Home Forums Discussions Problems Changing Current Med list not reflecting after note is saved

Has anyone else experienced this problem?

When changing a medication in the current med list box, the Rx is sent, finishing the note, signing it... but the medication addition, removal is not documented on the final note under the list?

Chazli,

The new med shows up the next time you open the chart in the current medication list. As far as removing a med, it shows up in the plan section after you add a reason for removal.

Ok.. but what about providing the note to other providers? It does not show up?

I would just print the current medication list and attach to the notes you send to other providers

I'm with Chazli. I have this problem all the time. And, while Marty_PA has a good workaround, one shouldn't have to attach a second note.

Chazli, I think it is documented, but in a different spot. An EMR can handle medication changes in different ways. I am not sure if the way AC does it is right or wrong; it is a matter of what people prefer. If most people truly prefer to do it differently, then we should suggest that AC change it.

When you open the note, the medication list and the note itself is designed to reflect the meds the patient came in on. In fact, at the conclusion of the note, if you print it as a SOAP note, for the medication section of the note it says "reported medications". Any changes are reflected in the plan section, where it says "Prescribed" or "discontinued" followed by the name of the medication.

The note (and the medication list) therefore reflects medications at the onset of the visit, with changes recorded at the end of the note. This is pretty clear, so long as you understand how it works. I am not saying it is necessarily the best way, though. What do people think?

I have evolved into doing all of my own medication reconciliation, and with projecting the medication list on a large screen to the patient with the chart open, we go through each medication individually, until our lists match up. This is done usually after going through the vitals, past med, social, family hx, allergies then I either print up a paper copy of the medication list right then or there, or send to the portal, and when I finish my note shortly thereafter the updated med list is captured when I sign off.

However, if I do any e-prescriptions or e-faxes of meds, or delete any meds, I will hold off and then print med list once this ritual is completed.

I have not had the problem with the lists not matching up doing it this way.
But I complete every note as I go before I start the next patient.

OK, here is the deal: Can't say anyone is wrong, and with the two med process, they are correct.

The problem for Chazli (I think) is there should be three lists of medications in a note and AC only lists two. The lists are this:

1) The notes the patient came in on
2) What you did, e.g. prescribed and inactivated. (And this is where most people stop)
3) The medications the patient walked out on

So, it's easiest if we go through a note. When you do this, even like the two list process, you have to think about every step over and over until you see it and it works. One screwup like not hitting CTRL + N or missing another check box and it gives you a different result. But, once you understand it, you can forget the steps and just write a note.

Caution: If this wasn't what you were looking for or what people wanted to read, I apologize. The nirvana has another byproduct. It finally allows me to understand Centricity's stupid three list plan. Also, if Jon had added a better name to the check box, I think more people would have seen it.

OK, say Bill Gates comes into your office. He is on Adderall, Ativan and acetaminophen-hydrocodone. Notice they all start with the letter "a." He walks into the exam room still on those meds. The physician decides to take him off his Adderall and put him on Vyvanse. This is what the doctor did during his/her assessment and plan. So, the plan should show that she continued his Ativan and acetaminophen-hydrocodone, was put on Vyvanse and she discontinued his Adderall. When the note is printed that is what it will say. Now the specialist can deduce from that what the patient is on, but it will be difficult to follow especially if there are three times the meds. Or if the patient brings a list.

What we need is a way for the plan to show the above and then a third list of medications show what the patient is now on.

So, if you check that little box called "Add med list to plan, it will add the third list. If you try this (and, again, I apologize if everyone knows this already and I am being condescending) in a note (and make sure you use CTRL - N (I forget a lot because my CMA usually does that), then inactivate and add a couple of meds. Right next to the listtle box, there is View Draft. Click it, and the last thing it will show is what you did. DISCONTINUE: Medication PRESCRIBE: Medication, ORDER: Labs. But, if you then check the box, you will see the list of meds the patient will leave with and the specialist will see the list of meds the patient is now on.

When you sign off the note and print a progress note, it will show the correct information. In fact, it will show the same information until you clear everything with CTRL + N.

When done right after signing the note, there will be these little > there in keeping with the incredible formatting of AC. If you go to print a letter, it will reflect that.

Finally, in the letter, you can check the boxes on the left to insert med lists.

Chazli, any luck? Curious.

Found out that when I inactivate or delete a medication from medication list in the summary page, the medication name does not get deleted from the list under "current medications" in the most recent encounter page. The only way to get rid of the medication without leaving it in the current note is to remove it by double clicking the current medication box and do it that way.