2015 Indian Health Service Southwest Regional Pharmacy Conference “The Quad” Technical Pearls: EHR/RPMS Practical Everyday Solutions Expected Dispense Unit in the Drug File - Setting up and using the APSQ DRUG AWP/AAC NOTIFICATION Embedding template fields into quick-orders - Neat ordering solutions Kendall Van Tyle, PharmD, BCPS Clinical Pharmacist & Informaticist – Northern Navajo Medical Center

Problem When entering new drugs into the drug file, how can you tell what the system expects for the dispense unit? Not an issue for tablets, capsules, etc. But what about: Mometasone DPI Inhaler; 30 doses, 135mg of drug/inhaler? Dispense Unit = MG? or Doses? Or Inhaler? Impacts billing and POS

Solution Have yourself or a designee setup to receive a MAILMAN message each time an NDC is changed….. Have your RPMS site manager add you as a member to the APSQ DRUG AWP/ACC NOTIFICATION mail group

Caution when entering/editing directly via VA FILEMAN…… It is recommended to use a menu structure if possible……. Talk to your RPMS Site Manager.

Trial 1: ORDER UNIT: BX// DISPENSE UNIT: MG// DISPENSE UNITS PER ORDER UNIT: 135// DISPENSE UNIT NCPDP CODE: ME// NDC: 00085-1461-02// 00085-1461-02 PRICE PER ORDER UNIT: 19.51 LAST PRICE UPDATE: APR 1,2015@12:07:21// BENCHMARK PRICE PER ORDER UNIT: BENCHMARK PRICE PER DISP UNIT is SOURCE OF SUPPLY: As a rule of thumb, most items will use a metric unit, so we will start there…….. The fact this field is blank can also be a clue you don’t have it right……

Trial 1: “Medi” is the system, expects one dispense unit per order unit, locally we have 135.

Trial 2 ORDER UNIT: BX// DISPENSE UNIT: MG// INH DISPENSE UNITS PER ORDER UNIT: 135// 1 DISPENSE UNIT NCPDP CODE: ME// INHALER IH Inhaler NDC: 00085-1461-02// 00085-1461-02 PRICE PER ORDER UNIT: 19.51 LAST PRICE UPDATE: APR 1,2015@12:08:58// BENCHMARK PRICE PER ORDER UNIT: 144.61// BENCHMARK PRICE PER DISP UNIT is 000144.61000 SOURCE OF SUPPLY:

Trial 2

Problem The Joint Commission requires an indication accompany orders How can I have one Quick Order meet all of the various indications? Mild pain Moderate pain Severe Pain Cough??

Solution Embed TIU template fields and data objects into the comments of the Quick Order

Steps: Work with informaticist/CAC to obtain access to editing “my templates” Find an existing data object or template field that suits your needs…….~OR~ Work with informaticist/CAC to create what you need Insert into a temporary template Cut and past into the comments of the Quick Order

Cut n’ paste this into the comments of the Quick Order

Cut n’ paste this into the comments of the Quick Order

Flexibility