Medication Not Effective

Med Not Effective

Prescription Writing Woes

Sorry for another long absence. Last week, we spent three days with folks in from Cerner headquarters in Kansas City to hear out and evaluate our disappointment with the Prescription Writer, Medication List and Medication Reconciliation tools. For the most part, we were pleased with the team's receptivity, though less than excited about what can be fixed quickly. The long and the short of it is that we will not see any major changes in the layout and appearance of the Prescription Writer for the time being. However, we will be putting together some documentation to help you optimize the function of what currently exists.

One crucial discovery I have made over the last week is that, in spite of being promised a seamless transition from EasyScript to Prescription Writer, many of the refill/renew and favorites woes are derived from an obvious lack of seamlessness. In fact, I am beginning to untangle myself from the older scripts and will also be building new Favorites folders. This is a major drag since I have about 350 favorites that came over from Easy Script. The problem is that all those extra terms in the sigs and all those problems with renewing and changing doses are a direct result of using old commands to create new prescriptions.

My advice is this: when renewing a med that was originally written in EasyScript, DO NOT use Renew. USE Cancel/Reorder. This will rid of the old version of the Rx, allow you to make changes to the dose and the sig , and should present the mandatory fields in a somewhat more logical fashion. It is definitely worth it. Then, save the new Rx as a Favorite if desired. This new favorite, whether written in the office or on discharge from the hospital, will end up in the Ambulatory Meds favorite folder where you can then organize a brand new folder set based on disease states, medication classes, organ systems, whatever you like. The favorites that fall outside of the Ambulatory Meds folder are all imports from EasyScript. Feel free to delete them as you build new ones.

Keep your eyes peeled for emails and updates on the CIS Info site. We will be getting out details for change in the coming days.

Prescription Writer and the Medication List

My two favorite topics... well, not really. So far, we have had a couple of teleconferences with senior Cerner analysts to share some of the major issues reported thus far. For one, "real estate", the amount of space given to view relevant information, is inadequate. While the old Med Profile seemed less than optimal to many, the new Med List is difficult to read and doesn't take good advantage of potential space.

I remember a time when many of us felt that EasyScript was difficult. With Prescription Writer, the cumbersome task of writing a prescription requires lots of practice and a little luck to boot. It pains me to hear that folks are reverting to paper prescriptions and so the repair of these tools is priority number one.

I am confident that we have been heard by Cerner. Though I can't pin a timetable to the improvements, I believe the practice and process of monitoring and prescribing medications will get better over time.

Below is a slide that Sandy Gagnon of the IS training team put together today. It is a great way to see the Medication List in single-spaced layout. Thanks Sandy!

Uploaded on authorSTREAM by nrk99



And, if anyone is interested, I led a webinar on the Medication List and Prescription Writer last week that can be reviewed via this link: Medication List Webinar

Medication List - writing a prescription

Transparent Informatics: writing prescriptions quickly and efficiently on Prescription Writer will take time and practice. Oddly enough, there are a couple of crucial tricks to getting them done without losing your mind. For instance, make sure that you select Dose as well as Duration in the Details section lest you risk your sanity. I can't say for sure why we are not prompted to select these two elements. Dose refers to the "1 tablet" part of the sig and, if you add Duration, e.g. 30 days, you will not be forced to go back and enter the unit, e.g. tablet, from the bottom of a scroll down list. I know that doesn't make much sense, but do it any other way and you will know what I mean.

I am being as honest as I can be here. I really do think the Enhanced View is a major step forward for CIS, particularly for the ambulatory setting. However, I also agree with all those who have raised concerns about the Prescription Writer. It is Change with a capital C. I've been working for a few hours on the following video and hope it clarifies the prescription writing process. Let me know what you think of the video and whether it needs more help.

Medication List 5 - Prescription Writing