Prescriptions

A prescription is the physician’s document. WideCare receives it, lets a nurse check its lines, and on confirmation turns each line into a treatment of the resident — what the round gives every day. Prescriptions are handled on the Medicines workstation (Nursing Care → Medicines), Prescriptions tab, and its To Read counter.

Before you start

Two settings, in Nursing Care → Configuration → Settings, block Prescriptions:

  • Receive prescriptions by e-mail — give the address (alias and domain): each e-mail sent to it becomes a draft prescription, its PDF beside the form. The sender is matched to the physician.

  • Read the lines off the PDF — Typed by hand, or Local OCR (Tesseract) to fill in the lines from the PDF. With OCR, set Create a missing medicine from the reference catalogue from this certainty (%): a medicine read that is not in the catalogue is created when the reading is that sure (0 = never created, only proposed in the line’s notes).

In Belgium

A prescription sent from a physician’s eHealthBox becomes a draft the same way, and the renewal can be asked there: see Prescriptions through the eHealthBox.

1. Receive the prescription

A prescription arrives as a Draft:

  • by e-mail to the prescriptions address — the PDF shows beside the form, and the message says how the resident was found, or why not;

  • with New Prescription on the workstation, typed in;

  • by dropping the PDF on a draft’s discussion: with OCR reading on, its lines are read and the form reloads.

The resident is the one the PDF names when the name, and the birth date where one is read, point to a single resident. Otherwise choose the Resident by hand. The Physician is the resident’s attending physician until another is said (the sender of the e-mail, or the one you pick).

A PDF of several patients

From the list of prescriptions, Batch of Prescriptions reads a PDF holding several prescriptions, one patient or more per page:

  1. Choose the file and click Read the File.

  2. Check the resident proposed for each patient read — a resident is proposed only when the name and the birth date point to one person. Pick the others by hand, or untick them.

  3. Click Create the Prescriptions: one draft per patient, with its lines.

Nothing is created before you have checked the residents.

2. Check the lines

On the draft, the Lines tab lists what the physician prescribed. When the lines are read off the PDF, a banner reminds you to check each one against it, and a line still missing its medicine or its dose is shown in yellow. Read the PDF reads the attached PDF again when the draft has no line yet.

Open a line to set:

  • Medication — picked from the catalogue; Read As shows the name read when no medicine was matched;

  • Dosage — picked from the list of dosages (Dosage Read shows what the PDF said);

  • Dosage Form, Meal Timing, End Date;

  • Schedule — Frequency, and the moments Morning, Noon, Afternoon, Evening, Night or Specific Times;

  • Notes.

At the top of the form: Prescription Date, Expiry Date and Physician.

3. Confirm

Click Confirm. WideCare asks for what is missing — the resident, the physician, at least one line, a medicine and a dose on each line. Then each line becomes a treatment of the resident, on the round from its start date, and the prescription moves to In Force. The Treatments smart button and tab show the treatments it started.

A line that renews a treatment ended less than a month ago (same resident, same medicine) keeps what the team had set on it: the intake, not together with, the pharmacy’s sachets and the box.

Each confirmed prescription read off its PDF teaches WideCare the medicines and the letterheads it recognised. See The medicine catalogue.

The life of a prescription

The states are Draft, In Force, Closed and Discarded.

  • Cancel discards a draft (a prescription received twice, a wrong file); Reset to Draft brings it back.

  • Close ends a prescription in force: the treatments it started stop today.

  • Expiry Date — past this day, the Expired ribbon shows, the date turns red in the list and the head nurse is asked to renew it. Nothing stops by itself.

Ask for a renewal

Ask for a Renewal (in force, highlighted once expired) e-mails the physician the resident and each line to renew. The physician’s answer arrives as a new draft at the prescriptions address, never on the old prescription. The request is shown on the form (to whom, when), in the list (Renewal Asked On) and under Waiting, nothing to do on the workstation; a new expiry date clears it.

Finding a prescription

All the Prescriptions, on the workstation, opens the list: number, resident, physician, prescription date, expiry date, treatments and state. Filters Open (default), Draft, In Force, Closed, Expired and Renewal Asked; groupings By Resident, By Physician and By State.

Going further