vxJourney Orders

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

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Streamlining the Medication Ordering Process for Prescribers

Marvin Friedman, PharmDJeanette Klement, MAEd

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

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

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

Drug File

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

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.

Dosage File

Application Use

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

Application Use

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)

Orderable Item File

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

Medication Route File

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.

Medication Schedule File

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

Example of Quick Order for Warfarin

vxCPRS

• Medication Quick Order for Warfarin

vxCPRS

• Warfarin Quick Order displaying pre-defined fields

vxCPRS

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

vxCPRS

• Order set orders are ready for signature

vxCPRS

• Prescriber highlights orders and signs all orders

Order Checks

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

medication

vxCPRS

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

vxCPRSAdverse Reaction Order Check

vxCPRSProvider must enter a justification before order can be signed.

vxCPRS

Order Checks: Duplicate Drug Class and Missing Lab Results

Pharmacist Overview of Pending Orders

Pharmacist View of Allergies

Pharmacist View of Prescriber’s Pending Orders

Pharmacist Finishing Pending Order

Pharmacist View of Order Checks

Duplication Drug Class Order Check

Drug-Allergy Order Check

Flag an Order

Pharmacist View that Pending Order is Flagged

vxCPRS

• Prescriber receives an alert

vxCPRS

• Flagged order in vxCPRS

vxCPRS

• Prescriber responds to the Pharmacist’s Flag

Questions?Thanks!

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