Some workflow choices are now available in SOAPware that do not exist in some previous versions.

Changes to prescriptions within Rx Manager are now automatically reflected in the current active SOAP note as long as an encounter note is displayed and unlocked (i.e. not signed off or in use elsewhere). For example, removing a prescription within the Rx Pad in Rx Manager, removes it from the SOAP note Medications field.

Rx Manager now allows new prescriptions to be created from within the manager itself. In other words, any/all prescriptions can be created within Rx Manager, which subsequently updates the encounter note.

The Rx Pad tab within Rx Manager has many areas within it:

1. Patient Information
2. Prescriber Information
3. Allergies
4. Formulary Eligibility
5. Add Rx
6. Pharmacy Selection
7. Prescription Information
8. Formulary Information
9. View Drug Interactions
10. View Errors
11. Update Summary
12. Submit Rx

Patient demographics are displayed in the top left corner of the Rx Pad so users can easily confirm which patient the current prescription is for.

Provider data is displayed to the right of the patient information.  This data is pulled from Provider Manager for the current Active Provider.

Both the prescriber and the patient information can be collapsed or expanded by clicking the arrows in the top right corner.

The Allergies field in Rx Pad displays a copy of the contents from the Summary Allergies field.

If the patient has no allergies, the SMARText Item Drug Allergies: No Known (Shortcut: nkda) must be entered into the Summary Allergies field to meet Meaningful Use criteria.

If the Auto Rx Formulary and Eligibility Retrieval setting is turned on, retrieving insurance eligibility will be done automatically whenever the Rx Manager is opened.  For instructions on setting up auto Rx formulary and eligibility checking, please see: Checking Patient Rx Eligibility.

After checking for eligibility (either beforehand or when opening Rx Manager), several new tabs will appear within the Notes section of the Rx Manager. Each tab represents different coverage plans for this patient. Depending on the particular pharmacy benefit manager, the exact data and format returned for any given coverage will vary. At a minimum, the type of benefits will be displayed, e.g. retail, PBM (i.e. mail order or both).

To add a medication, click to place cursor in the search field labeled Add Rx.  Begin typing the name of a medication and a list of SMARText Rx options will expand based on what is typed.  In the screenshot above, the options are limited to items that have already been used on the database.  

To view all available SMARText Rx options, check the box next to Include Cloud Library.  Simply click on the preferred option to add the medication to the Rx Pad.  It will also be added to the Medications field of the active SOAP note.

To select a pharmacy within Rx Pad, click the drop down menu (i.e. at the right in the Pharmacy field), and select a pharmacy from the list.

1. Open the Pharmacy Manager by clicking the plus to the right of the pharmacy field.
2. To add a new pharmacy to the local, Quick Access pharmacy list, click the Add (green +) button , then follow the steps in the following link to add a new pharmacy: Adding Pharmacies.

The Pharmacy viewer displays full pharmacy information on a single line/row. When beginning to type a pharmacy name in the field, a drop down window appears, listing all pharmacies that match the typed letters (much like with Chart Rack). The list of pharmacies are displayed in columns/rows, so they can be sorted by column (i.e. Pharmacy name, city, street, state, etc.).

The patient's preferred/default pharmacy can be set in two areas:

1. In the patient's Demographics chart section, the patient's preferred pharmacy can be selected by using the drop down menu.  The pharmacy that is selected as the patient's preferred pharmacy will be used, by default, when prescribing. The purpose behind this route is so that the default pharmacy can be defined (e.g. by front desk staff) in the patients General Demographics chart section as the patient's chart is initially created.
2. In addition, the patient's preferred/defult pharmacy can also be set directly from Rx Manager.  After selecting the preferred/default pharmacy by using the drop down menu, click the gold star (shown in screenshot above), to set the selected pharmacy as the patient's preferred pharmacy.  This will overwrite the preferred pharmacy within the patient's Demographics chart section.

In SOAPware version 2012.0.5044+, users will have the ability to select and submit individual medications to separate pharmacies. *Note: This feature is not available in versions prior to 2012.0.5044.

Within the Rx Manager, users can select a unique pharmacy for each individual medication that is listed within the Rx Pad by using the drop down menu.  SOAPware will submit the medications to the unique pharmacy that has been selected for each medication once the Submit button has been clicked.  

*Note: If the user selects a new default pharmacy for the patients using the Pharmacy drop down menu located at the top of the Rx Manager window, this will reset all medications to use the newly selected default pharmacy.

The list of medications on the Rx Pad displays all the individual prescriptions to be sent electronically, faxed, printed, or given as samples. The following sub-items for each medication can be directly edited from the Rx Pad by choosing another option from the drop down menu in the fields to be edited:

• Drug Name - E.g. Coumadin.
• Strength - Amount per unit.
• Sig - Dose, frequency, and route.  
• Dispense - The quantity and form (e.g.#30) tablets.
• Days Supply - Number of days prescription should last
• Substitution - Whether or not to allow generics.
• Refills -  How many refills are allowed.
• Written Date - Indicates the day when the medication was inserted on the note/Rx Pad.
• Notes to Pharmacy - Location for typing in free-text message for the pharmacy.

Clicking the downward facing arrows in each field displays the same pick list selections as when working with prescriptions in the Medications field in SOAP encounter notes.

Placing a check mark in the boxes to the left of each medication, allow individual prescriptions to either be included or excluded from a particular action. For example, there could be multiple prescriptions listed with all but one to be sent electronically. Simply uncheck the one not to be sent electronically. Note that faxing is not considered the same as sending electronically (this is an industry-government differentiation and not the opinion of SOAPware, Inc.).

To remove a prescription from the list of medications click the X to the far right of the drug name.  This will also remove it from the active SOAP note.

Under each medication, a status bar will indicate one of 4 statuses:

1. Pending - Prescription has not been sent.
2. eRx Sent - Prescription has been sent electronically.
3. Printed - Prescription has been printed.
4. Faxed - Prescription has been faxed.
5. Errors - Prescription was not sent due to a problem with transmission.

Scheduled medications will be indicated as CII, CIII, CIV, or CV.  These medications can only be printed or faxed.

Formulary Information will be populated to the right of each medication based on available insurance policy data.   If no data is found, these fields will not be populated and Formulary Information will be grayed out.  The field Formulary Details may contain alternatives, restrictions, or coverage.  Whenever the field reads Therapeutic Alternatives, click the drop down to view alternative medications.  To prescribe an alternative medication, you will need to remove the current medication and add the alternative medication, following the instructions above to Add Rx.

The View Interactions button is grayed-out unless interactions are found. Clicking on it displays a list of drug/drug and drug/allergy interactions based on SMARText allergies and medications in the Summary and in the SOAP note.

Clicking the Combined tab will display more detailed information that can be printed for the patient.

The View Errors button will be grayed-out if patient data is complete and all prescriptions are valid for prescribing.  If you are able to click on this button, it will display a list of items that need to be completed prior to prescribing.

Errors are also indicated by a red circle with an X next to the incomplete fields.  To correct, simply click in the required field, and select the appropriate option.

The Update Summary button will allow you to merge any newly prescribed medications with the medications that are currently listed in your patient's Summary Medications field.

The Submit button will send the prescriptions that are selected. It will send the prescriptions via the default method set under Tools > Options. For more information on these settings, see: Tools - Options.

The user can also use the drop down menu to the right of the Submit button, to select to send the prescription by printing, faxing, or by indicating that the user gave samples.