Positive Solutions Serial Prescribing

Topics Processing a new Prescription Claiming Subsequent Iterations The CMS Timeline Final Iteration, Treatment Summary Reports and New Scripts PRN’s and Medication Not Required Returning Issued Items Interruptions to a CMS Schedule Cancelling and Amending Claims Missing Electronic Messages

Processing a New Prescription

Requesting the serial script A serial script can be requested by either scanning the barcode on the Scripts Q or keying the barcode from the AMS/CMS Script Token Entry CtrL-T option When the script has been retrieved the hourglass becomes a blue arrow. To dispense select the script and click Expand

The Master script The Master Script is then displayed and the Dispensing Schedule created Master Script – see next slide

The Master script cont’d System calculates the quantities based on: Total quantity prescribed Dispensing Frequency c. Term An indications is given as to how many iterations have been dispensed. As this is the original dispensing it shows as 1. New screen for CMS dispensing E-script on left, note the iteration count System creates schedule based on a. b. and c. Scroll up and down to view all of the drugs.

The Master script cont’d It is possible to change the schedule specified by the prescriber. If major changes are required the script should be returned and replaced. Best not to change the figures, as no check by system that calculations are accurate Main reason may need to amend are for ‘When required’ where GP hasn’t given the required quantities for the iterations Select either the Edit schedule link or Schedule button., This should not be necessary in the majority of cases. Click Close once you are ready to dispense

Dispensing Schedule If you select to edit you can amend the quantity to be dispensed and the frequency Enter the quantity to be dispensed and the frequency Best not to change the figures, as no check by system that calculations are accurate Main reason may need to amend are for ‘When required’ where GP hasn’t given the required quantities for the iterations Click Reset if you want to return to the original schedule Click OK once you are happy with the changes

Labelling Having selected Expand dispense as normal Dispensing proceeds as normal Consider the quantity as defaults from prescribing

Endorsements All necessary Endorsements must be included electronically. From the dispensing screen select the item to be endorsed Endorsing Pane will display the endorsement for the highlighted item Select Endorse and amend as required

Additional Endorsements CMS relies on electronic claims/No paper endorsing Do all staff who label know how to electronically endorse? How will they handle Special prices/Short supply etc. e.g. holding claim until invoice received MOST IMPORTANTLY CMS relies completely on the electronic claim for payment purposes. You MUST ensure that all endorsements including, if appropriate, any additional are entered via the Endorse button for each item

Parking a script Scanned scripts will remain on Script Q. If required use Recall to view previous date. New Scripts will not appear on CMS Prescriptions screen until after Expand has been selected. N.B.You do not need to dispense to see them. Prompt re possible changes and option to discard and re-request script will be displayed when you select Expand If it’s a new CMS script and e.g. the patient collected a previous AMS script yesterday. Select Expand, then End. This will now show on CMS Prescription Request and you can Sync the due date

CMS Script Q Icons The Blue arrow indicates the item is ready to dispense Alternative icons could be :

Claiming

Claiming All claims for CMS are electronic and must be submitted manually. As scripts are dispensed they are added to the CMS Dispensing Claims Screen to be submitted. Items MUST be marked as collected before claims can be submitted A claim is submitted for each collected item after every dispensing At the point that you send a claim an electronic Item Collected Notification is sent to the GP practice and automatically files in the patient record. It is therefore important that you send the claim on the day the medicine is collected/delivered to the patient and NOT the day of labelling. GP notification sent when send claim. Don’t claim at end of labelling process!!

Claiming cont’d Before you submit a claim it must be “Collected”. Items can be marked as “Collected” by either: Selecting the items on the Script Q then select CtrL-C (Collect Medication) from the Misc menu OR Scan out bar-coded bag labels at point of collection, (*configurable option) * When the bar-coded bag labels option is enabled an extra column will appear on the left of the Script Q

The CMS Dispensing Claims screen CMS Dispensing claims are accessed by either: Ctrl-L option from the MISC Menu or CMS Claim

The CMS Dispensing Claims screen cont’d A filter dialogue box is then displayed By default it will show the last 28 days dispensing activity. If required you can alter the Dispensed on or after date to view a particular medication. Process for sending claims e.g. consider storing CMS scripts separately when handed out to patient and then submitting claims at set point during day

The CMS Dispensing Claims screen cont’d Alternatively by selecting the bottom section you can select to view Submitted Claims for a specific period by status/type

The CMS Dispensing Claims screen cont’d Submit a claim for each collected item Claim Status Icon (See next slides for descriptions) Select the item or items to be claimed then Submit Claims can now be amended anytime following submission

Claim Status Icons

Claim Status Icons cont’d

Holding Claims If you are not ready to send a claim you can HOLD it to ensure it is not processed unintentionally Select EDIT from the endorsing screen

Holding Claims cont’d Hold Claim Submission To release the claim repeat the process and remove the tick.

Subsequent Iterations

CMS Prescription Requests After the initial dispensing all subsequent iterations are managed via the CMS Prescription Requests screen. This is accessed via the Misc button and selecting ‘CMS Prescription Requests’ or Ctrl + R

CMS Prescription Requests cont’d Patients who have ongoing CMS prescriptions, or who have recently finished a serial script, are displayed in this screen. Status Indicator (see further slide for descriptions) Select one more scripts and click Repeat to take scripts to the Script Q to be dispensed

CMS Items to be Dispensed from the ScriptQ The Blue arrow indicates the item is ready to dispense Alternative icons could be : If the script is already available on the Script Q you will receive a prompt advising this when you select Repeat

CMS Prescription Requests cont’d History, Script and Patient details are available in addition you can Terminate and Synchronise items. Status Indicator (see further slide for descriptions)

CMS Prescription Requests cont’d Displays number of iterations.

CMS Prescription Requests cont’d History Displays both History and Collected Date Label allows you to reprint if required

CMS Prescription Requests cont’d Patient Displays Patient details. If required FULL patient history can be viewed from here.

CMS Prescription Requests cont’d If Terminate is selected you will be prompted to confirm you want to prevent any further processing of this script

CMS Prescription Requests cont’d If required you can select Sync and defer the next dispense until a date of your choice. e.g. if a patient has had two dispensings due to holidays you may wish to defer for a further 4 or 8 weeks. Useful to check Collected Date from History then Sync next due dates accordingly.

Status Indicators for Prescription Requests and CMS Timeline

The CMS Timeline

The CMS Timeline The CMS Prescription Time Line facility allows a patient's CMS current activity and history to be viewed in a single screen. To open the timeline click Misc and select CMS Prescription Time Line or use the keyboard shortcut of CtrL-1

The CMS Timeline cont’d This displays a list of CMS patients Dispensing Status column If multiple items and statuses, the most important will display e.g. due soon or overdue The TSR column displays the status of their Treatment Summary Report Explanation for selected line

The CMS Timeline cont’d Select Drugs or Patient to see their personal timeline. Dispensing & TSR Status for each item is displayed. Most recent at the top Items on same script turn blue The info panel displays status for the selected line History to review dispensing including labels Patient to open record Script to review original Not used as regularly as Prescription Requests Screen. Check regularly for due TSR’s.

Status Indicators for Prescription Requests and CMS Timeline

Final Iteration, Treatment Summary Reports and New Scripts

Final Iteration and TSR’s Treatment Summary Reports (TSR’s) are documents which are sent electronically to the GP Practice. They include dispensing information for all items and should be used to request new serial scripts when required TSR’s now cover the period of the script, NOT last 24 weeks For each item on a TSR you have 3 options, Y, N or Not Now. Y & N are only available once. i.e. having selected either of these you cannot dispense the item again from the original script. On receipt of new serial script it will link to old items re next due date There is no prompt at last dispensing. Due TSR’s are highlighted on CMS Timeline Overdue Repeat Requests are also highlighted i.e. New script not received A TSR process should be recorded as part of the pharmacy CMS SOP ? Re next due dates? - At the time of producing these slides it appears the new script takes the next due date from the original scripts schedule, NOT the last collected date.

Identifying Due TSR’s Due TSR’s can be identified from either the CMS Timeline or Patient/ Drug details This is a configurable option - default is 14 days TSR Status indicator (see further slide for descriptions) Repeat Request overdue

Creating a TSR Open the patient record from any preferred route and Select New TSR. Previous TSR’s are listed on the panel and can be viewed by selecting View TSR Select New TSR

Creating a TSR cont’d Current CMS items are displayed For each item select from the three options. Required: Not now, Now or Not at all. Select date new script required by. Notes for the GP can be added per item e.g. if a patient had holiday dispensing. View TSR, Dispensing History, Original Script Send TSR

Sample TSR

Sample TSR cont’d

  TSR ICONS N.B. No dispensings are possible following a completed TSR

New Scripts When the new script is scanned and Expand selected you may see the following: Select Yes to defer dispensing to next due date or No to continue Should you chose to dispense, remember to Sync next due dates accordingly.

PRN’s and Medication Not Required

PRN’s and Medication Not Required PRN’s could be Suspended & Resumed Alternatively From Prescription Request screen select SYNC and defer next dispensing

Returning Issued Items

Returning Issued Items It is possible to Return Issued items and decrease the count. Expand then Delete At the time of creating these slides, this is believed to be correct.

Interruptions to a CMS Schedule

Interruptions to a CMS Schedule If a CMS item is prescribed on as AMS you will receive the following prompt The View link will display the active CMS script If you chose to continue with the AMS script you will be prompted again. Continue will dispense from AMS leaving CMS active and unaffected Suspend will suspend BOTH AMS & CMS Cancel will leave CMS unaffected

Cancelling and Amending Claims

Amending Claims Items can be amended any time including after they have been claimed Open session to be amended from Script Q From Patient History select the item to change and amend as required Amended claims DO NOT need to be revoked before resubmitting Status indicator shows claim has been amended Select Submit

Cancelling Claims Highlight claim and select Revoke. You will then be prompted for a cancellation reason

Missing Electronic Messages

Missing Electronic Messages cont’d If a new CMS script is not available from the ePharmacy message store you can still dispense and process a claim Select the line with the yellow triangle icon from the scriptQ Open Patient record

Missing Electronic Messages cont’d 3. Dispense drugs as per GP10 and add dispensing schedule details

Missing Electronic Messages cont’d 4. After collection the items will remain on CMS Dispensing claims as Not Reconciled. Use Submit to reconcile each of the manually dispensed lines, the claims will then automatically submit.

Missing Electronic Messages cont’d 5. Add details for each item on the GP10 and increment the item number accordingly.

Questions?