1. Pharmacy Workflow Changes with EHRp13/APSP 1017 CDR Katie Johnson, Pharm D NPAIHB EHR Integrated Care Coordinator Pharmacy PSG Chair Pharmacy PSG Sponsored Training September 2014

2. Pharmacy Package Changes n Removal of POV function –Paperless refill, Suspense POV, All Rx POV n Removal of POV in Pharm Ed button n BCMA (Bar Code Med Administration) n RxNorm mapping to Drug file n SNOMED Route mapping n Discharge medication prompt

3. REFILL, SUSPENSE, AND WORKFLOW

4. Refills and POVs n No more Paperless Refill function –Medication will be refilled in Pharmacy Package –Visit “shell” created –Primary Provider will be added manually –POV(s) will need to be added manually from EHR GUI using the new Integrated Problem List

5. EHR Integrated Problem List n The only way to add a POV to a visit is to choose something on the Integrated Problem List (IPL)

6. EHR IPL

7. Medication Refill POV n Recommended SNOMED equivalent for V68.1 Med Refill code = Dispensing Medication 373784005 n Recommend making a Pharmacy SNOMED Picklist with this code on it

8. Example Pharmacy Picklist

9. Workflow Considerations n “Routine” refills n IVR refills – batch POV entry vs POV as you go n CMOP – Running reports and entering POVs after CMOP fills rx (work in progress) n All Rx POV

10. Sample Pharmacy EHR layout n See next slide

12. Additional Considerations n IPL Conversion to SNOMED n Coordinate with EHR Team and Medical Staff n Pharmacy will often be the first contact patients have with the clinic post patch installation n Pharmacy will play a role in IPL conversion n Problems must be converted before they can be used as POV

13. IPL Problems with * are not converted

14. PHARM ED BUTTON

15. Removal of POV from Pharm Ed Button

16. n Options to deal with Pharm Ed Button –Local decision – discuss with EHR Team and Coding Department –Option 1: Pharmacy enter POV through IPL and Coding complete visits –Option 2: Coding enter POV and complete visit

17. Pharm Ed Button n If Pharmacy is entering POV for dispensing only visits from IPL: –Recommended SNOMED = Medication coordination/ordering education, guidance, counseling 423509003 –Add to a Pharmacy Picklist

18. Coding Workflow Considerations n ACRX Auto-Complete Pharmacy Education Only Visits in PCC DE –This menu option automatically completed visits that were only pharmacy dispensing visits –No longer functional since dependent on V-codes Coders will manually have to complete these visits –**If Pharmacy uses recommended SNOMED 423509003 on Pharm Ed button visits, then the report will work **

19. ENHANCEMENTS COMING

20. Relief in EHRp14/APSP1018 n Refill and Suspend functions will automatically: –Create Pharmacy Visit –Stuff person processing med as primary provider –Add generic POV

21. Relief in EHRp14/APSP1018 n Pharm Ed Button –Parameters delivered to map ICD and SNOMED codes to the Pharm Ed button –ACRX Report restored for coding –Basically, functionality restored

22. Other Pharmacy Package Updates Drug File Med Route File Discharge Med Prompt

23. RxNorm Mapping

24. RxNorm Mapping (NDF rematch)

25. Route mapping to SNOMED

26. Discharge Med prompt