Home Forums Discussions Coding and Billing Premature transfer of meds from Rx Writer to Current Meds -a solution?

I think I have found a solution for the problem of medications prescribed during a visit prematurely appearing in "Current Medications" list before the visit is complete (Important for us letter-writing consultants as the problem makes it seem as if the patient had already been taking the very medications just prescribed during the visit ) try this:

1. Call up the patient's chart.

2. Document the patient's current medications through the routine "current medication" box on lower left.

3. THEN: Save the chart to your personal in-box by typing "Ctrl S".

4. NOW: Retrieve the chart from your inbox.

5. Proceed with the visit as normal including prescribing new meds using the "Write Scipts" icon on the chart's right side. For some reason the act of having saved and retrieved the chart after the incoming medicines are documented in chart's lower left (but before prescribing new medications with Script writer ) prevents the newly prescribed meds from prematurely transferring over to the current medication list . Newly Rx'd drugs do later transfer to the left side current medication list, but no longer prematurely. I do not know why this works, but it seems to.

Any thoughts?

(AC Developers- are you listening?)

Bruce Morgenstern, MD
Neurology, Denver

Thanks for the post Bruce. Does your nurse make any chart entries and then forward the chart to you? My nurse will update the chart in regards to medications and vital signs and then forward the chart to me. I then open the chart in the room. If I am not able to complete the note, I then forward it to my in box. If I have prescribed a medication, it often will show up in the list of current medications. As you noted above, this is incorrect. Are you suggesting that the solution is to open the chart and then save it again and then reopen it to prescribe? Would this get around the problem if the nurse has forwarded the chart? In this scenario, the nurse has already called the chart up, at the time of the visit.

Dear Users,

I have been looking at this in version 6.3.1 beta. In this version if you add or edit a med and then forward the chart when you pull the forwarded chart it looks like the current meds list has been changed. But once the note is signed the current meds for that encounter will show what they were at the start of the visit and not the now updated current meds.

Claire

Because I'm a consultant (Neurology) it is important for me to keep newly prescribed meds separate from current meds in my letter to the referring physician. Once the letter is written and sent, it is of course OK to add the prescribed meds into the current ones. (I am in solo, and don't use a PA, so I enter everthing myself)

The technique I stumbled upon appears to keep Newly prescribed meds out of current meds list :

Open the chart

enter pre-existing/current meds and hit 'Medication Reconcilliation complete" .

Forward the chart to myself (Ctrl-S) (though I suspect forwarding it to someone else would work just as well)

Re-open the chart

Now prescribing meds (using script writer on lower right) the two groups of meds will now stay separate.


Of course, if you don't have to write a letter, keping the two groups of medications separate becomes less important since newly prescribed Meds ultimately become part of the current med list (assuming patient compliance)

Hope this helps,

Bruce Morgenstern,
Neurology, Denver

THANK YOU!! to AC Development Team

I've just Downloaded and begun using V 6.3.3 It now quite successfully keeps separate the Incomming Meds field (lower left on chart - the medications the patient came in on ) from the medications newly prescribed during the actual visit (lower right - those prescribed using Script writer and appearing in Plan) . This is SO important for us consultants and specialists - Thank you to the AC development team for providing this!!

Bruce Morgenstern, MD Neurology
Dener, CO

That is good news...both because of the feature itself, and because of the responsiveness of AC development.
Bruce, I agree that it is important to specialists; I have never understood why primary care providers don't care more about it as well.

I think the reason, Jon, is because, like many things in AC (remembering the pharmacy for instance) only happens to some people. I haven't had the issue Bruce has described in any version over ten years or so. But, it should happen to some FPs since there are so many on here. So, good question.

Hi everyone,

FP response, v6.1.2:

Any med manipulations made from the LEFT med box will be incorporated immediately, if someone else has started a med and I enter it from this box, it will immediately appear as a current med.

Med changes made from the RIGHT Rx box will not be incorporated into the current note, but will appear as current meds after note is signed off. UNLESS I go back and use the left box, in which case anything done from the right box is now immediately incorporated.

So as long as I update first from the left box, and then do not go back to this, all works well.

Gene

That has been my experience as well.

I agree with Gene - the reason I never really complained is that I became methodical in my notes - cc, HPI, change ROS to current, update any new medical/surgical history, find out and review meds with the left side and update then do my diagnoses and plan - then add the meds I want and sign the note.

I think the reason it was mostly a specialist issue is they are more likely to try to generate scrips for the patient and finish the note after the fact, this is not saying that is wrong, but if you do it my way it never became a problem.

Certainly for specialists, it is important that our letters to the referring doctor do not suggest that the medications we have just prescribed during the visit were already being taken by the patient prior to the visit -

I agree with Steven . . . but only up to a a point about logistics -

In my (Neurology) practice, I, similar to others, try to enter current meds before I actually see the patient (to try to keep them separate.) - However, even after having entered current medications first, my newly prescribed medications would immediately and spontaneously transfer over to current medications box provoked simply by the act of right clicking in another field, such as to placing one of my templates (such as Review of Systems) in its appropriate field .

In any case, happily, the AC team appears to have solved the problem in the latest release of 6.3.3

A hearty thank you to them

Bruce Morgenstern (Neurology)
Denver CO

Wow!!!! I just tried that, and you are completely correct. How long has that been happening. I never noticed it, because the chance of my right-clicking in a field after I prescribed a med would be about 1 in 300, and then I would not likely notice it.

This is a HUGE bug for those not on 6.3.3. And, it was a HUGE bug for those in the past.