NewCrop erx with MI2 OpenEMR

Transcription

1 NewCrop erx with MI2 OpenEMR Workflows: (click to follow link to section) OpenEMR Settings to Be Aware Of Initial Setup - NewCrop erx Log into NC erx Build Master Lists Build / Edit Healthplan Master List Build/ Edit Pharmacy Master List Link Insurances and Pharmacies to Patient Midlevel Provider Select Supervisor Medication Order Tasks Order a medication Search for medication Medication Alert Compose Prescription Print out Prescription Delete/ DC Med Approve/ Leave for Staf 'Instant Refill' Medications Status Screen Doctor's List of Favorites Add Med to Doctor's List Use Doctor's List of Favorites Drugsets Create Drugset Prescribe a Drugset Delete Drugset or Drugs in Drugset Add Allergy Allergy Alerts Edit/ Delete Allergy Synch with OpenEMR Medication Literature Sources Administrative Tab Summary Navigation and Other Tips for NewCrop erx The NewCrop Panel Screen Objects Related Buttons Multiple Access Routes Med Entry /vs/ Compose Rx Navigating the Tabs Reprint a Prescription Appendix 1 NewCrop Data Requirements Appendix 2 NewCrop erx Roles Appendix 3 NewCrop Global Settings

2 OpenEMR Settings to Be Aware Of These settings may have been made by MI- Squared prior to your initial go- live. However, if you need to add or modify facility information or add a provider or other erx user, the steps below must be observed. Special characters are any characters besides numbers or letters. Facility Settings: 1. Left nav menu: Administration -> Facilities. 2. Select facility that will connect with NewCrop erx Edit Facility dialog items: 3. Name: only letters and numbers, no special characters 4. Address: no special characters 5. City: no special characters 6. State: ONLY use 2 character state ID. 7. Country: just leave it US: 8. Phone (also Fax): in format (111) Zip code: either 5 or 9 digit, but all one chunk of numbers, no hyphen 10. Tax ID: Always use EIN ; leave out 'slash' character (above) WARNING: Once entered, DO NOT CHANGE EIN and 'SAVE' button clicked. It serves as the facility's NewCrop erx account number

3 11. Facility NPI: Must be a 10 digit number; If in single provider office use provider's NPI 12. Ensure all boxes are checked: Billing location Service location Accepts assignment Primary Business Entity (only for the facility that is the PBE) AS WITH TAX ID NUMBER, once checked and saved do NOT change PBE. Click 'Save' button at top when finished (above). Remaining facility settings don't apply to NewCrop erx. User Settings * Check these settings for special characters if prescriptions are refused 1. Left Nav bar: Administration-> Users. Select User 2. First and Last Name: no special characters no special characters (including hyphens)

4 3. NPI: 10 digit NPI required for all prescribers 4. Federal Drug ID: DEA number required for all prescribers IMPORTANT: for Midlevel Prescribers or others operating under MD's license THEY MUST HAVE the word, "None" in Federal Drug ID 5. NewCrop erx role: (above) see Appendix 2 NewCrop erx Roles for specifics All users who will use NewCrop erx must be assigned one of these roles. NewCrop NewCrop NewCrop NewCrop NewCrop NewCrop Admin Nurse Manager (do not use) Doctor Midlevel Prescriber Supervising Doctor NOTE: If a Dr who's assigned NewCrop Supervising Doctor is refused login to erx, try switching them to NewCrop Doctor instead. If that allows them to log into erx, they will still appear on the list of Midlevel Prescribers' Supervisors. Click 'Save' button at top of panel when finished (green oval, 1st pic above)

5 Initial Setup - NewCrop erx NewCrop erx setup consists of 4 steps: Each provider's initial login to erx Build Healthplan Master List Build Pharmacy Master List Link Insurances and Pharmacies to Patient Refer to the section, Navigation and Other Tips for NewCrop erx as needed. Log into erx 1. In OpenEMR log into Dummy ZZZ's account 2. Click button, 'NewCrop MedEntry' at top of display Note: Each Provider's first login to erx requires agreeing to NewCrop erx terms of service Scroll down to bottom of screen, click button 'I agree' Next screen is New Crop News. Read the news, scroll down to bottom and click button, 'Continue'. You will then be shown NewCrop's initial screen:

6 Note the line of tabs across top of erx screen, as seen by Provider Select Dr/ Staf Compose Rx Med Entry Pt Details Diagnosis Admin Build Master Lists 1. Select 'Admin' tab at top right (green oval below) 2. Locate links at top right of screen: 'Location Pharmacy List' and 'Account Healthplan List"' Build / edit Healthplan Masterlist 1. Click 'Account Healthplan List' (2nd link circled above) 2. Click link, 'Add additional healthplans' (circled below)

7 3. Click in checkboxes of healthplans from default list in top of panel (see Aetna, below) Check all plans by selecting checkbox, Name (arrow) 4. Click button, 'Add To List' (rectangle) 5. Search for non-local plans: click link, 'Add additional healthplans' (green circle) 6. Enter name in search area to right (blue circle)

8 7. Click 'Search' button 8. Select from returns and add to list To remove plans from list: select their checkbox and click 'Delete from list' Build/ Edit Pharmacy Master List 1. Click 'Admin' tab 2. Click link 'Location Pharmacy List'

9 3. At top of next screen, click button, 'Add Pharmacy' IMPORTANT: must add BOGUS PHARMACY to use for all testing and demo purposes 4. Enter Bogus into search area (green rectangle) 5. Click 'Search' button to left (green circle) 6. Select lower left checkbox for Bogus Pharmacy from search returns (blue circle) 7. Click 'Add Checked Pharmacies' button (blue arrow) 8. Repeat 'Add Pharmacy' process to search for pharmacies with the search tool or to manually enter them.

10 Recommend searches using zip code of desired area

11 Link Insurances and Pharmacies to Patient 1. From patient's OpenEMR account log into NewCrop erx 2. Select tab at top, 'Pt. Details' (blue circle) 3. In dropdowns at top select patient's plans (Blue rectangle) 4. Click button, 'Save Insurance/ Formulary/ Consent' (green circle) 5. In 'Patient Pharmacies' section just below, click link, 'Click here' to add/ update patient pharmacy list (red circle)

12 6. In new panel 'Patient Pharmacies', click in checkboxes to select patient's pharmacies (green rectangle) 7. Click red button, 'Save Changes' (green circle) Click any tab along top of screen to close module

13 Midlevel Provider Select Supervisor 1. On initial setup of Midlevel Provider in erx, or whenever a midlevel's Supervising Physician changes: select tab, 'Select Dr/ Staf' (green circle) 2. Select Supervising Dr (Green rectangle) 3. Ensure Midlevel Provider is displayed in middle list (blue rectangle) 4. Admin-role staf in right dropdpwn list may designate Midlevels' supervisors (blue circle) 5. Click 'Save' button (red circle)

14 Medication Order Tasks Order a medication Search for medication 1. Assure patient's correct formulary is displayed in dropdown menu at upper right (blue circle) 2. Enter drug name in drug search text area and click pink Drug Search button (green circle) 3. New green bordered panel added to display contains search results; click on drug name to select desired preparation (green circle)

15 4. If desired preparation is not in formulary, click left column (blue circle above) for pop-up and select equivalent med

16 Medication Alert A medication alert triggers when a conflicting medication is selected in a drug search 1. Close alert popup 2. Next screen is composing the prescription. Decide to continue ordering med or click 'Cancel' button (circled green) 3. if continuing with order, finish composing (next section) and click 'Save Rx' 4. In next panel click pink button to 'Take Complete Rx to Review Page' (green circle below) 5. In new tan panel, click magnifying glass at the right (red circle)

17 6. In Drug Review screen select from middle dropdown, 'Select drug review override reason' 7. Enter more notes in the text area below the dropdown (green circle) 8. Click 'Save' button (red circle) 9. Click link, 'Close/ Return to previous page' Return to the 'Compose Rx' screen to print or transmit prescription

18 Compose Prescription 1. Select from top left to bottom right: Number of units per dose (green circle) 'Tablet' med form is transferred from formulary selection 'Route' from formulary Checkboxes (blue circled): 'PRN' if so

19 'DAW/ DNS' = Dispense as Written/ Do Not Substitute 'One Time' if one-time Rx Checkbox: 'Save this sig and add it to Dr's List': 2. Next column: Frequency - select in green area Number of days' supply - in blue links Select packaging Number of refills '2nd rx 90day ' if refill to be for 90 days 3. Lower panel text areas (green rectangle): 'Additional sig' - note to patient appears on label. 'Pharmacist Message' - will not appear on the label. Last object 'Select Diagnosis': Meaningful Use item N/A at present Click red button, 'Save Rx' (red circle) 4. Click the pink button at the top, 'Take Complete Rx to Review Page' (green circle)

20 5. On next screen 'Pending Rx' choose processing method from buttons (two green circles): 'Finish/ Add to Current Meds' - without printing or processing 'Approve/ Leave for Staf': approve this med for staf to process later (see following section) 'Return/ Additional RX': repeat process and add another med order 'Print Rx/ Add to Current Meds' with this button (see next section, Print Out Prescription 'Transmit Rx' electronically.

21 Print out Prescription 1. Click appropriate link to print just the paper prescription, the Patient Education leaflet or both (green circle) Preview of printed prescription is visible in lower pane 2. When processing finishes, click 'Compose Rx' tab.

22 Delete/ DC Med 1. At the 'Compose Rx' screen, in the patient's list of current meds, click right hand checkbox (green rectangle) of any/ all medications to be D/C'd. 2. Click button, 'D / C' (red circle)

23 Approve/ Leave for Staff Another staff authorized do to so (e.g., NewCrop Nurse role) may complete processing medication orders if a prescriber approves the meds (green circle). Notice the Green notification that med will be labeled DR 1. Authorized staf enters erx; clicks on the 'Compose Rx' tab Uncompleted medication orders appear as unfinished indicated by 'DR' (red circle) 2. Click button, 'Click to move to Current Meds' 3. Next screen, 'Pending Rx', click the pink button at the top, 'Take Complete Rx to Review Page' (green circle) 4. Proceed from step 5 of 'Compose Prescription' (Click to follow link)

24 'Instant Refill' Medications 1. Select the 'Compose Rx' panel while logged into erx in a patient's account. 2. Click the checkbox(es) for the med(s) to renew (red arrow). 3. Be sure the desired pharmacy is selected in dropdown (blue circle). 4. Click the button, 'Instant Renewal' (green circle) 5. All checked prescriptions will be processed in a batch 6. In the next screen click 'Transmit Rx' as usual with a regular order Remember that scheduled drugs must be handled by printed prescription so do not include them in a batch process) 'Instant Renewal' sends prescriptions directly to the pharmacy bypassing paper printouts of patient education materials or prescriptions. For the Surescripts medication refill function Prescribers are referred to the video listed on the 'Admin' tab.

25 Status Screen The Status Screen shows the status of medications in process at any moment in time. A Prescriber can access the status screen from the left half of the link displayed at the top of any erx page. (top green oval) A non- Prescriber must access it through the OpenEMR nav menu at New Crop-> Status / erx Renewal (left green oval) The headings of each section are self explanatory; each section will contain medication orders with that problem (purplish ovals). See more extensive documentation on the erx Admin tab, at the Support section link to the Reference Manual.

26 Doctor's List of Favorites Add A Medication to Doctor's List The second 'Pending Rx' (a.k.a. 'compose prescription') panel is the only place a med may be added to the Doctor's List of favorites. If the opportunity was missed to add it when the prescription was originally composed it may be added with this method. 1. Start from 'Compose Rx' tab with the initial display containing the patient's current medications (green circle) 2. Click on name of medication to be added to favorites (red circle). This adds 'Pending Rx' panel at top of display (green circle, below).

27 3. Click the 'EDIT' button at right of the UPPER display of medications (red circled above). NOTE: this will not work from EDIT button in lower med list 4. In resulting 'Pending Rx' (aka 'compose prescription') panel click 'Add to Dr's Favorites' (red circle above)

28 5. Click 'Save Rx' button (green circle above) and automatically go to next 'Pending Rx' screen for med review. 6. On next screen you must click on the X button at far right (red circle below) to cancel the automatic med review and return to normal 'Compose Rx' display. The medication is now in the Dr's List of favorites.

29 Use Doctor's List of Favorites 1. From 'Compose Rx' screen: click 'Doctor's List' button (green circle) 2. In new green- bordered panel select pink checkboxes of meds to add to patient's current meds (green rectangle below). 3. Click pink 'Select' button (green circle above)

30 4. On next panel click pink button, 'Take Complete Rx to Review Page' 5. Select processing method 6. Favorite now in Current meds

31 Drugsets Create Drugset 1. On 'Compose Rx' screen click button, 'Drug Sets/ compounds' 2. In green bordered panel named 'Drug Sets/ Compounds' click link 'Build Drugset/ Compound list'

32 3. In new 'Drugsets/ Compound' panel click link 'Add additional drug set' and give it a meaningful name (green circle) 4. Click button 'Add Drug Set' (green rectangle ) 5. Select new drugset from list on new panel. 6. Add compounds or pharmaceuticals to the drugset Compounds include topicals or other remedies. NOTE: Compounds are not checked for allergy and medication interactions. Add Free-form Compound 1. Click button, 'Create Free-form Compound Drug'

33 2. Enter ingredients in comma separated list of ingredients (green circle below) 3. Enter complete sig for a compound, e.g., Tincture of valerian, three drops PO in water QID PRN 4. Enter Pharmacists message if desired 5. Click 'Save' button (red circle) Add Pharmaceutical May have mixed drugsets containing both free-form compounds and pharmaceuticals 1. Search for pharmaceutical 2. Compose prescription per usual (Ctrl-click to follow link)

34 3. Completed Drugset is listed in green bordered panel (green circle) 4. Click 'Close' button on complete drugset (red circle) Prescribe a Drugset 1. In 'Compose Rx' screen. click 'Drugsets/ Compounds' button (green circle)

35 2. In new green bordered panel select link of desired drugset 3. In next panel click button, 'Prescribe All' 4. Process drugset as a pending Rx : click pink button, 'Take Complete Rx to Review Page' 5. Finish by selecting processing method 'Approve', 'Print' or 'Transmit' (not pictured)

36 Delete Drugset or Drugs in Drugset Individual drugs may also be deleted from a drugset. 1. In 'Compose Rx' screen click 'Drugsets/ Compounds' button 2. On 'Drugsets/ Compounds' screen select checkbox of desired drugset 3. Click button, 'Delete from list' or 'Delete Selected'

37 Add Allergy 1. From 'Compose Rx' screen click 'Allergy/ Intolerance' button 2. In new green bordered Allergy/ Intolerance panel: enter at least 3 characters of allergy (green circle) 3. Click button, 'Search for Allergy' Note the listing of common allergies for easy selection (blue circle)

38 4. Select specific allergen from the search results 5. Indicate reaction severity; optionally enter onset date; add free-text note 6. Click button, 'Save Allergy/ add another' or 'Save Allergy'

39 Allergy Alert Allergy alert appears when an allergy is entered that conflicts with a patient's treatments. Click 'Close' button in alert popup and address the issue. Edit/ Delete Allergy Allergies may be deleted, or edited from list On 'Compose Rx' screen, click on allergy name in 'Allergy/ Intolerance' panel (green circle)

40 3. In green bordered panel: to delete, click button, 'Delete this allergy' (red circle) or make edits 4. Click button, 'Save Allergy'

41 Synch with OpenEMR Upon completing work in NewCrop erx, exit to OpenEMR by clicking on the patient's name at top of frame. Allergies, Current Medication list and all prescription activity will display in lower right of pt's summary screen reflecting all activities in erx. In this example, all med ordering activities done while making this tutorial material is shown, and cannot be deleted.

42 Medication Literature Sources Many panels that display medications also provide links to literature. The drug selection panel: The Print Rx panel: 'TML' - (The Medical Letter), one of the industry standard sources of drug information Monograph' - which displays drug information from peer- reviewed journals 'Leaflet' - which is the Lexi-Pal information of the Patient Ed materials 'Patient Ed' - some Lexicomp information that is optionally ofered along with a printed or electronically submitted prescription. 'Espanol+' - presents website from which ofers Spanish language information onm the medications 'PDR Brief' - short version of the PDR's entry

43 Administrative Tab Summary Reports not accessible in preproduction version of NewCrop erx Pharmacy Communications Log Prescriber Report Refill Report Geriatric Drug Usage Med Entry/ Refill uses obsoleted Med Entry screen Account Settings for individual prescriber accounts Account-wide Settings global display preferences

44 Lists referenced in handout body Support links to pdf documents and other support forms Orientation Views instructional pdf's from NewCrop E-Prescribe Registration Utility to register facility prescribers with SureScripts

45 Navigation and Other Tips for NewCrop erx The NewCrop Panel defined: A 'panel' as used in this tutorial, is an area on the screen dedicated to a specific function. The entire screen area is surrounded by a thin black line; the panel has a thick solid blue border at top, or bottom. When some button or link invokes a new panel (per the Add Pharmacy button above) it may be added to the top or inserted inside the existing display on the screen A panel has text areas, buttons and links inside it The 'active' panel usually appears inside green border...

46 ...though there may be more than one green bordered panel displayed at a time Each panel has its own 'Close' button at top right to close that one panel (green circles) Screen Objects Buttons are white rectangles that change color on mouseover to blue or pink ('Delete from list' at right) Links are blue-underlined text which cause actions just as a button does ('Add additional healthplans' at right invokes new panel)

47 Lists of items (e.g., pt's current meds; pharmacy list) will have 'select' and 'delete' checkboxes on the left or right of each item. The two types of checkboxes may appear on diferent sides on diferent panels. However, the 'delete' checkboxes are all grey and the 'select' checkboxes are all pink. Related Buttons Frequently a set of buttons will perform many permutations of related functions. One example: When ordering a new med these buttons appear on the final med review screen: 'Route Page' invokes a new screen where you can print the Rx and add to current meds OR Transmit Rx to pharmacy 'Finish / Add to current meds' just add this Rx to current meds and return to 'Compose Rx' screen 'Approve / Leave for Staf' approve this Rx and add to list of meds for later processing by other staf; return to 'Compose Rx' screen

48 'Return / Additional Rx' - add this Rx to current meds and return to 'Compose Rx' screen with Drug Search activated 'Print Rx / Add to Current Meds' add this Rx to current meds and go to 'Print Rx' screen 'Transmit Rx' simply transmit Rx to pharmacy Multiple Access Routes Many functions may accessed by multiple routes and some are not fully functional. Particularly, some activities are present in both 'Med Entry' and 'Compose Rx' but only work in 'Compose Rx'. Learn only the recommended access route. Med Entry /vs/ Compose Rx PRESCRIBERS be aware of 'Med Entry' and 'Compose Rx' tabs. They present much of the same functionality with very similar displays 'Med Entry' is the default landing screen for all users upon entry to erx.

49 This works well for NC Admin users but Prescribers must remember to shift to 'Compose Rx' immediately to do their work. Navigating the Tabs Often some activity will be completed without returning the user to any starting point. Or, an activity may start on one tab then open another tab and finish there. Eg, when finished building the Healthcare Master List, click the Admin tab again to get back to initial Admin page and the Location Pharmacy List. Reprint a Prescription In 'Compose Rx' tab: 1. Click on blue underlined med name to bring up 'Pending Rx' panel 2. Click pink button, 'Take Complete Rx To Review Page'

50 3. Click button, 'Print Rx/ etc' 4. Print as usual 5. Click 'Compose Rx' tab to return

51 Appendix 1 NewCrop Data Requirements Field Sections Comments First Name All No special characters Last Name All No special characters DOB All YYYY-MM-DD Sex All Male or Female only Address All No special characters City All No special characters State All 2 letter ID only Postal Code All 5 or 9 digit, no hyphen Country All Only needed if USA Home/ Mobile Phone Contact Either one entered Phone Edit Facility (###) ###-#### Fax (###) ###-#### Federal Drug ID All DEA Nr required for all prescribers NPI All Required for all Prescribers Facility NPI Edit Facility 10 digit NPI for Facility Primary Business Entity Edit Facility Where you prescribe; once set never change it NewCrop erx Role Add/ Edit User Required for all users in the system; see below

52 Appendix 2 NewCrop erx Roles Role Titles Comments NewCrop Admin Front Desk, MA, Office Mgr Allows completion of med orders, allergies, refill requests NewCrop Nurse RN, LPN/LVN, MA, CNA Nurse roles may send Rx's to Pharm for Dr NewCrop Manager Nobody; DO NOT USE Only permits viewing of facility's NewCrop account status. NewCrop Doctor MD, DO Any Prescriber with their own DEA Nr NewCrop Midlevel Prescriber NP, CNP, PA, Resident MD's Providers that prescribe under an MD's DEA Nr NewCrop Supervising Doctor MD, DO Only for Doctor supervising a Midlevel Prescriber

53 Appendix 3 NewCrop Global Settings OpenEMR menu: Administration -> Globals / Connections tab Field Comments Enable NewCrop erx service Checkmark (enabled) NewCrop site address See TS Wiki for link NewCrop Web Service Address See TS Wiki for link NewCrop Partner name See TS Wiki for creds NewCrop erx name See TS Wiki for creds NewCrop erx password See TS Wiki for creds Only upload active prescriptions Does not display non-active prescriptions on demographics Enable import status for NewCrop users Enables the pop=up box displayed upon pulling up demographics Do not display medications uploaded to Do not display medications on NewCrop Demographics Do not display allergies uploaded to NewCrop Does not display allergy info on Demographics entered into NewCrop Default Patient country Overrides Demographics Country selection