E-DISCHARGE MEDICATION MODULE Last updated: 7/25/2017 1 GETTING ORIENTED Shows most recent Home Med List Displays all med lists within San Francisco Health Network (SFHN)
e.g. eCW, Jail Health Services, Laguna Honda Create a complete Discharge Med List using Home & Inpatient med lists Send electronic or print paper rxs Find formulary & insurance info 2 STEPS
CREATE HOME MEDICATION LIST Required For Every Admit DISCHARGE MED LIST Imported to Discharge docs SEND PRESCRIPTIONS To Retail or Discharge Pharm. 3 STEP 1: Collect Home Meds Done By Provider or Med Rec Techs
HOME MEDICATION LIST Cannot start any discharge process until home meds are collected Required For Every Admit DISCHARGE MED LIST Imported to Discharge docs SEND PRESCRIPTIONS To Retail or Discharge Pharm.
4 STEP 1: Collect Home Meds HOME MEDICATION LIST Required For Every Admit To Request Home Med collection from Med Rec Techs Select Home Med Request under Collect Home Meds Expect 24 hr turnaround time DISCHARGE MED LIST Imported to Discharge docs
SEND PRESCRIPTIONS To Retail or Discharge Pharm. 5 STEP 2 HOME MEDICATION LIST Required For Every Admit Patients Instructions
Discharge Summary Discharg e Meds DISCHARGE MED LIST Outpatient Providers Imported to Discharge docs
SEND PRESCRIPTIONS Home Health Worker Accuracy Counts! Used by all KEY STAKEHOLDERS To Retail or Discharge Pharm. 6 STEP 2: Create Discharge Med List
Step 1: MUST select Eligibility Benefits to enable eprescribing. You cannot e-rx later if this step is missed. [choose any available option and then click complete] 1. 2. Step 2: Select Reconcile Discharge. 7 Step 3: Address all Home Meds
Tips Any Home Medication stopped (X), will be automatically noted in the Patient Discharge Instructions A BLUE arrow appears when a provider: Clicks the gray arrow to push the home med over to the discharge medication list. This med cannot be e-prescribed later e.g. telling the patient take your home supply Changes the home meds directions OR prescribes a new medication. To prescribe a home med, click on the med. Complete the Rx
fields and add to discharge meds. 8 Step 4: Address all In-house Meds Click X to stop any medication 9
This creates your discharge med list. Meds listed here = ALL meds the patient should take upon discharge This list is imported to the ePDP and patient discharge instructions 10 Add any new meds 11
To Prescribe a med, Select the med name Then fill out additional Rx information Be mindful of tablet strength (325mg) vs. Dose (650mg) 12 Always.AlwaysAlways
***HIT THE E-RX BUTTON*** when available Failure to hit eRX button will prevent you from e-prescribing a prescription !!! 13 Select Rx destination. Each row is an Rx with unique destination. TIP SFGH Discharge Pharmacy can be chosen by MDs without DEA license, i.e. interns
Retail Pharmacy Only DEA licensed providers can send eRX to Retail pharmacy. (ask Attending or R3 to send prescriptions) 14 Select Paper Rx for: 1. Any controlled medication TIP: schedule II meds, e.g. oxycodone, requires a secure script in addition to entering in discharge med list 2. All Supplies (e.g. test strips) TIP: supplies to any RETAIL (non-discharge) pharmacy must also be called in OR paper faxed
3. To hand a physical prescription to patient 15 To remove a med from Discharge List, select the med, then the Remove button 16 Save all work if navigating away
from this page **or it will be lost** 17 Complete the Discharge List after all meds are addressed 18 Clinical Checking will identify potential interactions
Click here to address the issue 19 Select appropriate choice or freetext reply, then hit Update 20 Green Triangle indicates issue is resolved. 21
****WARNING: hit COMPLETE or WORK WILL BE LOST** 22 The GRAY screen indicates your work is saved. (If you navigated away without saving/completing, you do NOT see this screen) 23 STEP 3
HOME MEDICATION LIST Required For Every Admit Final step Remember: interns cannot e-Rx to Retail Pharmacy (get attending/ R3) Even if not Rxing, discharge list should contain ALL meds patient takes upon discharge DISCHARGE MED LIST
Imported to Discharge docs SEND PRESCRIPTIONS To Retail and/or Discharge Pharm. 24 Select send eprescriptions 25 Prescriptions ready to send will have
both an icon and a quantity 26 You can change quantity/destination by selecting the medication then adjusting in Med Detail pane below **then hit UPDATE PRESCRIPTION* Or just hit Clear to deselect the medication 27
Red Triangle indicates a problem with rx 28 Here, problem is Rx #2 has no destination. Note: Retail Pharmacy grayed out. Why? 29
Because no Retail Pharmacy was selected. Use the Change button to select one. 30 No problems are present, (note Retail pharmacy selected). Ready to send Rx! 31
Icons indicate meds queued up to prescribed Electronically Or Printed 32 Hit Complete 33
LCR discharge medication reconciliation communication pop-up This pop-up will appear at the end of the medication reconciliation process. NO POP-UP = NO Rx SENT This is ONLY sent to the ZSFG Discharge Pharmacy. Community pharmacies do NOT receive this information. Free text message to pharmacy Click OK!
LCR Discharge Med Rec Pop-up: This is only to be used for communication with the ZSFG Discharge Pharmacy and will not transmit to any community pharmacies.
Anticipated DC time helps the pharmacy prioritize the filling of the prescription. Check boxes if the answer is YES! o Is a secure script en route for Schedule 2 (e.g. morphine)? o Is it OK to dispense 10-day supply of meds if limited by insurance? o Is patient being discharged to Medical Respite? o Will this patient benefit from more in-depth discharge medication education by a pharmacist? Msg to Pharmacy: Free text message to pharmacy. (e.g. If this is a repeat e-Rx, use the free text box to summarize the changes that you are sending to the Pharmacy.)
Issues That Arise ISSUE RESOLUTION I cant select a destination to send my Rx!
My med says free-text medication and I cant prescribe it I cant add a med due to invalid frequency
Im an intern/resident but not enrolled to e-Rx to Discharge Pharmacy 1. 2. Did you (or person who entered med) hit gray e-Rx button and do an Eligibility Request?
Perform those functions, remove med in question, re-add it Try removing medication from discharge list, then using the Search for New Med tab rather than using Home or InHouse med list Pagerbox Superuser to make aware of issue: 443-5794?? Last resort: keep free-text medication on DC med list, call in rx to pharmacy verbally Use a frequency from the drop-down list OR Use the alt dose field to write out sig free-hand Email [email protected] with the following: name, CHN #, NPI #, department and DEA (if you have it). Call the IT Help Desk 628-206-7378
36 Problems? 1. 2. Ask your Clinical Pharmacist (if available) Ask your Chief Resident 3. Discharge Pharmacy
4. If discharge pharmacy unable to help resolve the issue, ask for Med Rec Support pager # 327-0673 (business hours only) All help info and powerpoints available at: http://tiny.ucsf.edu/edischarge Last updated: 7/25/2017
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