Adding Orders Outside of Clinic


For new or to refill current medications:

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) 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.

2) 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.

3) TIP: 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!

4) Please Route this refill to Dr. Meah and David Skovran (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.

For imaging studies or to specialty referrals:

_To add orders (imaging, referrals to specialty providers) outside of clinic, you canNOT use the “Refill Medication” option above. You must lend the order by addending an old office visit as per the instructions below. You can also do this through a telephone encounter if this is related to an ongoing conversation / series of notes that you have there.

1) Go to Epic Button → Patient Care → Addendum.

2) Click on addendum and enter pt MRN. If you are already viewing the patient’s chart, the name will appear as a suggestion on the bottom of the pane. Click accept

3) A list of possible office visits to addend will appear. Choose the last office visit from EHHOP for the patient. It must be an office visit and not a student note. Click accept.

NOTE: If there is no visible last office visit after you do the above, and the patient has been seen previously at EHHOP for a new patient or return visit, AND you see a previous office visit under Chart Review → Encounters, it means that the encounter was not closed by the attending. In this case, in order to add a labs order, you must open the office visit through the schedule. First, make sure you are logged into EHHOP department. Second, click on Schedule → find the date of the last office visit → find your patient’s name (note that it is an open encounter) → double click → go to Dx and Orders through the visit navigator → place and pend order → xeit the encounter. You cannot close the encounter as a student; only the attending can.

4) A new addendum page will open for the patient. You may enter orders as usual from the bottom left corner where it says "Add Order."

5) After you have entered the orders, click “Pend” (top right corner). Nothing will happen, and that’s fine.

6) Next, close the encounter. A yellow yield sign will pop up saying there are still orders that are unsigned. Ignore this (the attending will sign in later and sign the orders).

7) A screen will then give you the option to sign the encounter. Sign and accept.

8) Send an staff message in Epic to Dr. Meah, Dr. Thomas, David Skovran, Chief TS, and your TS mentor letting them know that you pended an Rx to the last office visit (you must include the date of that Office Visit so they know which one to click on), with the patient’s chart linked to the message, and asking them to sign it.

9) Note this new referral in the TS referrals request tab of the ACT referrals spreadsheet here: https://docs.google.com/spreadsheets/d/1djcNBhEqabCXWQPw8siuT_FUkq2exggFS1zIaOq8LGg/edit#gid=1308614903