Allergies/Medications Tab Summary View

To access the Meds Tab in a patient’s e-chart, click E-Chart on the left sidebar menu.
Search for the patient you wish to view. Get into the patient’s file.
Click the MEDS tab at the top menu in the patient’s file. The MEDS summary screen pops up. This screen is the same screen you would see if you clicked the List link on the right top options also.
If patient has NO allergies/intolerances entered, and/or NO medications entered, the screen will give you a message that says Allergies have NOT been entered for this patient. Then you would either go add allergies/intolerances by clicking Add Allergy/Intol or Quick Allergy (see other instructions within this document) or you click the Document patient has No Known Drug Allergies (NKDA) from this screen.
Same for Medications have NOT been entered for this patient. You would enter or prescribe medications (see other instructions within this document) or you click the Document patient has No Medications from this screen.

You can undo NKDA or undo No Medications for the patient. Undo would mean that a user has tagged this patient as having No allergies and/or No Medications. A user can undo the category because either 1) it was done as a mistake/in error or 2) now need to add an allergy/intolerance and/or medication for this patient.
You do not have to undo a category. You can bypass this by clicking the prescribe or quick add hyperlinks in the Meds tab to add/prescribe meds or add allergies/intolerances.

If a patient does have allergies or medications entered into the Meds tab, it will list the allergies, refills due (if any) and medication history on this screen (instead of showing the previous).

Allergies/Medications Lists

Allergies & Intolerances

This will list any entered allergies or intolerances. If a patient does have allergies/intolerances entered, it will then list:

• Allergy Name: Product or item the patient is allergic to. Can click on underlined product/item name and add another reaction to submit.
• Type: Allergy or Intolerance
• Reaction: How patient reactions to this product or item.
• Entered by: Username of person who entered this allergy or intolerance. Can click on underlined username to view the user and their Enterprise Health status information.
• Date Modified: Date this allergy or intolerance entered or last modified.
• Options: Delete. Click this to delete the allergy or intolerance from this patient’s history. Type in a reason and submit.

If a user has entered NKDA for the patient, it will say This patient has no known drug allergies (NKDA) and the list view shows zero results.

Next to the heading title Allergies and Intolerances there is the option to show/hide deleted.
If click show deleted the Allergy/Intolerance summary screen will show all allergies/intolerances ever entered for this patient. It shows the deleted ones and under reaction will be the reason it was deleted (if a user typed something).

Under options it shows deleted if allergy/intolerance was deleted which gives no further option to modify, etc. If only want to see active allergies/intolerances then click hide deleted and it does not show any deleted allergies/intolerances in your view.
To add an allergy or intolerance: click either hyperlink Add Allergy/Intol or Quick Allergy at the top right.

• Add Allergy/Intol: Will allow you to add an allergy and/or intolerance one at a time.
• Quick Allergy: Will allow you to add 10 allergies and/or intolerances at a time.

Add Allergy/Intol.

Allergies/Intolerances show up in a list in the medication history screen, and also at the top of any other tab you are working in for a patient.
See other separate help documentation called Allergies and Intolerances for help on how to add/edit/delete allergies and intolerances.

Pending E-Refill Requests

The next section will show any Pending E-Refill Requests if your practice uses the electronic e-refills queue which allows users to work incoming electronic refill requests from pharmacies using the E-RX tab.
This will only show up if your practice is using the E-RX tab and has that feature turned on for the physicians.
If your physician is set up to work the e-refills queue, they will now see pending e-refill requests in the patient’s e-meds tab. They can see any pending e-refills specific to that patient that need worked (are pending) if they’re working in a patient’s chart. This saves a step of having to go to the E-RX tab to find the refill for that patient. This will only show up for the physician who has been set up with SureScripts to receive E-Refill requests. Other users will not see this pending e-refill requests section, unless they have security rights to manage e-refills for others.

IF the physician or any other user has security to MANAGE E-RX REFILLS FOR OTHERS, then they will also see ALL pending e-refill requests specific for that patient and it will denote which prescriber the e-refill is pending for.  These people with rights can work these refills from here also instead of going out to the E-RX tab also.

Refills Due

This summary box will show if your system setting for it is on to display this section.

This section shows medications that are due for refills according to the Medications in the history input below. Only meds that were prescribed without a discontinue date will appear here.
This refill screen means that the prescription has expired according to the original duration and original number of refills on the original prescription.

• Drug Name: Shows brand name on the left. Under that at the right it shows the generic brand name. Can click on these underlined drug names to view drug info that was input (also shows below in the Medication History). If you click on the specific drug name in the refills due column, it will show detail and also will show any comments. If longer than 20 characters, it will have a trailing (…). The whole comment can be read by hovering the computer mouse over the comment text.
• Next Refill Due: Due date of refill.
• Pharmacy Note: Displays any notes to pharmacist for that medication if system setting is turned on.

To refill from this queue, simply click the Refill hyperlink in the options column. Medications fall into this queue when the original prescription is marked ‘expired’ according to the duration and number of refills that were entered on the original prescription. Down in Medication History it shows this medication as expired also.

• Refill Date: click today. Sig stays same. If you need to edit a sig- you have to go down to the Medication History and select that med and click edit. Refills do not allow you to ‘modify’ the therapy of the drug except for duration and refills.
• Duration: Type # of days or weeks this prescription is good for. Type d for days (example: 30d for 30 days) or type w for weeks (example 3w for 3 weeks) or type y for year (example: 1y for 1 year) or type m for month (example 2m for 2 months) Or can be a combination of weeks, days, etc (example: 3w 2d for 3weeks 2days. If you forget to type d or w or y, and then use your tab key—it will default to w for weeks).
• Quantity: Use your tab key and it will automatically calculate the quantity for you, or allow you to free-type quantity.
• Refills: Type in # of refills allowed for this prescription.
• May Substitute (allow generic): Yes or No Each physician can specify their own list of drugs that they never want substituted. When MIE loads these, regardless of Yes or No to allow substitute, it will print their signature in ‘dispense as written’ field. This specific list and capability is tied to the prescribing physician. (MIE has to load these requests)
• Prescriber: Select person prescribing this refill.
• Managed By: Type in person/physician this drug is being managed by.
• Comments: Type any comments. This does not print on the script. This is just for office comments.
• Print/Fax Script: Select if you want to print/fax this or not. If you don’t, it will just input this prescription into Enterprise Health and not print for the patient or fax to a pharmacy. Click Prescribe Refill to submit. (Or Cancel to get out and start over). It then takes it out of the Refills Due summary and puts this new refilled prescription therapy down in Medication History. Shows when it was refilled (what you just did) under Office Comment column.
• Task Prescriber for Approval: This may or may not show up depending on how your system is programmed. If your system setting is set to have the ‘option’ to be able to task a provider, you will see a check-mark option to task this refill for approval. Check-marking it will task the provider for refill approval via a task before anyone can print or fax the refill. Uncheck-marked means the user can go ahead and refill this medication without approval and render it in the print/fax queue.

If your system setting is set to mandate all refills are to be tasked and approved by a provider before rendering the printed or faxed refill, you will see this message at the top. Upon prescribing the refill, it will then task the provider first for approval. (See other help documentation named Refill All Meds.pdf for further explanations.)

Medication History

View the detailed list of medications that this patient is on, has been prescribed, or has discontinued, etc.

• Drug Name: Shows brand name on the left. Under that at the right it shows the generic brand name. First DataBank announced in Sept 2010 of an enhancement to generically named medication concepts. To comply with the Institute for Safe Medical Practices (ISMP) standards, FDB has lowercased the first letter of each ingredient in the generically named medication descriptions. Can click on these underlined drug names to view drug information that was input. (When it was refilled, when it was modified, when it was printed or faxed or e-sent (electronically transmitted via SureScripts feature). If click the blue-circled for this drug, it will pop up the drug guide and information concerning this drug. This is an information link that brings up drug guide information for recommended dosage, drug interaction information, side effects, etc. Close out this screen using the X at the top right. If the drug has an asterisk next to it, that means it is a drug that is not found in the known drug listing/guide.

* Sig: Directions for label/patient on how/when to take this medication. This also pulls the ‘special instructions' field when prescribing a drug. To see the full special instructions simply hover your mouse over this section and it will display the whole text in a box on your screen. * Qty: Shows quantity of the medication that was prescribed. * Ref: Number of refills the original prescription was written to include. * Comment: Shows office comments that were typed in those fields when prescribing a drug. Shows any conflicts with this medication vs patient's allergies. Shows any duplicated drug therapies and what the drugs are. Shows date of a prescription refill a Enterprise Health user did for this drug. Shows reason why changed or edited. If viewing deleted meds then shows reason why drug was deleted. Also will any fax information (when prescription was faxed and who to) and shows any transmit information (electronic transmit to pharmacies). If this drug prescription was electronically transmitted, each prescription will now show the date it was initially sent to the pharmacy as well as when any e-refill requests were approved or denied (if your practice utilizes the SureScripts e-refills feature). Additional information of who prescribed the medication, the pharmacy it was sent to, and any additional notes can be found by clicking on the date. To see this information, simply click on the E-sent or E-Refill date link in this comments column for the drug.

• Start Date: Date that was entered when to start this drug or date prescription was given.
• Options: Shows end date, discontinued, if drug is expired, changed or will discontinue. (If wish to see/hide the meds in this list that are discontinued, click the Show/Hide Discontinued option). Also gives you these options:
  • Edit: Allows you to choose to change therapy of the drug or correct error on the prescription. See directions on how to perform these options below in How to Edit a Prescription Already Done
  • Delete: Only delete a drug if it is entered in error or is on the wrong patient, etc. If a patient has stopped using this medication, you would choose discontinue. A warning box will appear when you click delete to specify this also. Type in the reason you are deleting the drug and click Submit.
  • Discontinue: Only discontinue a drug if the patient is no longer taking the medication or you want to have the patient stop taking this med, etc. Type the date discontinued and reason for discontinue. Click Simply Discontinue, or Mark Intolerant, or Mark Allergic, or Cancel. Mark Intolerant or Allergy will automatically put it in the patient’s Allergies/Intolerants summary. To discontinue multiple drugs at once, go to Quick Add and scroll down to check-mark boxes of drugs to discontinue with a reason. However, this will not allow you to mark it as intolerant or as an allergy and will not put that drug in the patient’s Allergies/Intolerances summary if that is the reason for discontinuing the med.
  • Refill: See directions above in Refills Due.
  • Reprint: The “Reprint” link on the medication list will only be available for 5 days after the prescription is written. In the options column, it will also show status of prescriptions. For example it will show if the prescription has been Changed or if the prescription has been Discontinued or if the prescription is Expired, etc.

• If it says Changed on the far right options column then someone changed the therapy of the original prescription and the modified one is in this summary with the other options available (if you are “Showing Discontinued). This history summary screen saves and shows any changed/discontinued drug prescriptions—unless you choose to hide discontinued from the top.
• If it says Discontinued then the prescription had a discontinue date entered upon prescribing, or it was manually discontinued by a user so the patient should or did stop taking the drug.
• If it says Expired then the physician provided an end date (a specific duration date) for the length of the drug (a date the drug should stop being taken), and didn’t provide any refills. Ex: A physician prescribed an antibiotic for 4 days (duration=4d) and no refills. The drug would show Expired in this history view after the 4^th day the drug was prescribed. At the top, next to the heading Medication History there are the options to show/hide classes, show/hide deleted, show/hide discontinued, show/hide modified by, show/hide prescriber, separate/together outside meds, & save view.
• Show classes to show the column of DRUG CLASSES that displays the drug classes all drugs falls in.
• Hide classes to not show this column for the drug classes.
• Show deleted to show all drugs that have been deleted.
• Hide deleted to not show these deleted drugs with this status.
• Show discontinued to show the drugs or original prescriptions that have been discontinued or changed/edited.
• Hide discontinued to not show these drugs with this status.
• Show modified by to show the column Last Modified By. This shows date and username of who last did anything to this drug/prescription.
• Hide modified by to not show this column of who and date modified.
• Show prescriber to show the column Prescribed By. This shows the username of the person that prescribed this drug/prescription.
• Hide prescriber to not show this column of who prescribed the medication.
• Separate outside meds to split the medication history into 2 different categories. Medications-In House will appear first and list all the medications that were prescribed by your practice. Medications-Other will appear next and list all medications that were entered for a patient that were prescribed by an outside source other than your practice.
• Outside meds together to list all of the patient’s medications as Medication History. Nothing will be split up by where it was prescribed. Click save view to save the options you have choose to hide or show. This saves the way you like the display for the next time you log in. Anytime you make a change in show/hide then you can click save view again and it will save those settings then for the next time. There is also an option that can be turned on for your system that will separate In-House medications (meds that are prescribed by you, the practice) from Other Medications (meaning medications prescribed outside of the practice). If this is turned on, you will see 2 categories:
• Medications – In-House means these meds were prescribed by a physician within your practice.
• Medications – other means these meds were prescribed by an outside source or an over-the-counter that the patient is listing as taking. You can turn this off of your view by clicking Outside Meds Together (see below screenshot) and it will merge all the medication lists together and you won’t see them separated by In-House vs Other. It will show them all as MEDICATION HISTORY.

If you wish to view them as separate categories again, then simply click Separate Outside Meds and it will show them as separate categories again.

Unmatched Refill Requests

This is where you can view any unmatched electronic refill (e-refill) requests for that specific patient’s medication history if you utilize the SureScripts e-refills feature. The drug requests showing in this unmatched refill requests section means an electronic refill request was able to be matched to this specific patient, but not matched to an actual drug/medication on the patient’s medication list.

List Quick Link

Click this to show the list of everything. It is exactly the same view/list as you see when you click on the tab called MEDS above in the patient’s e-chart tabs. You can do everything here as you can when you click MEDS tab and see the summary view.

Medication History Specifics

When in the Medication History (list) section of a patient’s e-meds screen, you can click on the underlined name of the medication in their system to view a few status categories for that prescribed med.

A summary of the prescription will appear in the center. You can edit a prescription from here.

Other categories found below the edit section are:

• Refills: shows a list summary of when that med was refilled.
• Medication Revisions: shows a list summary of all revisions done to this medication.
  • When: When the change/revision/edit was made.
  • By: Who made the change/revision/edit.
  • The other categories display what the Drug Name/Prescriber/Sig/Start Date was prior to any edit/change/revision. Shows the history of revisions and what all was changed each time.
• Printed/Faxed Dates: shows a list summary of all printed/faxed dates & information regarding this medication.