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Create New Orders

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Create new orders by entering a new order, copying an existing order, or using an order group.  

► Notes
  • The process of checking for duplicate orders based on the order code will only check against existing orders of the same order category.
  • The Expected Days Supply field defaults to the value "30", which is the maximum.
  • Orders with a frequency code of One time only (1 x ONLY) are discontinued automatically when a successful administration event is recorded in myAvatar  eMAR. (Install Avatar eMAR 2007 Enhancement 37 (Update 65) or equivalent to make this capability functional.) 
  • The ability to require the reason code for orders can be based on the Order Type (Require Reason Code extended data element)  or the Require Reason Code registry setting value.
  • For systems integrated with RxConnect, use the Order Category dictionary extended attributes Maximum Value Allowed for Expected Days Supply and Maximum Value Allowed for # of Refills Allowed to specify maximum values that cannot be exceeded for a specific Order Category. The intended use is to allow the facility to define a maximum amount for the Days Supply and Number of Refills for leave and discharge orders. For example, if the Maximum Value Allowed for Expected Days Supply extended attribute is 15 for leave orders and the user enters 20 for the Expected Days Supply, an error message would indicate the Expected Days Supply cannot be greater than 15 for leave orders.

Role Based

Prior to final sign, physicians are presented with the opportunity to review details associated to the order including medication name, dose, route and frequency. Prior to final signature, it is the physician’s responsibility to ensure that all orders and details accurately reflect the therapy that is intended for the client. 

Order Duration

  • For new orders the duration does not become one day until the difference between the new order's Start Date/Time and Stop Date/Time reaches one full day (1,440 minutes, inclusive). This calculation applies to initial order durations of any number of days. For example, a new order's duration does not become two days until the difference between the new order's Start Date/Time and Stop Date/Time reaches two full days (2,880 minutes, inclusive).
  • An order is not allowed to be created with a duration longer than the one specified by the Maximum Eventual Order Duration extended data element of the Order Types dictionary.

Taper or Titration Orders

  • For individual taper or titration orders (not part of an order group), after filing each new order the user is returned to page two of the Create Order section. All fields in the Create Order section retain the values from the previous order in the series, with the exception of the following fields: Start Date/Start Time (value defaults to the previous order Start Date/Start Time plus one minute) and Duration (Days) and Stop Date/Stop Time (value is cleared).
  • When creating an order with a taper or titration order group, the Check here if entering a taper or titration series of orders field is selected automatically. The start date and time for each order will be calculated depending on how the order group has been defined. If the Start Date Offset is not used, each subsequent order in the taper or titration series of orders will have a Start Date/Time defaulted to a value equal to the previous order's Stop Date/Time plus one minute. If the Start Date Offset is used, each order's start date will be defaulted by adding the designated Start Date Offset (Days) value for that order group component order to the current date. In this situation the start time for each order defaults to the same value as the previous order.
  • When using a taper/titration order group, if the Basic Duplicate Order Code Checking registry setting is enabled, this checking is performed only on the first selected order within the order group.
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NCPDP Billing

  • Avatar Order Entry sends the Expected Days Supply, Number of Refills, and DAW values to RxConnect, where the information is used to generate pharmacy charges that contain NCPDP billing information sent to myAvatar PM.
  • The Number of Refills Allowed field defaults to a value based on whether or not it is a controlled substance. Non-controlled substances will default to '99.' C-I and C-II controlled substances will default to a maximum of '0', which is enforced. C-III, C-IV, and C-V controlled substances will default to a maximum of '5', which is enforced. This field does not apply to inpatient settings; it is used to support NCPDP billing, including Medicare Part D.

NCPDP Billing

  1. Go to: Avatar Order Entry > Order Entry Client Information > Client Profile / Physicians Orders > Create Orders
  2. In the Select Client screen, enter the client name or ID and select.
  3. In the Client Profile section, select the filters used to determine the orders available for selection in the Client Profile / Physicians Orders form.
  4. In the Create Order section, select the order entry source.
  5. For the Delayed Entry field, select if the order is delayed.
    Note: If the client has been discharged it is recommended the order be delayed. Delayed orders are filed after the order has been given to a client.
  6. In the New Order Will Be For Episode field, select the client episode.
    Result: A dialog box displays if the client episode has a discharge date before the current date. If appropriate, the order should be a delayed entry.
    Use the Default Latest Ep. in Create New Order registry setting to default this field to the latest/current episode or the latest/current inpatient episode or only inpatient episodes.
  7. In the Order Category field, select the order category. Use the extended attributes for the Order Category dictionary to enforce maximum allowed values for Expected Days Supply and # of Refills Allowed.
  8. Use one of the following options to create the new order:

Direct Entry of New Order

  1. For the Order Type field, select the order type.
    Note: If Pharmacy Orders is selected, complete the Pharmacy Order Types section. 
  2. In the Order Code field, enter the order code.
    Note: If the order code was set up with an age/problem alert, a message displays notifying the user of the alert and requesting the entry of an override reason to continue with the order.
  3. In the Order Text field, enter text that identifies what is being ordered. 
    Note: Use this field to clarify what the order code refers to.
  4. For the Order Guidelines field, enter guidelines for completing/administering the order.
  5. Optional. In the Check here if entering a taper or titration series of orders field, select if the order is a taper or titration order.
    Note: It is desirable to have each step coincide with one or more full calendar days. To do this, set the order start time to 12:00 AM, which results in an order stop time of 11:59 PM.
  6. In the Check here if this order is a FIRST DOSE of this medication field, select if the order is the first dose of medication.
    Note: This field is used by myAvatar  eMAR (if installed) to set a corresponding First Dose field on the Administration Event screen until a successful Administration Event is filed for the order.
  7. For the Quantity and Quantity Unit fields, enter the order quantity and the quantity unit. 
    Note: If the quantity and quantity unit are not entered, select Dose Calculator to calculate the dose for the client and automatically populate the Quantity and Quantity Unit fields. The ability to require the Quantity and Quantity Unit fields can be based on the Order Type (Require Quantity and Quantity Unit extended data element) or the Order Code. 
  8. In the Frequency Code field, enter the frequency code.
    Note: The frequency code can be made required by using an extended attribute of the Order Types dictionary.
  9. In the Routine or PRN (As Needed) field, select how the order will be administered.
    Note: If a frequency code is used, this attribute is taken from the frequency code and cannot be changed.
  10. In the Special/Additional Instructions field, enter specific order instructions to associate with a frequency code, or for an order without a frequency code.
  11. Optional. If entering a diet order, select Additional Order Details.
    1. In the Additional Order Details dialog, select diet restrictions.
    2. Enter diet supplements. 
      Note: If a Dietary Oral order type is selected and there is already a Dietary Oral order in existence, a warning displays if the Allow Only One Active Order At a Time extended data element is set to Yes (Order Types dictionary).
  12. In the Reason Code field, enter the reason code.
    Note: Reason codes defined as Standard/Preferred reason codes display in bold at the beginning of the search results whether or not they meet the search criteria. To restrict the reason codes available for selection based on the order code and order type, use the following options:
  1. In the Reason Text field, enter reason text for an order that does not have a defined reason code.
  2. Select Dose Calculator to calculate the dose to administer.
  3. In the resulting pop-up, enter the client's weight (in kg), the dose/kg value, and the unit. Select Calculate.
    Note: The Dose field displays the resulting dose to administer.
  4. Select Accept, then Close.
    Note: The Client's Weight (kg) field defaults to the value from myAvatar  CWS.
  5. Optional. If appropriate, in the Diagnosis Code field, enter the diagnosis code.
    Note: Diagnosis codes are maintained in the Diagnosis Table Maintenance form (RADplus Utilities).
  6. Enter information in the Order Date and Time and Start Date and Time fields.
    Note: The start date can be a future or past date.
  7. If the Make Order(s) Open Ended field is enabled through the Allow Open-Ended Orders registry setting, select whether to make the order open ended.
    Note: Open-ended orders have no duration or stop date. If the order is not open ended, enter the duration in the Duration (Days) field.
    If the Support Duration In Hours/Minutes registry setting is enabled, the Duration( Hours) and Duration( Minutes) fields display for specifying the order duration in any combination of days, hours, and/or minutes.
  8. Enter the durations.
  9. For the Current Stop Date and Current Stop Time fields, enter the order stop date and order stop time.
  10. In the Comments field, enter comments about the order.
  11. In the Ordering Practitioner field, enter the ordering practitioner name or ID and select.
    Note: The Ordering Practitioner field is populated with the staff member associated with the user if Yes was selected for the Use Staff Member As Ordering Practitioner field in the Order Entry User Definition section of the Order Entry User Definition form.
    If the practitioner is not enrolled in the facility, enter the practitioner name in the Ordering Practitioner Who Is Not Enrolled field. Practitioners are enrolled in the Practitioner Enrollment and Practitioner Enrollment (Brief) forms of myAvatar PM.
  12. In the For NCPDP/Outpatient/Partial Hosp. And Leave/Discharge Orders section:
  • In the Expected Days Supply field, enter the number of days the order is expected to cover. This value is required for all pharmacy-type orders. 
    • This field typically has no relevance in an inpatient setting, but is being captured to support NCPDP billing requirements, including Medicare Part D.
    • If NCPDP Billing is enabled, this field defaults to the number entered in the Default Fill Days Supply field of the NCPDP System Defaults form. If NCPDP Billing is not enabled, the number defaults from the Default Settings For Processing An HL7 Inbound Charge Batch form, which resides under the myAvatar HL7 2004 product. If this form is not installed, or if this prompt contains no value, then a default value of 30 is used. The system does not allow the default value for the Expected Days Supply to exceed 30.
  • For the Quantity To Be Dispensed field, enter the order quantity.
  • In the Number of Refills Allowed field, enter the number of refills. This field is required for all pharmacy-type orders (inpatient and outpatient).
    Typically, this field has no relevance in an inpatient setting but is being captured to support NCPDP billing requirements, including Medicare Part D. The value in this field sometimes defaults in, only for pharmacy-type orders, to maximize the dispensing that can be claimed against the order before that order must be re-written.
    • For non-controlled substances a value of "99" will be defaulted.
    • For controlled substances with a DEA schedule of C-III, C-IV or C-V a value of "5" will be defaulted.
    • For controlled substances with a DEA schedule of C-I or C-II a value of "0" will be defaulted.
  • In the Dispense as Written (DAW) field, select Yes if the order is DAW. DAW orders prevent the medication from being substituted with a generic equivalent. This field is required if the client is assigned a guarantor that is defined as an NCPDP guarantor.
  1. If the order entry source has the Require Read-Back Confirmation extended dictionary set to Yes, the Confirmation: This Order Was Read Back To The Ordering Practitioner field displays. Select Yes if the order was read back to the ordering practitioner. This setting is typically used when placing verbal or telephone orders.
  2. In the Customize Frequency Code Attributes field, select Yes to enable the time-related attribute fields.
    Note: The time attributes can be specified even when a frequency code is not used.
  3. Specify the time attributes for the order.
  4. The Problems field displays only if the client has problems recorded in the Problem List form (Avatar CWS).
    Note: This field displays all problems affiliated with the client and allows the user to associate those problems with an order.
  5. Select the problems.
  6. Select Preview Order Notification and either File Data or File Data And Print Order.
► Additional Sections
► Registry Settings
► See Also