Dispensing Use Case Questions

Overall 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?

   • 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?

     • 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?

   • 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?

   • Status dependencies/hierarchies

     • What statuses are the final statues vs can be updated by another status? For example: Expired should not overwrite a Complete status

   • 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?

   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 expried.

3. What tabs are needed? (in mock ups there are All, Active, Completed, Returned, Cancelled)

4. What filters should be included?

5. What information is shared back with prescriber when an order is dispensed? What screen do they see that on?

   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 )

6. Should cancelled or expired prescriptions be prevented from being dispensed?

7. What should the Delete Prescription button do? Should there be a scenario where a pharmacist can delete the order?

   1. What are the use cases for a pharmacist to remove a prescription order from the list?

8. Dispensing prescriptions with refills:

   1. What’s the refill workflow?

   2. Does the system need to track when the person should come back to get their next refill?

9. 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

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

11. 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?

12. Permissions for allowing to delete dispense event

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

Phase 2 Questions

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?