Posting in medicationRequest

[Nicholas Appelbaum]

Hi Cerner Team

When one writes back a medicationRequest, where does this surface in PowerChart?

We have a use case whereby we are trying to hook into the prescribing workflow, either at "Orders for Signature" or into "Drug Administration". Is this possible? 

Kind regards

Nicholas 

[Nicholas Appelbaum]

Hi Fenil

Just checking in on the above. 

Kind regards

Nicholas 

[Nicholas Appelbaum]

Hi Cerner team

Just following up on this again. 

Kind regards

Nicholas

[Davis Christi (Oracle Cerner)]

Hello Nicholas,

Apologies for the late response.

When MedicationRequest is posted via FHIR, the medication should ideally show up on PowerOrders or on a MPage that has Orders section.

I understand that, within PowerOrders, the Orders for Signature is a process, where you can sign all the orders on the orders scratchpad. With the current capabilities supported with MedicationRequest, I am not sure if there is a way to hook that with prescribing workflow. However, if you can provide a little more detailed description please, on the workflow to help understand this better? I can put this as an idea for future enhancements.

For DrugAdmin, currently we do not support write workflows, search capability is supported as of now.

Thank you

Davis (Oracle Cerner)

[Nicholas Appelbaum]

Hi Davis 

Thank you very much for getting back to me. 

We are developing a SMART-on-FHIR application which generates dosing recommendations. In the case that a clinician wishes to use one of the doses suggested by the application we would like to reduce transcription error by posting in fields like dose quantity, route of administration etc as a MedicationRequest. Our application would ideally hook into the e-prescribing workflow at a pre-signature stage, as shown in the screenshot. Could MedicationRequest.status potentially help achieve this? 

Kind regards

Nicholas 

[Davis Christi (Oracle Cerner)]

Hey Nicholas,

Thanks for the description of your usecase.

What it looks like is you might be needing to integrate the CDS Hooks Order Select workflow or the Orders Sign workflow.

Oracle Cerner has been doing some POC development on the CDS Hooks front but we are not yet GA with the functionality. 

I have put forward this use case with our group as a future enhancement idea.

Thank you

Davis (Oracle Cerner)

[Nicholas Appelbaum]

Thank you for your help again Christi

Just to confirm, is it correct that if a (valid) MedicationRequest is posted via FHIR, that it would show in PowerChart Drug Administration as in the figure attached? 

Kind regards

Nicholas 

On Wednesday, 12 October 2022 at 18:34:24 UTC+1 Davis Christi (Oracle Cerner) wrote:

[Davis Christi (Oracle Cerner)]

Hello Nicholas,

Posting MedicationRequest via FHIR would show up on the Orders Tab, since its a request for the medication. It would not show up on the Drug Admin since  MedicationRequest does not represent the administration of the drug.

Thanks

Davis (Oracle Cerner)

[Nicholas Appelbaum]

Hi Davis

Thanks again. 

Can you confirm therefore that, at present, it is not possible to send a prescribing recommendation from a SMART-on-FHIR application into the Cerner e-prescribing workflow until such time as write in is supported for medicationAdministration? 

Having had a look at the CDS Hooks, I am not sure (even if they were available) that cards will adequately serve the use case whereby a 3rd party application has calculated a dose which the doctor wishes to send across without the need to transcribe values into the prescribing form. 

Kind regards

Nick 

[Nicholas Appelbaum]

Hi again Davis

Last question (hopefully)

On the "Orders" tab in PowerChart, one can see a section for "Medications", along with their "Status" - see screenshot below. 

Is this where a medicationRequest written back would surface? If so, what would a clinician be able to do with this entity? Could it be used as the basis from which to create a prescription? 

Kind regards

Nicholas 

[Nicholas Appelbaum]

Hi Davis

I have just learnt that the destination we are wanting to write back to is called the Scratch Pad... Can you confirm whether, at present, any FHIR resource supporting write back points to this step in the prescribing journey? 

Might you be able to offer any clarity on the above too? I.e. where does the medicationRequest surface in Powerchart? 

Kind regards

Nicholas

[Nicholas Appelbaum]

Hi Davis 

Just following up on the scratchpad question 

Kind regards

Nicholas