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vxJourney – vxVistA Webinars – Sponsored by DSS, Inc. www.vxvista.org

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Recorded Webinar: https://www.vxvista.org/x/0IAQ Streamlining the Medication Ordering Process for Prescribers. Become familiar with Pharmacy – ‘under the hood’ functionality in vxVistA Become familiar with the relationship of Pharmacy and Medication orders in vxCPRS Learn about Medication Order Checks

TRANSCRIPT

Page 1: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Page 2: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

www.vxvista.org

Sponsored by

www.vxvista.org

Sponsored by

Streamlining the Medication Ordering Process for Prescribers

Marvin Friedman, PharmDJeanette Klement, MAEd

Page 3: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

vxVistA and vxCPRS

• ObjectivesBecome familiar with Pharmacy – ‘under the

hood’ functionality in vxVistABecome familiar with the relationship of

Pharmacy and Medication orders in vxCPRSLearn about Medication Order Checks

Page 4: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Pharmacy Data Management

• Pharmacy Data Management provides:

– Tools for managing pharmacy orderable items

– Centralized control of pharmacy files and frequently used options into one location

– A new drug enter/edit option, which allows the user to edit fields for all pharmacy packages

– Ability to identify drug interactions

Page 5: vxJourney Orders

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Drug Enter Edit

• Allows users to make a new Dispense Drug entry into the DRUG file

• Dispense Drug formulary status is designated via this option and formulary alternatives may be designated for non-formulary Dispense Drug entries

• Dispense Drug entries may be marked or unmarked as a LAB MONITOR

• Allows the user to enter a dosage in a language other than English

Page 6: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Drug File

Page 7: vxJourney Orders

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Dosage File

• The Dosages option controls the entering and editing of dosages

• The Enter/Edit Dosages option allows you to edit Possible Dosages and Local Possible Dosages for a selected Dispense Drug.

• These dosages may be specified for Inpatient Medications, Outpatient Pharmacy, or both packages

• The BCMA UNITS PER DOSE field is used by Inpatient Medications to populate the Units Per Dose information for Unit Dose orders

Page 8: vxJourney Orders

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Dosage File (Cont’d)

• The Enter/Edit Dosages option allows the user to enter a dosage in a language other than English

• Entries in this file will be used as default values in the construction of the Outpatient Pharmacy prescription SIG

• PDM defaults to the values entered in the VERB, PREPOSITION, or NOUN fields. – e.g. Place 1 tablet under the tongue every 5

minutes for up to 3 doses as needed for chest pain.

Page 9: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Dosage File

Page 10: vxJourney Orders

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Application Use

• Identifies whether a dispensed drug is selectable for inpatient use, outpatient use, or both.

Page 11: vxJourney Orders

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Application Use

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Orderable Item

• These defaults will be displayed to the user during the medication order entry processes for all applications through which medication orders can be entered. – Dosage– Restrictions/Clinical Pathways– Medication Route– Dosing Frequency– Patient Instructions (Outpatient Use)

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vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Orderable Item File

Page 14: vxJourney Orders

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Medication Route File

• If an Outpatient Pharmacy expansion has been entered at the “OUTPATIENT EXPANSION” prompt, the Outpatient Pharmacy expansion portion of the medication route will appear as part of the SIG on the prescription label

• Determines that the order can be processed through the IV portion of the Inpatient Medications package

Page 15: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Medication Route File

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Medication Schedule File

• The set of times associated with the standard dosage administration schedules can be assigned, as can ward-specific administration times.

• Entry of a frequency in minutes allows the software to calculate the interval between dosages for Inpatient Medication orders

• The Standard Schedule Edit option allows the user to enter the outpatient expansion value in a language other than English.

Page 17: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Medication Schedule File

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Medication Quick Orders

• After the medication is setup in the Pharmacy module, a quick order can be created

• Quick orders will streamline the ordering process

• Quick orders are created with pre-defined fields

• Quick orders can be combined to create an Order Set

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Example of Quick Order for Warfarin

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vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

vxCPRS

• Medication Quick Order for Warfarin

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vxCPRS

• Warfarin Quick Order displaying pre-defined fields

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vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

vxCPRS

• Quick Orders are combined to create an Order Set – Diabetic Orders

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vxCPRS

• Order set orders are ready for signature

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vxCPRS

• Prescriber highlights orders and signs all orders

Page 25: vxJourney Orders

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Order Checks

• Order Check Examples Adverse ReactionDuplicate Drug ClassLab results needed before prescribing

medication

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vxCPRS

• Patient allergies are displayed in Patient’s chart on the Coversheet

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vxCPRSAdverse Reaction Order Check

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vxCPRSProvider must enter a justification before order can be signed.

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vxCPRS

Order Checks: Duplicate Drug Class and Missing Lab Results

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Pharmacist Overview of Pending Orders

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Pharmacist View of Allergies

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Pharmacist View of Prescriber’s Pending Orders

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Pharmacist Finishing Pending Order

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Pharmacist View of Order Checks

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vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Duplication Drug Class Order Check

Page 36: vxJourney Orders

vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.www.vxvista.org

Drug-Allergy Order Check

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Flag an Order

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Flag an Order

Page 39: vxJourney Orders

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Pharmacist View that Pending Order is Flagged

Page 40: vxJourney Orders

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vxCPRS

• Prescriber receives an alert

Page 41: vxJourney Orders

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vxCPRS

• Flagged order in vxCPRS

Page 42: vxJourney Orders

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vxCPRS

• Prescriber responds to the Pharmacist’s Flag

Page 43: vxJourney Orders

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Questions?Thanks!