Magic 5.67 ePrescribing and partial tabs | Forum

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Jan 11 '17
2017-01-11 18:36:43
Hello all,
We're in the beginning stages of implementing eRx with Dr. First and
curious about
how other e Rx facilities handled half and quarter tablet entries built in
their PHA and RXM drug
dictionaries.
Our facility policy is that pharmacy splits and packages all partial tab
doses, so we built these as
their own entries in PHA, RXM, and Omnicell drug dictionaries when we
implemented eMAR/BMV.
If you could share what your process was for handling these partials with
eRx, we'd greatly
appreciate it!
Thank you,
Nancy
*Nancy Leveille* | Pharmacy Applications Analyst
Heywood Hospital | 242 Green Street | Gardner, MA 01440
Phone (978)669-5916 | *nancy.leveille@heywood.org
<nancy.leveille@heywood.org>*

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Jan 13 '17
2017-01-13 20:30:34
Here’s a thought that we semi-implemented:
Create an RXM rule that doesn’t allow conversion of inpatient drugs to outpatient scripts if the inpatient drug is a half-tab, or other in-house fake product not matching the NDC’s actual unit strength and form. Hopefully you don’t have enough fake entries in your formulary for that to be problematic.

Andrew Ventura, Pharm.D, MBA
Pharmacy Informaticist, Information Systems
Augusta Health, Fishersville VA
C/S 5.67pp6 -->pp19 in progress.


Jan 16 '17
2017-01-16 17:15:37
Thank you to Chuck, David, and Kim for your helpful suggestions!
I've already begun the process of removing the partial tab entries from our
RXM dictionary and have a rule for Pharmacy that will prevent the RPh from
verifying partial tab dispense forms on our most frequently used
medications.
We did this initially to prevent the possibility of an error occurring when
editing the medication, both for our in-house pharmacists and the remote
service we use for overnight coverage. We unfortunately didn't have
e-prescribing in our sights at that time. As always, a lesson learned!
Thank you again!
Nancy


*Nancy Leveille* | Pharmacy Applications Analyst
Heywood Hospital | 242 Green Street | Gardner, MA 01440
Phone (978)669-5916 | *nancy.leveille@heywood.org
<nancy.leveille@heywood.org>*

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On Fri, Jan 13, 2017 at 3:21 PM, Chuck Bedel <cbedel@drfirst.com> wrote:
> This is straight from Medtiech actually:
>
> Considerations for RXM Users:
>
> -
>
> When an inpatient medication is converted to an outpatient
> prescription via the Discharge routine, a hierarchy will determine what RXM
> Drug will be used for the prescription:
> -
>
> RXM Drug Mnemonic linked to the PHA Drug - The system will check
> to see if the mnemonic of the inpatient medication from the PHA Drug
> dictionary is listed in the “PHA Drug” field on the General Information tab
> in the RXM Drug Dictionary. If the system finds an RXM Drug with the PHA
> Drug mnemonic in that field, this RXM Drug will be used for the conversion
> to an outpatient prescription.
>
>
>
> -
>
> NDC Number linked to PHA Drug matches NDC in RXM Drug Dictionary - If
> the system does not find an RXM Drug mnemonic match in hierarchy check #1,
> the system will check the NDC number linked to the PHA Drug in the PHA
> Drug Dictionary. The system will search for an exact NDC match in the RXM
> Drug Dictionary. If the PHA Drug's NDC exists in the RXM Drug Dictionary,
> the system has found a match and will use this RXM Drug for the conversion
> to an outpatient prescription.
>
>
>
> -
>
> RXM drug with same generic product code (GPC) and FSV trade name as
> the PHA Drug - If the system is unable to find an exact NDC match in
> hierarchy check #2, the system will check for another NDC in RXM that
> shares the same generic product code and FSV trade name as the PHA NDC to
> use instead.
>
>
>
> -
>
> If no match is found in hierarchy checks 1-3, the system will display
> the PHA trade name in brackets, indicating that the medication will convert
> to a free-text prescription in RXM.
>
>
>
> -
>
> If a half tablet drug dictionary entry is created in PHA using a whole
> tablet NDC, then the outpatient prescription that is generated in RXM will
> utilize the whole tablet NDC.
> - Note: For example, even though a PHA Drug may have been built with a
> strength of 12.5 MG, the RXM Drug will have a 25 MG strength due to the NDC
> that is referenced. The dosing (12.5 MG) information entered in PHA will
> carry over to the RXM prescription.
>
>
>
> What it amounts to in the end is that if you say are splitting Metoprolol
> Tartrate and you created a 12.5 mg version by copying the 25 mg version,
> when you go to “convert” or “write rx” in the end, if you did it correctly,
> that 12.5 mg half tab should automatically convert to 12.5 mg of a 25 mg
> tablet which would go over the eRx interface (i.e. DrFirst).
>
> DO NOT DO NOT DO NOT build the half tab entries in RXM.
>
> Now matching on the way in is much more problematic. If the patient is
> taking and is recorded as taking 12.5 mg of a 25 mg tablet, it will cross
> to pharmacy as 12.5 mg of the 25 mg tablet as well. Your pharmacists will
> have to manually switch it to the half tablet. You could easily write a
> rule to stop them from verifying it though if the dose is less than the
> strength or something. You could get creative.
>
> Consider for a moment that you are billing for the entire tablet/sending
> the NDC for the entire tablet. Should you actually be splitting the
> tablets or should you be dispensing the whole thing and letting nursing do
> the splitting? Just throwing that out there.
>
> Have a great weekend.
>
> *Chuck Bedel PharmD, RPh*
> Senior Consultant
> The IN Group, A division of DrFirst
>
> cbedel@drfirst.com
> (513) 348–4961
>
> On January 12, 2017 at 06:10:18, Leveille, Nancy (
> nancy.leveille@heywood.org) wrote:
>
> Hello all,
>
> We're in the beginning stages of implementing eRx with Dr. First and
> curious about
> how other e Rx facilities handled half and quarter tablet entries built in
> their PHA and RXM drug
> dictionaries.
>
> Our facility policy is that pharmacy splits and packages all partial tab
> doses, so we built these as
> their own entries in PHA, RXM, and Omnicell drug dictionaries when we
> implemented eMAR/BMV.
>
> If you could share what your process was for handling these partials with
> eRx, we'd greatly
> appreciate it!
>
> Thank you,
> Nancy
>
> *Nancy Leveille* | Pharmacy Applications Analyst
>
> Heywood Hospital | 242 Green Street | Gardner, MA 01440
>
> Phone (978)669-5916 | *nancy.leveille@heywood.org
> <nancy.leveille@heywood.org>*
>
>
> CONFIDENTIALITY NOTICE. This message is for the sole use of the intended
> recipient(s) and may contain confidential and/or privileged information.
> Any unauthorized review, use, disclosure, or distribution is prohibited. If
> you are not the intended recipient, please destroy all copies of the
> original message, including any and all attachments, and notify the sender
> immediately.
>