Frequently Asked Questions
December 2009
General Info
Is it true that if you don’t complete the reconciliations as due, you will not be able to place orders?
NO - failure to complete the reconciliations will not prevent placement of orders.
Getting Started
How can I add the orders reconciliation column to my patient lists?
Choose “view” from the header, then “column selection” from the drop down. Find “order rec” on the left side, click on it, and then click “add”. You can then use the “move up” button to change the location of the column in your SCM screen view.
How can I add the ORM icon to my toolbar?
Choose “preferences” from the header, then “toolbar from the drop down. Find “order reconciliation” on the left side, click on it, and then click “add”.
Home List
How do I enter an insulin aspart sliding scale as a home medication? Why can’t I convert it to an admission order?
Once in the home medications header within ORM, enter “insulin” and find the option for “insulin aspart- sliding scale”. Choose this option and complete the details within the form. Insulin, like any medication that can only be ordered via order sets, cannot be converted to an admission order within ORM. The order sets must be entered via the order icon, then go back into ORM to auto- reconcile within the admission reconciliation.
Do I need to include everything the patient takes on the home medication list?
YES. You should include all over the counter medications, herbal supplements, etc in the home medication list. This will enable them to be included on the discharge list and communicate that they are safe to be taken with the medications they are prescribed.
If the medication dose a patient is on at home has not been able to be verified during the patient’s admission, how can I include the medication in the discharge list of medications?
Sometimes, despite our best efforts, medication information cannot be verified during the patient’s admission. As a last resort, these medications can be entered as a miscellaneous home medication where dose is not required. Enter “dose unable to be verified, please confirm dose from prescribing physician” in the Rx instructions section of the form. This information will be pulled into the discharge home med list and then given to the patient.
How do I handle non- formulary combination medications in ORM?
To enter a non- formulary combination med as a home medication, enter “miscellaneous home med”, then in the prescription name enter the name of the medication. To the right of that field, click on the look- up button. This will open a screen for Multum drug mapping. Click the open box next to “all” in the name types to search section, then click on the search button. Choose the appropriate medication.
To enter such a medication as a discharge medication, the process is the same. A home medication can be converted to a discharge medication if moved into the pre-discharge medication column.
If I’m not convinced that I have the complete list of home medications, what should I do?
Enter the order “home medication list incomplete” on admission. Then, enter any information you have regarding the missing medication information using a “miscellaneous home medication” entry as a home med (i.e. little blue pill or high blood pressure med).
Admit Reconciliation
Should I use “mark all remaining as reviewed” on admission reconciliations? It seems faster.
NO - this function should only be used at transfer as a way to continue active orders post- transfer. When used for reconciliations at discharge and admission, this function doesn’t clearly communicate the physician’s intent to either continue or hold the medication. Providers should use the appropriate reconciliation comments (such as continue, replace, and hold).
Discharge Reconciliation
If I complete the discharge medications in the orders reconciliation module, do I still need to complete the paper discharge forms?
YES - the discharge paperwork needs to be completed, however, you do not need to write the discharge medications in that section. In that section, write something to the effect of “See printed medication list”. Then, print the home medication list from the printer icon in the toolbar and give it to the patient.
Do I need to include coumadin on the electronic discharge medication list if I am also filling in the coumadin section on the paper discharge form?
YES – You need to add coumadin as a medication on the electronic discharge reconciliation form AND you need to fill out the coumadin section on the paper discharge form. This insures that coumadin remains a part of the electronic medication record while still giving the patient instructions on when to check their INR.
Why can’t I convertmetformin to a discharge med?
The medications which are only orderable via an order set cannot be converted to a discharge medication. You have two options:
- If the medication was in the home medication column, that medication can be moved from that column to the pre-discharge medicationcolumn where it can be then converted to a discharge medication.
- If the medication was not in the home medication column, then use the current order found in the pre-discharge medication column, right click with your mouse, select “replace with”, and enter the discharge medication.
I’ve saved the discharge medication reconciliation as complete, and now want to change a dose on a discharge medication. How do I do this?
First, discontinue the discharge medication as you would any other order. Then you have two options:
1. Stay in order entry, change the session type to “discharge order” and order the medication.
2. Go into ORM via the icon on the toolbar, choose the completed discharge reconciliation from the view/ maintain history tab and choose “Set to incomplete” found in blue in the list of actions on the right side of the screen. Then, pick the reconcile orders tab at the top of the screen, choose discharge from the drop down and complete the reconciliation by ordering the discharge medication with the appropriate dose.
I’ve saved the discharge medication reconciliation as complete, and now want to add a medication. How do I do this?
Go to the order icon and then change the session type to be “discharge”. Here, you can order the medication and it will be included on the discharge medication list.
Discharge Med List and Prescriptions
How do I print the discharge medication list? What about the prescriptions?
Go to the print reports icon on the toolbar, choose “med rec” from the report category drop down, and then choose “Discharge medication list”. This is also the path used to print any prescriptions sent to the que during completion of the discharge reconciliation.
Why do I need to sign these electronic prescriptions in blue ink?
Some pharmacies will not accept those signed in black as they cannot be sure then that the prescription wasn’t photocopied.
Is it true that I cannot use these prescriptions for narcotics?
YES - narcotics need to be printed on tamper- resistant paper, so they must be handwritten on tamper- resistant scripts. This is also true for Medicaid patients.