Medication Reconciliation configuration
Medication Reconciliation allows providers to easily convert prescriptions or client-reported medications to inpatient orders on admission and inpatient orders to prescriptions on discharge. In myAvatar Order Entry use the registry settings and the product substitution capability described here to configure medication reconciliation for your organization.
Registry settings
The registry settings listed here provide configuration options that control the behavior of Medication Reconciliation within myAvatar Order Entry.
- Enable Medication Reconciliation in the Order Entry Console
- Enable Dose Conversion During Medication Reconciliation
- Create OE Discharge Order during Discharge Medication Reconciliation
- Internal Pharmacy Fills Discharge Orders
- 'Medication Category' codes to retain 'Stop Date' in OE Console (Disch. Med Rec)
- Require 'Discharge Disposition' in OE Console (Discharge Med Rec section)
- Default for 'Discharge Disposition' in OE Console (Discharge Med Rec section)
- Prevent Admission Med Reconciliation if med history not completed on Home Meds
Product substitution
Use the Product Substitution Setup form in myAvatar Order Entry to configure product substitution at your organization by identifying a therapeutic or product substitution for any given order code in the system. For the scenario described in this article, Prevacid 15 MG Oral Tablet has been identified as the P&T approved substitution for Prilosec 10 MG Oral Tablet.
myAvatar Order Entry leverages the Micromedex CGID to determine the appropriate match for the inpatient order during medication reconciliation. During Admission Reconciliation, the system looks for an exact CGID match. If the originating order is a Brand product (for example, Advil) and is marked as non-formulary, the system looks to determine if a Generic product is on formulary (such as Ibuprofen). If so, the system automatically switches to the generic. In this instance a substitution icon displays on the resulting inpatient order with a hover indicating to the provider what has occurred.
For every product substitution defined, your organization has the following options:
- Product Substitution - The system does not honor multiple 'chained' substitutions. If a product (for example, Prevacid 15 MG Oral Tablet) is defined as a substitution for another product (for example, Prilosec 10 MG Oral Tablet) it cannot have a substitution defined for it, nor can that product be deactivated until it is removed as a product substitution. This configuration is honored during File Import as well. Product substitution only occurs during medication reconciliation. It does not occur when the order is placed via Orders This Episode.
- Equivalent Dose - This option indicates whether or not the dose can be transferred safely from the original order (for example, Prilosec 10 MG Oral Tablet) to the resulting order (for example, Prevacid 15 MG oral Tablet). If set to 'No,' neither dose nor frequency populates the new inpatient order.
Note: Dose will only carry over when set to 'Yes' and if the medication is an oral solid or oral liquid of the same concentration.
- Dosing Instructions/Guidelines - This text is available in the hover over the substitution icon upon substitution and allows an organization to provide guidance to the provider. In the example of substituting Prevacid for Prilosec, these are the dosing instructions:
This text is also available at the time of accepting or rejecting the substitution if the system has been configured to prompt the user.
- Method for Product Substitution - This option indicates whether or not the substitution is automatic or whether or not the physician is allowed to reject the substitution during admission.
