1. Long Term Care Workflows PrescribersConnection Switch
W1: Census
Facility
CENSUS msg to Pharmacy
PrescribersConnection Switch
CENSUS msg to Prescriber
Long Term Care
Pharmacy
CENSUS msg from Facility
CENSUS msg from Facility
Prescriber
Script Message Directional
Facility is system of record for patient
Start of workflow
Trigger Events
End of workflow
Admit: Facility sends Census to establish patient record in Prescriber and Pharmacy systems upon a New Admit. Prescriber and Pharmacy systems tie the facility’s patient id to their system’s internal patient id. This ensures all future messages are associated with the correct patient.
Change: Facility sends Census to update patient record in Prescriber and Pharmacy systems when demographics change.
Discharge: Facility sends Census to update patient record in Prescriber and Pharmacy system when patient is discharged. Discharge type: expected to return vs. not expected to return has implications to existing orders as well as to the Resupply and CancelRx (discontinue) workflow.
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2. Long Term Care Workflows
W2: NewRx
PrescribersConnection Switch
NEWRX msg to Prescriber
NEWRX msg from Facility
NEWRX msg from Prescriber
Prescriber completes all Meaningful Use work for message.
NEWRX msg to Pharmacy
Prescriber
Long Term Care
Pharmacy
Facility
Adds or Changes to order after created by Facility will be handled via phone call from Prescriber.
Script Message Directional
Facility is system of record for patient
Start of workflow
End of workflow
Trigger Events
Facility admits a resident and enters current medications as NewRx orders to be approved by the Prescriber.
Facility director has determined patient requires an additional medication. Facility system is updated and medication is sent as a NewRx order to be approved by the Prescriber.
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3. Long Term Care Workflows PrescribersConnection Switch
W3: RxFill
Records updated by Prescriber Order Number to add Rx Reference Number and Dispensed Medication details to reconcile any changes.
Facility
RXFILL msg from Pharmacy
PrescribersConnection Switch
RXFILL msg to Facility
Long Term Care
Pharmacy
RXFILL msg to Prescriber
Prescriber
RXFILL msg from Pharmacy
Records updated by Prescriber Order Number to add Rx Reference Number and Dispensed Medication details to reconcile any changes.
Script Message Directional
Facility is system of record for patient
Start of workflow
End of workflow
Trigger Events
Pharmacy has dispensed medications ordered on a NewRx and submits the RxFill message to the Facility as well as to the Prescriber to update each system with the Rx Number, Dispensed Medication information and reconcile the systems to any changes made. This message also notifies the Facility staff that the medication will be delivered.
Pharmacy has dispensed medications ordered on a Resupply and submits the RxFill message to the Facility to update the systems with any changes or substitutions and to alert the Facility staff that the medication will be delivered.
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4. Long Term Care Workflows
W4: Resupply
PrescribersConnection Switch
RESUPP msg to Pharmacy
RESUPP msg from Facility
Prescriber
Long Term Care
Pharmacy
Facility
Records updated to record medications delivered.
Script Message Directional
Facility is system of record for patient
Start of workflow
End of workflow
Trigger Events
Facility staff determines more medication is needed for a patient based on managing inventory and/or soon-to-expire orders.
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5. Long Term Care Workflows W5: CancelRx & CancelRes
Facility
CANRX msg to Pharmacy
Records updated by Rx Reference Number and Patient to discontinue medication.
CANRX msg to Prescriber
PrescribersConnection Switch
CANRES msg from Pharmacy
Long Term Care
Pharmacy
CANRX msg from Facility
CANRES msg to Facility
Prescriber
CANRX msg from Facility
Records updated by Prescriber Order Number to discontinue medication.
Script Message Directional
Facility is system of record for patient
Start of workflow
End of workflow
Trigger Events
Prescriber has determined patient no longer requires a medication. The Facility system and MAR are updated and a CancelRx is sent to the Prescriber system as well as the Pharmacy system to discontinue the medication.
Pharmacy responds with either approved or denied CancelRxResponse to the Facility.
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6. Long Term Care Workflows W6: NewRx – Discharge Orders
PrescribersConnection Switch
Facility
Retail
Pharmacy
NEWRX msg to Pharmacy
NEWRX msg from Facility
Adds or Changes to order after created by Facility will be handled via phone call from Prescriber.
Script Message Directional
Facility is system of record for patient
Start of workflow
End of workflow
Trigger Events
Prior to discharging a patient, Facility staff enters current medications as NewRx Discharge Orders to be sent to the patient’s choice of retail pharmacies.
There is no RxFill returned as its strictly a retail pharmacy.
There is no Refill Request or Refill Response between the facility and retail pharmacy as facility is LTC.
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