Process an Unmatched Change Medication Prescription Request

When a pharmacy sends a prescription change request, and the system is unable to match that request to an existing patient, you will be notified of this request via a To-Do List message that will populate the user’s To-Do List with a Subject of Electronic Prescription: Unmatched Change Request. You have the ability to process and reply to these types of requests. Use the following steps to process and reply to an unmatched prescription change request.

 

 

  1. When a pharmacy sends a prescription change request, and the system is unable to match that request to an existing patient, a To-Do List message will populate the user’s To-Do List with a Subject of Electronic Prescription: Unmatched Change Request. Double-click this message; or highlight this message, and then click the View button.



     

  2. A Match Change Request dialog will appear allowing you to deny the request, or to match that request with an existing patient. In the Change Request Information section of the Match Change Request dialog, the patient, medication, pharmacy, and prescriber will be listed for the unmatched patient sent from the pharmacy.

    To deny this request, select a Denial Reason, or enter a Comment for why the request is denied, and then click the Deny Request button. The system will then send the denial to the pharmacy and the process will be completed.

    To match this information to an existing patient in the system, you can search for the patient in the Select Patient field, highlight the applicable patient in the list, and then in the Select Patient Medication section, highlight that patient’s medication that you want to match the request to, and then click Match button.
     

  3. Once the unmatched change request has been matched to an existing patient, you can access the patient’s chart and the medication will be highlighted and a [CHANGE] prefix will be attached in the patient’s facesheet. You can process the change request in a similar manner as a general change request or prior authorization change request outlined below.



     

  4. Once the unmatched change request has been matched to an existing patient, can access the matched patient’s chart and the medication will be highlighted and a [CHANGE] prefix will be attached in the patient’s facesheet. To begin processing the change request, click the asterisk (*) button next to the medication in the Medication List of the patient’s facesheet, and select the Process Change Request option.



     

  5. If the change request is a general change request, a General Change Response dialog will appear that allows you toggle between the original prescribed medication (indicated by a [Original Medication] prefix) and the requested changes, as well as search and select a different medication via the Other... button. When the original mediation is selected, you can review the medication information, prescriber information, Patient demographics, and pharmacy information.




    Click the initial Medication Requested drop-down list to toggle between the original medication and the requested changes, or click the Other... button to search for and select a different medication than the original or requested medication.

    If you click the Other... button, a Medication Search dialog will appear, allowing you to search for and select a different medication. Once the desired medication has been located, highlight it, and then click the OK button. That medication will then appear selected in the drop-down list.




    After you toggle the medication in the initial medication drop-down list, or searched for and selected a medication via the Other... button, any changes will be highlighted in the applicable fields where changes are taking place. If the actual medication is different from the original medication prescribed, then the medication itself will become highlighted.

    You have the ability to add or modify the Quantity, Days Supply, Substitution, Directions, Notes to Pharmacist, Diagnosis, Effective Date, and Refills for the medication, as well as viewing medication information via the Medication info button.

    To approve the change request, and send any modified changes in the Medication Requested section, you can enter a Comment, if applicable, and then click the Approve button.

    NOTE: When a change response involves a controlled substance, the various EPCS warnings and signing protocols will be activated, similar to electronically prescribing a controlled substance. You will be required to check the Ready to sign option, insert the IdenTrust USB token, as well as enter your token passcode prior to being able to approve the request.

    To deny the change request, select a Denial Reason or enter a Comment as to why the request is being denied, and then click the Deny button.



    Once the request has been approved or denied, the response will then be sent to the pharmacy.

    If the change request was approved, the system will automatically discontinue the original mediation and generate a new medication drug log comprised of the changes, while also updating the patient’s facesheet. Likewise, applicable changes will be made in the History tab and the Audit Trail.

    If the change request was denied, the system will generate a drug log that will include the patient’s name, account number, date of birth, sex, the denied medication information, the denied reason, any comments, and the user who denied the request.
     

  6. If the change request is a prior authorization change request, a Prior Authorization Change Request dialog will appear. In the Prior Authorization Change Response dialog, you can review the medication information, pharmacy information, prescriber information, and patient demographics.

    To approve the change request, you can enter an Approval Number in the Approval # field, if applicable, enter a Comment, if needed,  and then click the Approve button.

    To deny the change request, select a Denial Reason or enter a Comment as to why the request is being denied, and then click the Deny button.

    Once the request has been approved or denied, the response will then be sent to the pharmacy.

    If the change request was approved, the system will generate a medication drug log comprised of the changes, while also updating the patient’s facesheet. Likewise, applicable changes will be made in the History tab and  Audit Trail.

    If the change request was denied, the system will generate a drug log that will include the patient’s name, account number, date of birth, sex, the denied medication information, the denied reason, any comments, and the user who denied the request.