1. E-DISCHARGE MEDICATION MODULE
Last updated: 7/25/2017

2. GETTING ORIENTED Shows most recent Home Med List
Displays all med lists within
San Francisco Health Network (SFHN)
e.g. eCW, Jail Health Services, Laguna Honda
Create a complete Discharge Med List using Home & Inpatient med lists
Send electronic or print paper rx’s
Find formulary & insurance info 2

3. CREATE HOME MEDICATION LIST
STEPS
SEND PRESCRIPTIONS
To Retail or Discharge Pharm.
DISCHARGE MED LIST
Imported to Discharge docs
CREATE HOME MEDICATION LIST
Required For Every Admit 3

4. STEP 1: Collect Home Meds
SEND PRESCRIPTIONS
To Retail or Discharge Pharm.
DISCHARGE MED LIST
Imported to Discharge docs
HOME MEDICATION LIST
Required For Every Admit
Done By Provider or Med Rec Techs
Cannot start any discharge process until home meds are collected

5. STEP 1: Collect Home Meds
SEND PRESCRIPTIONS
To Retail or Discharge Pharm.
DISCHARGE MED LIST
Imported to Discharge docs
HOME MEDICATION LIST
Required For Every Admit
To Request Home Med collection from Med Rec Techs
Select “Home Med Request” under Collect Home Meds
Expect 24 hr turnaround time

6. Patient’s Instructions
STEP 2
SEND PRESCRIPTIONS
To Retail or Discharge Pharm.
DISCHARGE MED LIST
Imported to Discharge docs
HOME MEDICATION LIST
Required For Every Admit
Accuracy Counts!
Used by all KEY STAKEHOLDERS
Discharge Meds
Patient’s Instructions
Outpatient Providers
Home Health Worker
Discharge Summary

7. STEP 2: Create Discharge Med List
Step 1: MUST select Eligibility Benefits to enable e-prescribing. You cannot e-rx later if this step is missed.
[choose any available option and then click complete] 1. 2.
Step 2: Select Reconcile Discharge.

8. Step 3: Address all Home Meds
Tips
Any Home Medication stopped (X), will be automatically noted in the Patient Discharge Instructions
A BLUE arrow appears when a provider:
Clicks the gray arrow to push the home med over to the discharge medication list. This med cannot be e-prescribed later – e.g. telling the patient “take your home supply”
Changes the home med’s directions OR prescribes a new medication. To prescribe a home med, click on the med. Complete the Rx fields and “add to discharge meds.”
Each medication needs to either have: red X [do not take], green arrow [home medication, continue to take home supply upon discharge], blue arrow [new medication or home medication with changes to instructions]

9. Step 4: Address all In-house Meds
Click X to stop any medication

10. This creates your discharge med list.
Meds listed here = ALL meds the patient should take upon discharge
This list is imported to the ePDP and patient discharge instructions

11. Add any new meds

12. To Prescribe a med, Select the med name
Then fill out additional Rx information
Be mindful of tablet strength (325mg) vs. Dose (650mg)

13. ***HIT THE E-RX BUTTON*** when available
Always….Always…Always
***HIT THE E-RX BUTTON*** when available
Failure to hit eRX button will prevent you from e-prescribing a prescription !!!

14. Each row is an Rx with unique destination.
Select Rx destination.
Each row is an Rx with unique destination.
TIP
SFGH Discharge Pharmacy can be chosen by MDs without DEA license, i.e. interns
Retail Pharmacy Only DEA licensed providers can send eRX to Retail pharmacy. (ask Attending or R3 to send prescriptions)

15. Any controlled medication
Select Paper Rx for:
Any controlled medication
TIP: schedule II meds, e.g. oxycodone, requires a secure script in addition to entering in discharge med list
All Supplies (e.g. ‘test strips’)
TIP: supplies to any RETAIL (non-discharge) pharmacy must also be called in OR paper faxed
3. To hand a physical prescription to patient

16. To remove a med from Discharge List, select the med, then the Remove button

17. Save all work if navigating away from this page **or it will be lost**

18. Complete the Discharge List after all meds are addressed

19. Clinical Checking will identify potential interactions
Click here to address the issue

20. Select appropriate choice or free-text reply, then hit Update

21. Green Triangle indicates issue is resolved.

22. ****WARNING: hit COMPLETE or WORK WILL BE LOST**

23. The GRAY screen indicates your work is saved.
(If you navigated away without saving/completing, you do NOT see this screen)

24. STEP 3
SEND PRESCRIPTIONS
To Retail and/or Discharge Pharm.
DISCHARGE MED LIST
Imported to Discharge docs
HOME MEDICATION LIST
Required For Every Admit
Final step
Remember: interns cannot e-Rx to Retail Pharmacy (get attending/R3)
Even if not Rx’ing, discharge list should contain ALL meds patient takes upon discharge

25. Select send e-prescriptions

26. Prescriptions ready to send will have both an icon and a quantity

27. **then hit UPDATE PRESCRIPTION*
You can change quantity/destination by selecting the medication then adjusting in Med Detail pane below
**then hit UPDATE PRESCRIPTION*
Or just hit Clear to de-select the medication

28. Red Triangle indicates a problem with rx

29. Here, problem is Rx #2 has no destination.
Note: Retail Pharmacy grayed out. Why?

30. Because no Retail Pharmacy was selected
Because no Retail Pharmacy was selected. Use the Change button to select one.

31. No problems are present, (note Retail pharmacy selected).
Ready to send Rx!

32. Icons indicate meds queued up to prescribed
 Electronically Or
Printed

33. Hit Complete

34. LCR discharge medication reconciliation communication pop-up
This pop-up will appear at the end of the medication reconciliation process.
NO POP-UP = NO Rx SENT
This is ONLY sent to the ZSFG Discharge Pharmacy.
Community pharmacies do NOT receive this information.
Free text message to pharmacy
Click OK!

35. LCR Discharge Med Rec Pop-up:
This is only to be used for communication with the ZSFG Discharge Pharmacy and will not transmit to any community pharmacies.
Anticipated DC time helps the pharmacy prioritize the filling of the prescription.
Check boxes if the answer is YES!
Is a secure script en route for Schedule 2 (e.g. morphine)?
Is it OK to dispense 10-day supply of meds if limited by insurance?
Is patient being discharged to Medical Respite?
Will this patient benefit from more in-depth discharge medication education by a pharmacist?
Msg to Pharmacy: Free text message to pharmacy. (e.g. If this is a repeat e-Rx, use the free text box to summarize the changes that you are sending to the Pharmacy.)

36. Issues That Arise ISSUE RESOLUTION
I can’t select a destination to send my Rx!
Did you (or person who entered med) hit gray e-Rx button and do an Eligibility Request?
Perform those functions, remove med in question, re-add it
My med says “free-text medication” and I can’t prescribe it
Try removing medication from discharge list, then using the “Search for New Med” tab rather than using Home or In-House med list
Pagerbox Superuser to make aware of issue: ??
Last resort: keep free-text medication on DC med list, call in rx to pharmacy verbally
I can’t add a med due to invalid frequency
Use a frequency from the drop-down list OR
Use the ‘alt dose’ field to write out sig free-hand
I’m an intern/resident but not enrolled to e-Rx to Discharge Pharmacy
with the following: name, CHN #, NPI #, department and DEA (if you have it).
Call the IT Help Desk

37. Problems?
Ask your Clinical Pharmacist (if available)
Ask your Chief Resident
Discharge Pharmacy
If discharge pharmacy unable to help resolve the issue, ask for Med Rec Support pager # (business hours only)
All help info and powerpoints available at:
Last updated: 7/25/2017