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Medication Management on Epic

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Medication Management on Epic

New Medications or Refills:

If a patient calls requesting a refill or you are prescribing a medication previously discussed with the patient/attending and you are not in clinic, you may e-prescribe the medication as follows:

  1. Please make sure you review the patient’s medications beforehand. Sometimes patients already have refills on medications and you do not need to place another order. You can then clarify with the patient or call the pharmacy (212-241-7720 or x47720) to confirm the status of the medication.

  2. Choose Epic → Patient Care → Refill Medication

  3. Epic will list patient’s current medications, next to which there is a Reorder button. Click on Reorder for the medication you wish to refill. Alternatively, you can type in the name of the medication in the Order Entry text box.

  4. Click on that order to make sure the information is correct: Under “Class” select E-Prescribing. This ensures that the refill goes directly to the Icahn School of Medicine Pharmacy. Check that the Pharmacy (top tab) has “Icahn School of Medicine Pharmacy” listed. This is important, because if it is NOT listed, our pharmacy will NOT see the e-script.

  5. You may see an error message below the medication being ordered saying "Medication can't be e-prescribed, no authorizing provider." If you see this, click the checkbox to the left medication name on the main refill encounter navigation screen. It will prompt you to list an "Authorizing Provider." You can list Yasmin Meah or David Skovran, and click accept. This should make the error message "Medication can't be e-prescribed, no authorizing provider" disappear!

  6. Please Route this refill to Dr. Meah, David Skovran, and the head TS (and Dr. David Thomas if covering for both). Include a brief message about why you are placing this refill order. NOTE: You will not be able to close the refill encounter, but routing it is sufficient and it will be sent to be signed. You can just “X” out of the refill encounter. Once the order has been signed, you will get an "Rx response" in your basket notifying you that the med has been refilled.

Historical Medications:

Medications that patients receive by PDAP should still be listed in Epic but are classified as a 'historical medication' so they aren't accidentally prescribed. To make a medication historical:

  1. Go to your patient's last EHHOP visit. If the encounter has been signed by someone already, just click "Create Addendum." You can also do this through a refill encounter (Epic → Patient Care → Refill Medication).

  2. Navigate to the "Plan" on the left tab. Find the "Meds & Orders" section of the Plan. Find the medication you are making into a historical medication and press "Change." If this patient has not been prescribed this medication previously, click "+ ADD ORDER" on the bottom left corner of the screen and find the medication. You may need to search in "Database" to find it here. Do NOT click in "+ Patient Reported"!!

  3. For Sig, put the instructions you told the patient (e.g. "22U in the morning and 20U in the evening") and then "Contact EHHOP Pharmacy Team with any questions"

  4. Keep scrolling down. For "Class" of medication, click "Historical Medication." (Dr. Meah and Dave usually fill out this part, but normally medications are under class "E-Prescribing."). Pend this medication.

  5. Make sure you discontinue the original E-prescribed medication under the Visit Navigator "Medications" tab - can select something like "Alternate therapy" as reason for discontinuation.

  6. Exit out of the encounter, sign the encounter if prompted.

  7. Send a staff message to Dave, Dr. Meah, and the head TS to let them know where you've pended this historical medication to be signed.

Discontinuing a Medication

If you need to discontinue a medication previously discussed with the patient/attending and you are not in clinic, you may do so as follows:

  1. Choose Epic → Patient Care → Refill Medication

  2. Epic will list patient’s current medications, next to which there is a Discontinue button. Click on Discontinue for the medication you wish to discontinue.