Home Forums Discussions Problems Electronic Prescribing - Sigs

Hello - I'm new to the Forums, but have been using AC for about a year.

I have not switched over to the integrated ePrescribing function, because it seemed to me that the routine directions for meds were not pre-programmed to be selected.

As an example, directions for many of the triptans are usually pretty standard - and I have usually chosen the standard sig in the ePrescribe service I have been using for several years (by Allscripts). If I have to, I can tweak the directions for an individual patient, if needed, but this is not usually needed for the majority of patients.

It will be quite a pain for me to type the directions for all the scripts that I write - even if it is required only the first time for each patient (which I assume is the case with AC).

Have I seen this functionality incorrectly in AC? Would appreciate any clarification on this - as it would be nice to start using the integrated ePrescribing function. Thanks for any feedback -

Raj

Hi Raj,

Welcome to the ACUB. I am a little confused, because you say that "it would be a pain for you to type the directions for all the scripts that "I" write.." What do you do now? You must write sigs for the scripts now. And, being paper, they don't remember.

You are correct that the program remembers. Writing a prescription for Amoxicillin suspension 400 mg/5mL, 1 tsp po bid for 10 days, write number and leave refills blank.

Leaving it blank will produce *None*.

The next time you write for the same Amoxicillin suspension, it will give the sig and the dispensed and the refills (usually). Of course, you may need to tweak it, especially as we pediatricians do. What is 1 1/2 tsp po bid must be changed to 1 tsp po bid depending on the weight.

I guess I don't understand as I don't see why writing the sig once would be that difficult. You didn't list what specialty you are in, but I am guessing it is not peds.

All I can do is advise you to use ePrescipe even thought it is SureScripts. It is the single best upgrade AC has ever had, and although it may be less so to you due your being used to Allscripts, it is the only choice, but I think a very good one.

Raj,
There are several features that we would like to see in an eRx program that are not included in New Crop, which is the program AC partners with to provide eRx. One of those is inclusion of dosing information. So when you pull up pantoprazole, even if you don't know the usual starting dose, the program will fill in "40 mg qAM". This is NOT the case in AC. So you will need to find out the appropriate dose, and enter it in at least once.
The program SHOULD remember the details of what you prescribe and a. pull it up in that patient's chart the next time you go to prescribe the medication, and b. remember it when you start to type in the drug name for other patients.
Unfortunately, for some of us, the latter feature is not consistently working (it always worked well for me, but now it does not work predictably in V6.3.3).
By the way, you should be aware of the option of using the "Quick Script Writer" on the eRx screen which allows you to mostly use radio buttons to fill in the prescription. Explore that, if you have not already.

Thanks Jon,

LOL, everything is adult medicine. I would likely kill half my practice with a starting dose that high for peds. So, I am not sure if its suggesting the starting dose is a good idea. But, it may work for adult medicine.

We should do a poll, although polls don't work well, and ask how many people use that Quick Script Writer. It's good you mentioned it, but do you find it useful.

Now, what would be cool would be if ePocrates or Lexi-Comp automatically popped up or did when you clicked. I know it's there, but it isn't always convenient. Also, would be nice if you had single sign-on, e.g. sign onto AC, and that would sign you on to ePocrates.

Raj,

I am in the same boat, but midstream. I am also still attached to an eRx I've had for 3 years that has more features. I will probably keep paying for it until New Crop allows me to see what other doctors are prescribing for my patient. That is especially useful with narcotics. SureScripts has all that information, so why not New Crop? It also allows me to send a Rx to a national pharmacy or to print a Rx without losing the local pharmacy, but now I'm just showing off.

Anyway, it is better for you and the patient that every Rx you write is recorded in your progress note properly, and it is better for you if you don't have to add it to the progress note after you use your favorite eRx program.

I'm having my nurse enter all the medications, allergies, and diagnoses before I see a patient for the first time with AC.

You can do this!

Dan

V7 of AC also includes some upgrades to eRx. One of them is exactly this one...you can see all of the prescriptions for a patient; even those written by others.

Thanks for your suggestion on the auto-fill of dosing information. I asked for that 2 yrs ago. It is a huge help in adult medicine and I really miss it. I find the radio buttons to be cumbersome and time-consuming. I want less button pushing, not more. PLEASE improve ERX!

I also have noticed that rx that are refilled from electronic refill requests from pharmacies do not show up in the pt's script list. Instead, I have to check in Past Encounters to see if it was refilled. Tedious.

You can see everything that Surescripts has for your patient on the New Crop screen right now. I usually access it by the "check formulary eligbility" button on the top of the "write scripts page." Then select the blue :Sure Scripts Drug history: link and choose how far back you want to look. You can't tell who wrote the Rx, but you can select the Rx and import them into your patient's chart. The drug name and dose show up, but not the sig or dispense quantity, it is a timesaver for my patients that are joining our practice.

SoloDoc: My rx that I renew from inside AC do show up just like the regular ones.... glitchy?

I agree with Raj, I want the computer to suggest the usual sig for me. It used to remember all the time and now is spotty.

It could easily give you options though, for the kids a lot of stuff is Xmg/Yml and if it gave you those options it should work out well becasue pediatricians would go pick that one first. The other thing is that it would be awesome if it you could put in the conversions for the medicine you use a lot ...for example zantac and how many mg/kg you need it to be at and remember that once you enter it the first time....i know i know but just thought i would put it out there.