Home Medications Section

Before You Begin

• The Enable Home Medications in the Order Entry Console registry setting must be enabled.

Details

This provides the end user with an alternate user experience from the native OrderConnect user experience. There is no specific configuration required for Home Medications within myAvatar beyond user configuration within Order Entry User Definition, frequency mappings and registry setting outlined in previous section. All standard OrderConnect configuration must be completed. Please refer to that documentation for appropriate setup and configuration. 

 The approach with the Home Medications was not to deliver 100% of the planned functionality in the initial release. Our goal is an agile and iterative approach to the development which has impact on the functionality that is available at any given time. Please review the list of capabilities below and ensure that your organization does not require any of the functionality below prior to implementing the console. If an item has been identified as planned, please contact your Netsmart representative to determine if it has been released. Also, functionality released via OrderConnect will not necessarily be automatically available in the OrderConsole. If you have specific questions regarding planned functionality for OrderConnect and its timeline for availability in Home Medications, please contact your Netsmart representative. 

Current OrderConnect Functionality Not Supported in myAvatar ePrescribe	Planned
Drug-food, drug-ethanol, drug-lab, drug-tobacco, drug-disease, drug-pregnancy, drug-lactation, general precautions interactions, warning generated from validate profile, age-based alerts, unknown severity Alerts supported by myAvatar ePrescribe:  Drug-drug, drug-allergy, therapeutic class duplication, therapeutic class antagonism, ingredient duplication	Yes
Custom alerts	Yes
Commonly Used Note to Rx	Yes
Variable Dosing within Titrations myAvatar Supports:  Taper/Titrations and Variable Dosing, just not within single order	TBD
Default in Days Supply from ISC Admin Conscious decision to ensure PRN medications for controlled substances do not default in full 30 day supply when inappropriate	TBD
Prescriber Commonly Prescribed	Q2 2017
OrderConnect  Commonly Prescribed	No
Lab Orders Out myAvatar supports: System currently supports launch from myAvatar ePrescribe to OrderConnect for easy access.	Yes
Refill Requests myAvatar supports: System will support launch from myAvatar ePrescribe to Prescriber’s desktop for easy access	No
Current OrderConnect Functionality Not Supported in myAvatar ePrescribe	Planned
Drug-food, drug-ethanol, drug-lab, drug-tobacco, drug-disease, drug-pregnancy, drug-lactation, general precautions interactions, warning generated from validate profile, age-based alerts, unknown severity Alerts supported by myAvatar ePrescribe:  Drug-drug, drug-allergy, therapeutic class duplication, therapeutic class antagonism, ingredient duplication	Yes

Details 

Physicians are able to filter the view by Status (i.e., show only active orders) or by Date Range (i.e. show all orders from the past 12 months).

Physicians also have access to links that allow them to view the most recent vitals, lab results, and more as they make their ordering decisions.

• Recent Vitals displays the last 72 hours of vitals that have been recorded for the client. 
• View Lab Results launches the existing Lab Results widget and allows physicians to view lab results from within the ordering conversation.
• Order Labs launches the OrderConnect Current Order Profile, from where physicians can create and submit new lab orders for the currently selected Program.
• External RxHx launches the OrderConnect External RxHx tab to allow physicians to view Surescripts records.
• Prescriber's Queue launches the OrderConnect Prescriber's Queue to allow prescribers to view/approve/deny refill or change requests.

 

The table view includes the following:

• History - This includes both the individual order history (who ordered, who verified in the pharmacy, who reviewed in nursing, who completed, who discontinued) as well as the order code history (when has this exact order been placed in the past, by whom).
• Order Type - This indicates the type of order (i.e., Prescription, Client Reported), and the OrderConnect Rx ID number.
• Order Details - This includes not only the description of the order being placed (i.e., Haldol), but also specific order details appropriate for the order type (i.e., Dose, route, form, frequency, instructions for medications).
• Order Status - This indicates the current status of the order (i.e., Ordered, Discontinued).
• Start Date - This indicates the start date for the original order.
• Stop Date - This indicates the stop time for the order.
• Ordering Physician - This shows the ordering physician responsible for the order.
• Last Compliance - This indicates the last time compliance was documented for a medication order. Clicking the View button allows the user to pull all compliance documented for the specific medication over time.
• Fill Status - This displays the fill status information from the pharmacy, when available.
  When a transaction has been received from the pharmacy, the date and status of the fill is shown.
  A Click here for more link also displays for Partial and Not Filled transactions.

An additional icon  is available to indicate when prescriptions were unable to be sent successfully via the Sure Scripts network. When clicked, the user will be presented with a cross-client list of orders that need to be resent or reprinted to communicate the order to the pharmacy. Users will also have the option to cancel the alert. When selected, the use will cancel the retransmission, but the order will remain. In these rare situations, we anticipate that the order has been communicated a different way or that the user will need to discontinue the order and retransmit.

The  icon indicates that the logged-in practitioner has pending orders in OrderConnect that require approval. The accompanying number indicates how many.

At the bottom of the table view, clinicians are presented with order actions that are available based on the items selected in the table view. The available actions include:

• D/C - Only available when an order or orders are selected in the table view, this will present the physician with the details required to discontinue an order.
• Reorder - Available when one or more orders are selected, this allows the user to copy selected order details to new prescriptions.
• Modify - Only available when a single order is selected, this will copy the selected order to a new order and discontinue the original order. The physician will have the option to modify all details prior to signing.
• Make Rx - Only available when a client-reported medication is selected, this will copy the details of the selected order to a new order. The physician will have the option to modify all details prior to signing. A Stop Date is added automatically if one is not already defined that is prior or equal to the current date.
• Validate -  Only available when the current clinician has signing privileges and the order(s) require validation. This option allows the clinician to validate pending orders and transmit to pharmacy.
• Reject - Only available when the current clinician has signing privileges and the order(s) require validation. This option allows the clinician to reject pending orders and cancel transmission to pharmacy.
• Reprint - This allows the user to reprint a prescription.  All prescriptions that were submitted to OrderConnect at the same time will be returned in the PDF to the user.

Details

The details available will be coded in the system inherently. The following details are available for new orders based on the Order Type Category which is a system-defined (locked dictionary) value:

Order Type	Details
Prescription	Dose, Dose Unit, Route, Frequency, Form, Diagnosis, Start Date, Stop Date, Refills, Days Supply, Dispense Quantity, Dispense Quantity Unit, Earliest Fill Date, Directions, Note to Pharmacist
Client Reported	The same fields available for prescription writing are included when documenting a client-reported medication. However, not all fields are required.

The following details are available for the following order actions: 

Order Action	Details
D/C	Discontinue Date, Discontinue Time, Discontinue Reason
Copy	All new order details for order type category
Make Rx	All new order details for order type category
Reject	No details display
Validate	No details display
Reprint	No details display, user is presented with PDF to reprint selected prescription

Details

Physicians are regularly interrupted during the course of their day. By creating a Scratchpad, physicians can easily see the orders that have been queued and awaiting signature and then sign all orders in one action. From within the Scratchpad, users are able to remove items or edit items prior to signing. 

Scratchpad Feature	Behavior
Remove from scratchpad	Removes the selected order(s) from the Scratchpad.
Program	Populated with facility-applicable programs.
Ordering Practitioner	If the current user has ordering privileges, the user name will default in. If the current user does not have ordering privileges, the user will be required to select a practitioner.
Source	This drop-down allows the user to select the source of the original order (Original Computer Entry, Verbal Order, etc). This looks to the xxx dictionary for selection options and the Order Entry User Role/User Definition for the default.