Page Comparison

Overall Questions:Outstanding Questions:

1. Encounter/Prescription Status Questions:

   • Two new statuses: "Ready" and "Paused." Ready would be once the order is prepared by the pharmacy and is ready to be picked up, but it has not yet be dispensed. Paused is when a medication is not available because it's out of stock. The order would be changed back to Active once the medication becomes available. 
     • When a drug is not available, should the whole order be Paused or just the drug?
2. What tabs are needed? (in mock ups there are All, Active, Completed, Returned, Cancelled)

3. Pharmacist creating a Prescription Order from paper: Should this order be connected to a Visit?

4. Changing the drug formulation: If you change the drug formulation and the Quantity dispensed doesn't match the quantity ordered, should there be a way for the pharmacy to indicate the order is complete (instead of assuming it's partially dispensed)?
5. Should an order be able to be dispensed if the prescribed didn't specify a formulation?
   1. If it's allowed to be dispensed, we should indicate that row in the dispense event in a different color or visual indicator. 
6. What is the functionality of ordering in O3? Does it allow you to order concepts only?

Answered Questions: 

1. Encounter/Prescription Status Questions:

   • Completed Orders: What makes an order complete? Refills = 0 and there is at least 1 dispense event

     • What happens if an order is only partially dispensed because one drug is out of stock or the full quantity isn’t provided? PA: An order should remain Active until all Medication is dispensed or it Expires

   • Returned: What is the workflow for returns? Is this status is set by the Send Back to Prescriber button?

   • Expired: What makes an order expired in the Dispensing app? Ticket:

     Jira Legacy
     server OpenMRS Issues serverId 45c5771b-fa4b-3e43-b34a-c19dc45ccc95 key O3-1712

     • Currently it’s based on the duration to take the medication. What should be the duration that a prescription order can be Active in the pharmacy (vs being the duration a person is prescribed the drug) if it’s not picked up right away

...

1. • • ?

   • Status dependencies/hierarchies

     • What statuses are the final statuses vs can be updated by another status? For example: Expired should not overwrite a Complete status PA:Cancelled, Filled are final. Returned, Ready and Active can be updated

   • Other statuses with no questions:

     • Renewed Orders: When a prescriber Renews the prescription → cancels the initial Prescription order and creates a new one

     • Active Orders: When any of the drugs in the order are not Cancelled or Completed

     • Cancelled Orders: When the prescriber discontinues all drugs in the order

2. Granular Status for Orders with more than one drug. How does this role up to the Encounter/Prescription Level status? FA: Speaking with PIH SMEs, they didn't think it was necessary to have substances, but rather just one overall status for the order. For example, if an medication was partially dispensed, they would want the order to remain in the Active status. 

   1. Out of Stock Drugs: how should a drug be indicated it’s out of stock? Should it be indicated with a status?

   2. Orders that have more than one drug, but only one of them is cancelled. How do we indicate that drug should not be dispensed?

   3. Partially Dispensed: When only one drug in the order is partially dispensed, so the Order is not complete

   4. Expired: When only one drug is expired, so the Order is not expired.

3. What

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What filters should be included?

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1. filters should be included? PA :Drugs, Dispenser, Status, Prescriber, Date range or exact date

2. What information is shared back with prescriber when an order is dispensed? What screen do they see that on? PA: Though this wasn't completely defined in the design docs, you can see here what we intended to render back in the Patient Chart UI from the tile and menu. Notes would open in a side panel. https://zpl.io/5EMjoAo

   1. Should sites be upgraded to O3 to see the new ordering screens or should we consider something custom before sites are upgraded so they can see dispensed orders?

   2. A clinicians Medication Dispensed Page? (see Dave’s mock ups: Clinician Patient Medications page ; Back to Clinician page ; Dashboard Medication Widget )

3. Should cancelled or expired prescriptions be prevented from being dispensed? FA: yes

   Jira Legacy
   server OpenMRS Issues serverId 45c5771b-fa4b-3e43-b34a-c19dc45ccc95 key O3-1711

4. What should the Delete Prescription button do? Should there be a scenario where a pharmacist can delete the order? PA: This workflow was mainly added for orders the Pharmacy raised themselves. I think if the order comes from the EMR then returning rather than deleting should be the workflow.

   1. What are the use cases for a pharmacist to remove a prescription order from the list?PA: We heard that the system should allow Pharmacists with relevant permissions to create orders (prescriptions) - I believe this is common for HIV Differentiated service delivery cases, as an example. As they can create, they should be able to remove too.

5. Dispensing prescriptions with refills:

   1. What’s the refill workflow? PA: This would be defined in the original order...

   2. Does the system need to track when the person should come back to get their next refill? PA: I could see this being useful but we didn't design it in to this MVP.

6. Dispensing some of the drugs in the order, but not all

   • Partially dispensing an order/Drugs that are out of stock

   • Should there be a status for drugs to indicate it is partially dispensed. The order shouldn’t be marked as complete

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1. • FA: Talking with PIH SMEs, instead of a status they would prefer to keep the Order status as Active, but have the system track the quantity remaining medication to be dispensed. This could be an issue if they change the formulation of what is dispensed so we need to consider having the pharmacist indicate on the dispense event if the Dispense completes the order when it's changed. 

2. What are the requirements for printing?

   • Use case: Print a list in the pharmacy to prepare drugs in the back. What is the criteria for drugs that would need to be prepared in advance?

   • FA: Pharmacy workflow: New view/printable list for medication list that can be used to prepare (e.g. “bag up”) orders.  Should be grouped  by patient.  This should be printable or easily viewable on a mobile device. We need to include the patient name, ID, and barcode on the print out

   • FA: Printing for patient - Label or sheet to give to patient that explains dosage info clearly and includes patient instructions from the dispense record (future phase)

3. Permissions for allowing to delete dispense event

   Jira Legacy
   server OpenMRS Issues serverId 45c5771b-fa4b-3e43-b34a-c19dc45ccc95 key O3-1709

PIH EMR Questions:

1. Should more forms include prescription orders? (currently only HIV and OB/GYN)

2. Data warehouse for reporting

   • What data do we want in the warehouse

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1. What is the workflow when a pharmacist sends a prescription order back to the provider?

   • How do they receive that order?

   • Does the order have a Cancelled status on the dispense list? PA: No, "Returned"

   • Status Question: Send a Prescription back to prescriber: What is the workflow to set this status when a pharmacist needs to send a prescription back to a prescriber?