pharmacy information Creating Prescriptions 1. From the Main Application toolbar, select Order Reconciliation. 2. Select Discharge. 3. From the Orders To Reconcile column on the left, right-click the desired medication. 4. Hover over the desired medication. The Home Med is identified by the house icon at the beginning of the menu choice. If a home and visit med is available to be continued at discharge, select the home medication over the visit medication whenever possible to avoid patient confusion. When a visit med is continued, the generic/chemical drug name will appear on the patient s discharge instructions 5. From the fly out menu, select Create Prescription. 6. Adjust the fields at the bottom of the window as desired for dose, dosage units, routes, frequency, quantity, etc. Job Aid 1 March 28, 2013
7. Enter the desired number of days and/or quantity. 8. Select the PRN checkbox to indicate PRN prescriptions; this populates the verbiage as needed in the instructions box. 9. From the instruction list menu, select the desired instruction; this action populates the selected verbiage in the instructions box. 10. Click Done. PRN directions and prescribed instructions can also be manually typed in the Instructions box. Quantity and Dispensed Units When creating a prescription, physicians will populate the Quantity field as desired when tablets, capsules and oral liquids are prescribed. The Dispensed Units field will be grayed out. The Dispensed Units field will be active for items such as opthalmics, otics, inhalers, topicals, etc and should always be populated when prescribing these medication types. Show Days in SIG The Show Days in SIG checkbox must be selected when prescribing medications, such as antibiotics, for a specific number of days. When this checkbox is selected, the instructions will read times number of days to accurately instruct the patient how long to take the medication on the Home Going Instructions report. SIG Field (Instructions) Box If a SIG is greater than 140 characters, the text in the instructions box turns red and it is set to automatically print, even if esubmit is selected when you are ready to review and submit prescriptions (after discharge reconciliation is complete). A red exclamation mark and the work PRINT will also appear in the Review Prescriptions window. Hover over the verbiage next to the red exclamation mark to see the error message, too many characters to e submit. Additionally, if a SIG is greater than 350 characters, not only is the generate prescription option limited to print; the system stops printing instructions beyond 350 characters. Physicians need to ensure medication instructions do not exceed 350 characters. If instructions exceed 350 characters, the instructions must be manually edited by clicking in the instruction text box and revising the typed text. Using the Quick Prescription Toolbar Button A toolbar button is available for Quick Prescription actions. When the Quick Prescription button is selected from the toolbar, green text describing the available Best Match option will appear under the medication. Quick Prescription is NOT available on all medications. If there is no Best Match, green quick prescription text will NOT appear when selecting the Quick Prescription toolbar button. 1. From the Discharge Order Reconciliation Manager window, select Quick Prescription. 2. Medications that are configured in the system with a Best Match option have green quick prescribe text under each item. 3. From the Items To Reconcile window, click once on the desired medication to display the Modify Prescription window. 2 Job Aid IT&S Training and Development, MSC
4. From the Modify Prescription window, enter the dose, units, route, frequency, instructions, etc as desired. 5. Click Done. The selected medication is continued and appears as a reconciled new prescription in the Home Medications At Discharge column. Note the comment in the Items to Reconcile column indicating prescription is created.also note the prescription icon in the Home Medications at Discharge column. Using the Pop up Quick Action Window ( Hover Window ) When quick action mode is enabled via the Format Layout icon, you can hover over a discharge medication and display a pop up quick action window. Click an action in the pop up window to perform the desired action on the selected discharge medication. If the Quick Prescription quick action is light blue in the pop up window, there is no Best Match and quick action functionality is not available. If the quick action is dark blue, Best Match exists and quick action functionality is available. 1. From the Items To Reconcile column, hover over the bolded medication name. 2. From the Popup Quick Action Window, select the blue quick prescription arrow. 3. From the Modify Prescription window, enter the dose, units, route, frequency, instructions, etc as desired. 4. Click Done. Creating New Discharge Prescriptions 1. From the Discharge Order Reconciliation Manager window, select Enter Prescriptions 2. From the Add Medication window, Drug Search field, select Quick List. The Quick List and Favorite Drug Search options can be set as the default preference on the Add Medication window. See Setting Preferences and Creating/Selecting Favorites in Prescription Writer. 3. Begin typing the desired medication name. The Quick List of available concentrations, doses and frequencies displays 4. Select the desired medication from the Quick List. The Dose, Units, Route, Frequency, Days, Quantity and Instructions fields automatically populate with preconfigured values. 5. Modify the auto-populated fields as desired. 6. Click Done. Click the Add Another button to create additional new discharge prescriptions. The Home Med list automatically updates to include all newly entered prescriptions. IT&S Training and Development, MSC Job Aid 3
Reviewing and Generating Prescriptions Prescriptions are reviewed for accuracy and then generated from the completed discharge reconciliation. The Review Prescription window is where prescriptions are reviewed and selected for print or electronic transmission. 1. From the Discharge Order Reconciliation Manager window, click Save as Complete. The Review Prescription(s) window displays. All prescriptions created during discharge reconciliation are available for review and generation. 2. Select the submit method for each prescription. If all prescriptions will be submitted electronically, click the esubmit radio button in the lower left corner of the Review Prescriptions window. 3. Click Submit. 4. Reauthenticate with an SSO badge tap, or answer two SSO challenge questions. Narcotics are not permitted for electronic prescription. All narcotic prescriptions must be printed or hand-written. Click the Preview hyperlink to preview submitted prescriptions. Provider Location Field Prescribing providers need to ensure that the Provider location field in the lower right corner of the Review Prescriptions window accurately reflects the location they are at prior to submitting a prescription. Click the Provider Location list menu and select correct location. Pharmacy Field The pharmacy field needs to reflect the patient s preferred pharmacy. If this field is blank or has the incorrect pharmacy when a prescription is electronically submitted, the prescription will error out and not generate to a pharmacy (duh!) or it will be sent to the wrong pharmacy. Adding a Preferred Pharmacy Nursing will add the preferred pharmacy to the OMR when home meds are collected. If the pharmacy field is blank when submitting prescriptions, the prescribing provider can add the preferred pharmacy prior to electronically submitting the prescriptions. See Adding a Preferred Pharmacy The patient s preferred pharmacy can be added and modified from the Review Prescriptions window in the pharmacy field. 1. From the Review Prescriptions window, click the arrow in the pharmacy field. 2. Select ***Search for Pharmacy***. The Manage Pharmacies window opens. 3. Click the Search Pharmacy arrow. 4. In the Name field, type the desired pharmacy name. 5. In the city field, type the desired city. 6. Click Search. The results display in the Search Results area of the Manage Pharmacies window 7. From the Search Result field, select the desired pharmacy and click Add to Preferred 4 Job Aid IT&S Training and Development, MSC
The selected pharmacy populates the Preferred Pharmacies window and is the default preferred pharmacy Pharmacies that appear in the Search Results window prefaced with a blue triangle icon Surescripts network and are able to receive electronic prescriptions from UHCare. are in the Pharmacies prefaced with a blue triangle and red slashed circle icon are not in the Surescripts network and are NOT able to receive electronic prescriptions from UHCare. Prescriptions must be printed and manually presented to pharmacies not in the Surescripts network. If the pharmacy you are looking for does not appear in the Search Results window, it can be manually added and designated as the patient s preferred pharmacy. Pharmacies that are manually added are not in the Surescripts network and are NOT able to receive electronic prescriptions from UHCare. Prescriptions must be printed and manually presented to pharmacies not in the Surescripts network. To narrow your search, enter as much demographic information as possible about the patient s preferred pharmacy. Working with the Inbox Notification of errors preventing the electronic transmission of prescriptions to the preferred Surescripts pharmacy will route to the Inbox tab of the patient chart. Error messages typically display within seconds of transmission, allowing the physician to manage the error(s) with the least amount of impact to the patient. Physicians should check the Inbox for transmission errors whenever possible while the patient is still onsite at the hospital. The Inbox is accessed via a toggle menu residing in the upper left hand corner on the Patient List tab. At this time, the Inbox will only be used for eprescribe error notifications. 1. From the Patient List tab, toggle menu, select Inbox. 2. Double-click the desired error message. The Rx Viewer window displays the non-transmitted prescription 3. Select Print or Cancel as desired. 4. From the Inbox tab, toggle menu, select Patient List to select another patient. Setting Preferences and Creating/Selecting Favorites in Prescription Writer Setting the Quick List Preference The system default drug search option in RxWriter is Full Catalog. It is recommended that physicians set the drug search default in RxWriter to Quick List. Quick List options contain the most frequently prescribed medications, dose, units and frequency to streamline drug search and selection options. 1. From the Main Application toolbar, select Prescription Writer. The Prescription Writer window displays IT&S Training and Development, MSC Job Aid 5
2. From the Prescription Writer window, select User Preferences. 3. From the User Preferences window, select Display. 4. Select Quick List. 5. Click OK. Creating and Selecting Favorites Favorite prescription preferences can be created and used to quickly prescribe medications for a patient. The Favorites list includes your personal user favorites created by and available only to you, as well as enterprise favorites that are available to all users. Favorites can be created from Orders Reconciliation or Prescription Writer using the Add New Prescription / Enter Prescription icon 1. From the Main Application toolbar, select Prescription Writer. 2. From the Prescription Writer toolbar, select Add new Prescription. 3. From the Add Prescription window, Drug Search field, begin typing the desired medication name. 4. Select medication name from the list below the Drug Search field. 5. Select dose, unit, frequency, etc. as desired. 6. Click Add to Favorites 7. Select or create the desired medication category. 8. Click OK. 9. Click Close. 10. From the Main Application toolbar, select Prescription Writer 11. From the Prescription Writer toolbar, select Add new Prescription 12. Change the drug search default to Favorites. 13. Select the desired category. 14. Select the desired med and modify the dose, units, frequency, quantity, etc. as necessary. 6 Job Aid IT&S Training and Development, MSC