Pharmacy Setup for OR Management
Pharmacy Setup for OR Management
Drug Dictionary
Dispensing-
Strength: Identifies the drug's strength in the units it will be dispensed.
Example: 325 MG, 1 TAB, 100 ML.
Note: Although a lookup is not available at this field, the system does look to the PHA Unit of
Measure Dictionary to make sure the unit of measure typed in actually exists.
Order Size: Indicates the smallest whole amount of the drug that can be ordered. The unit of measure defaults from the Strength. The value entered at the Order Size prompt in the PHA Drug Dictionary appears in the view only Dose Unit field in OR.
Example: If you have a drug with a multi-strength such as MG/ML, the unit of measure that
defaults for the order size is MG. MG will display in the view only dose field in OR, not the
strength of MG/ML.
Ordering-
IV Fluid: Define whether this drug is a fluid. Yes or No field.
Additive: Define whether this drug is an additive. Yes or No field.
Unit Dose Pack: This field affects how medications can be charged to patients and decremented from inventory.
Y= the entire dispensing form is charged for and decremented from inventory, even if a lesser
amount is ordered.
N= only the portion used is charged for and decremented from inventory (must be a Unit-based
charge formula).
Routes of Administration: This field dose a lookup into the PHA Route of Administration Dictionary. At this field, you would identify all the possible routes by which this medication can be given to a patient. If the route is not attached here, it will not be available in the route lookup on the ordering screens in both the OR and PHA modules.
Restrict to Ordering Site: The user can restrict this drug to a PHA site. For example if the OR was the only department to use this drug then it can be restricted so it can only be ordered from OR If the drug needs to be available for all PHA sites then leave this field blank. Please refer to Knowledge Base 24989 for additional information.
NOTE: If PHA restricts drugs to other sites, other than OR, OR will not see the drug in the
lookup within the surgical profile.
Purchasing-
Unit Cost: Indicates the cost at which the hospital acquired the drug. This is one of the basis choices in the Charge Formula Dictionary.
Unit Price: The price is determined by the hospital. This is one of the basis choices in the Charge Formula Dictionary.
Unit AWP: The Average Wholesale Price: The average wholesale price can be set to a national wholesale average price for each unit of the drug. This is one of the basis choices in the Charge Formula Dictionary.
Note: The AWP can be updated from the Formulary Service Vendor on a monthly or quarterly basis. After charges have been calculated, the Pharmacy Module creates batches of billing information according to the times you define at the Bill Compile Prompt in the parameters. The billing compile job creates the batches for the MEDITECH Billing/Accounts Receivable Module. B/AR retrieves the batches and you can then use the B/AR Module to process patient accounts.
Inventory
Inventory: This field dose a lookup into the inventory dictionary in Materials Management. If you want to attach an OR inventory (such as a dispensing machine inventory) to this field, then the sub inventory's MAIN inventory must also be attached. This can be done manually here, via a Pocket or Bin Load from the dispensing machine, or the Enter/Edit Inventory Stock routine.
Dose Checks
Dose Range: This field does a lookup into the PHA Dose Range Dictionary. The system warns the user if the ordered dose is inappropriate for the patient based on criteria that is setup in the system. The system evaluates the MIS Interaction Conflict group first, the the Drug Dictionary, and finally the Customer Defined Parameters to check dose ranges while entering orders in OR, PHA and other modules.
Restrict to Dose types for Inpatient and For Outpatient Orders: The system can be restricted to evaluate specific dose types by schedule for inpatients, outpatients, and discharge patients.
String/POM Site
Note: Users may change the PHA Site at the top of this screen to define the fields for an OR site if one exists. Otherwise leave the default site as .DFT and all sites will use the same defaults.
Default Order Type: This prompt looks into the PHA Order Type dictionary. If this medication is to have only one Order Type for all routes of administration, select the default order type at this prompt. If the drug can be ordered via both a med order type and an IV order type, this prompt should be used to select the IV order type. The MED order types can be attached in the Medication Order Type Defaults prompts.
Administration Route/Inpatient Order Type/Outpatient Order Type/Discharge Order Type: If the medication has multiple routes of administration (defined on the Dispensing Tab), list out the different routes and attach the appropriate Order Type for Inpatients, Outpatients, and Discharge Patients. Keep in mind that these selections are for MED Order Types only.
Note: Default MED order types can also be defined globally in the PHA Route of Administration Dictionary, but MEDITECH recommends setting it here.
Site->Defaults-
Note: Users may change the PHA Site at the top of this screen to define the fields for an OR site if one exists. Otherwise leave the default site as .DFT and all sites will use the same defaults.
Dose: Enter the most common dosage of this drug. This will default into the Dose field when ordering or administering the drug in OR, but users can edit the defaults.
Route: This field looks into the PHA Route of Administration dictionary. Select the most common route of administration. This will default into the Route field when ordering or administering the drug in OR, but users can edit the defaults.
Charge Type Defaults: This does a lookup into the PHA Charge Type Dictionary. Define the default charge types for inpatients, outpatients and discharged patients. The system will first look to the Stk MED (or Stk IV) type value when applying a charge type to an order. The system will then look to the charge type defined in the MED (or IV) Charge Type field. If neither is defined, the OR user will receive an error message, “no charge type defined”. The charge type will be listed on the PHA Print Order.
Note: Overrides file into Pharmacy as inpatient stock orders, the system will use the charge types defined for Inpatients for these orders.
Edit Charge: If users are allowed to edit charges for this charge type and patient type during order entry in the PHA module only, enter Y. Otherwise, enter N.
Order Type Dictionary
This is where PHA order types are built.
Type: There are five hard coded options in the lookup- MED, COMP, SPLIT, IV, AND ALT IV. Only MED and IV types can be used when ordering from OR.
PHA Site: This looks up into the PHA site dictionary. You can identify the site for which you want to define NPR/RW fragments for the system to use for label fragments. By assigning .DFT then all sites will use the same fragments.
Type: Enter the type of label output for which you define an NPR/RW fragment.
Fragment: This field dose a lookup into the Report Fragments that are housed in NPR. Users can identify a fragment for each type. If the Prompt for Labels is set for stock orders, the labels will be sent to printers that are defined in the Device Dictionary to the Customer Defined Parameters
Order Type Dictionary Continued-
Max IV Fluids: This is the maximum number of IV Fluids that a user may attach to the PHA order set when this IV order type is used. The fluid can be edited to be less than the maximum at order entry.
Order Set Dictionary
The PHA module uses this dictionary to predefine or group together both standard Iv's and MED orders. This dictionary is also used to identify Iv's that will be ordered in the OR module. Only one order can be defined on a set that will be attached to an intake, however multiple fluids and additives can be added to that one order.
Type: There are two options for this lookup: I and O. To be able to see the order set in the OR module, this field must be set to I (Inpatient).
Order Type: This field looks up into the PHA Order Type Dictionary. At this field, identify the order type to be included in this order set.
Route of Administration Dictionary
Define all possible routes by which a drug can be administered to a patient.
POM/OR Ft Order Type: This field looks up into the PHA Order Type Dictionary. The user can associate a default order type for medications given by a particular route in OR.
Note: OR will look to the PHA Drug Dictionary first for the default order type. If it is not associated there, then it will look to this field to associate an order type based on the route of administration that is associated to the order.
Access Dictionary
An OR pharmacy access group can be created here for OR staff users.
Default Drug Lookup: Enter the default Drug lookup for users in this access group. This default applies to all lookups into the PHA Drug Dictionary. If this prompt is left blank, the Lookup for users in this access group is Combination. For a full listing of all available options, the F1 key can be used to access the on line help.
Note: If there is not an OR access group defined, the system will use the .STD access group.
Enter Stock Orders- This section applies if an OR user is placing orders through the PHA Stock Order/Stock Meds routine.
Allow Override: This determines whether users in this Access group can order medications without verifying whether they are stocked at the current locations.
-To allow users to enter medications without viewing the message, enter Y.
-To prohibit this access group from ordering medications not stocked at the current locations, enter N
-To allow users to order medications not stocked at the current location after viewing a warning
message, enter A.
Ask Service Date: This determines whether users in this Access Group will be prompted to enter a service date for stock medication orders for inpatients, outpatients, and discharged patients. If this prompt is set to N, a default Service Date must be entered in the PHA Default dictionary as this is a required field.
Ask Charge Info: This determines whether users in this access group will be prompted to enter charge types and charge per dose information during stock medication ordering for I/O/D patients. The user can file without entering a charge type, but the order will file as incomplete.
Prompt for labels: This determines whether or not users in this access group will be prompted to print stock medication labels for I/O/D patients enter Y.
Check Interactions: This prompt determines if users in this access group will receive drug interaction messages. The options for this setting are:
-N- no interaction checking message
-C- check interactions but do not display messages
-D check interactions and display messages
Note: If set to C and D, the system will then use the PHA Customer Defined Parameters to check for interactions, allergies, and duplicates if the site is not using a MIS Interaction Conflict Group.
Customer Defined Parameters
Default OR Access Group: This field does a lookup into the PHA Access Dictionary. At this field, attach the default OR access group.
Note: If there is not an OR access group defined then the system uses the .STD access group.
Customer Defined Parameters
DM Med Order Type/ DM IV Order Type: This field dose a lookup into the PHA Order Type dictionary Enter the medication order type the system uses when filing orders transmitted from dispensing machines.
Customer Defined Parameters
On this screen, set up whether drug interaction checking, allergy checking, food interactions, etc will occur. You can base this screen on a PHA site. The .DFT applies to all PHA sites that exist.
Note: If an MIS Interaction/Conflict Group is defined and attached to OR users in the OR access dictionary then those settings will override the settings here for interaction checking.
Customer Defined Parameters
Use this screen to define global pharmacy dose range checks. The system warns the user if the ordered dose is inappropriate for the patient based on criteria that is setup in the system. The system evaluates the MIS Interaction Conflict group first, then the Drug Dictionary and finally the Customer Defined Parameters to check dose ranges while entering orders in OR, PHA and other modules.
Pharmacy Site Dictionary
This dictionary is used to build various PHA sites. For example, the hospital could build an OR PHA site in order to restrict medications in the drug dictionary to the OR department.
Rx Prefix: This field can be used to set a prefix that appears in front of every order created from the defined site.
Example: The OR site above has an Rx prefix of OR. Any drugs entered in the OR surgical profile will be seen in PHA with an RX number prefixed with OR. EX. OR123456789
Note: If PHA has multiple sites, this field is required for new site entries. Each site must have a unique prefix and the prefix cannot be edited once an Rx has been filed for the site.
Inventory Defaults: The system checks this field as part of the inventory hierarchy
Pharmacy Location Dictionary
This is the first place the system evaluates in determined the order's inventory. In this dictionary, you can attach multiple inventories. IF OR wants the order to be dispensed from the OR inventory, the OR inventory should be listed first. Keep in mind, if the drug is not stocked in the OR inventory, the system will utilize the Inventory Hierarchy (Location, Site, Cart, Drug Dictionary, CDP) to determine the order's inventory. The inventory will be listed on the PHA print order.