When you click open the Outpatient Meds category, the Meds Review plug-in displays a summary list of your patient's outpatient medications. As with inpatient medications, each summary item delivers at-a-glance data that you can use to quickly identify the patient's current medications, each medication's status and dose-route-schedule, and much more. Following is a full list of items you'll see in the Outpatient Meds summary view:
- Medication name:
- The summary displays the medication's full name unless it is too long to fit in the name's alloted space. If it is too long, the plug-in displays a truncated version of the name and provides a hover hint that displays the medication's full name.
- Dose, route,
and schedule:
- The summary normally displays dose, route, and schedule in order—40 MG PO Daily, for example. In some cases, however, it displays a message instead. For example, it displays Complex Dose for complex doses. And for non-standard doses, routes, and schedules, it displays dose-route-schedule information from the signature (the term signature refers to human-readable instructions for taking the medication). If you see the message Multiple Doses, the plug-in is telling you that the patient has more than one clinically active or pending order for the medication. (The term clinically active refers to medications having any of the following statuses: Active, Suspend, or Hold.) Finally, if the summary displays See Detail, the medication's dose-route-schedule information doesn't meet any of the aforementioned display criteria.
- Status:
- Statuses include Pending, Active, Active/Suspend, Active/Hold, Expired, and Discontinued (D/C). A number preceded by the multiplication sign (×) on the right side of the status indicates the number of overlapping orders for the medication. For example Active(×2) indicates two clinically active orders for the same medication.
- Type:
- Types of outpatient medications include: Out Pt, PRN/Out PT, Non-VA, and Supply
- Last filled:
- The plug-in displays the date the pharmacy last filled the medication.
- Refills remaining-
days Supply:
- The plug-in tells you at a glance the number of remaining refills and the days supply for each refill: 1 refill (90 days each) for example.
- Total daily or Maximum daily dose:
- The summary displays either total daily dosage or maximum daily dosage information when this information is meaningful. For example, if your patient is taking 250 MG of medication twice daily, the application displays Total daily 500 MG. But if schedule orders are pro re nata (PRN), it displays the maximum daily dosage: Max daily: 500 MG, for example. (The plug-in does not display non-PRN dosages that occur less than once a day, nor does it display maximum or total daily dosages for complex dosing or other dosing schedules that are not reliably computable.)
- Expiration and discontinued dates:
- The plug-in displays this information for all medications except medications that have both active and pending orders. Dates that appear in red boxes indicate medication orders that will expire within 60 days; expiration dates in yellow boxes indicate that the medication order will expire within 180 days; and expiration dates in light gray boxes indicate the medication order will not expire within the 180 days.
Finally, the plug-in's summary includes a timeline graph that represents the medication's history over the past two years.
The graphs have year markers for easy visual orientation. Shaded boxes indicate discrete medication orders, and the shaded bars beneath the boxes indicate fills:
- Green shading indicates clinically active orders.
- Red shading indicates discontinued orders.
- Yellow shading indicates expired orders.
- Gradient gray shading indicates multiple, overlapping orders.
- Dark gray (on the fill bar) indicates medication fills. (Fill bars are located beneath medication-order bars.)
- Black on the fill bar indicates overlapping fills.
When you point your mouse at a medication element, the plug-in displays a hover hint containing details such as the medication's start and stop dates, dose, status, dispense drug and status, and the signature. When you point your mouse at a dark gray fill element, the plug-in displays a hover hint containing the fill date and days supply. If you point your mouse at a black fill element, the hover hint provides the dispensed date and days supply for each of the overlapping medications and the number of days the medication fills overlapped. And if you point your mouse at a gap between fills, the plug-in provides the exact number of days in the gap.
You can drag graphical timelines to the left and right by using your mouse pointer.
Outpatient Meds Details
When you click a medication summary on the Outpatient Meds list, the Meds Review plug-in displays details that supplement the summary list, thus helping you focus on specific aspects of your patient's history with the medication.
The Outpatient Meds detail view has two sections. The left pane contains an Actions menu, Infobuttons, and order and fill history lists (labeled Order Hx and Fill Hx, respectively. The right pane displays additional details. The plug-in displays the Fill Hx list by default.
The Order Hx and Fill Hx lists toggle. Click the Order Hx or Fill Hx button to display the list you want to view.
For each order, the Fill Hx list displays the fill date, quantity, days supply, and pick-up method. The Order Hx list displays each order's start and stop dates, and status.
You can view further details about a particular order by clicking it. When you do this, the plug-in scrolls the Meds Review graphical timeline to the date of the order you clicked.
The plug-in displays the additional details for orders in the detail view's right pane. These details include a patient-label box that contains the medication's name and dispensed strength, the order's status, and the signature. Beneath the patient-label box, the plug-in displays the following details:
- Prescription number
- Dose-route-schedule (using medical acronyms)
- Ordering provider
- Pharmacist
- Location
- Facility
The Actions menu enables you to create a new task, which the Meds Review plug-in automatically associates with the medication. It also offers links to knowledge resources called Infobuttons
.