View/Enter Patient Record. 3.1 CP-UC1-PS1 Refill Prescription (CASH)

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1 3 CP-UC1 Dispense Prescription The community pharmacy use case group one (CP-UC1) contains workflows and activities that are focused on the dispensing of a medication to the patient. ID CP-UC1-PS1 CP-UC1-SS1 CP-UC1-SS2 CP-UC1-SS3 CP-UC1-SS4 CP-UC1-SS5 CP-UC1-SS6 CP-UC1-SS7 CP-UC1-SS8 Name Refill Prescription (CASH) Refill Prescription (Payor) Existing Patient, New Prescription New Patient, New Prescription Receive Prescription from Prescriber Receive Prescription via Transfer Reversal of Transaction (CASH) Reversal of Transaction (Payor) View/Enter Patient Record 3.1 CP-UC1-PS1 Refill Prescription (CASH) Business Overview Refilling a cash prescription involves first locating the client in the DIS, verifying their information for accuracy, and updating and/or confirming their allergies/intolerances. If the client has the prescription in hand (bottle or note), it can be located via the prescription number; otherwise the Pharmacist or Pharmacy Technician must review the prescription profile and/or the DIS, and identify which prescriptions have refills remaining and which prescription the client would like refilled. Once the prescription has been located, the worker can proceed in filling the prescription and having it signed off by the Pharmacist. The Pharmacist then counsels the client on the prescription they are receiving. Volume 3(a): Technical Rules 12

2 3.1.2 Workflow Technical Rules The profile must be requested and viewed prior to dispensing; The local system must display both locally dispensed and externally dispensed prescriptions in the same view; The local system must clearly indicate those prescriptions that were dispensed locally; and The local system must transmit the dispense to the DIS prior to third party payors. Volume 3(a): Technical Rules 13

3 3.1.4 Jurisdictional Variations PE As defined in workflows CP-UC1-SS2 and CP-UC1-SS3, the vendor software (local system) must send a new prescription to the DIS when new paper prescriptions that do not already exist electronically in the DIS are first transcribed in the local system. Following an individual store s integration to the DIS, there exists the scenario where new prescriptions were transcribed prior to DIS integration and subsequent refills need to be dispensed. In these situations, an electronic representation of the original prescription does not exist in the DIS. For refills falling into this scenario, the vendor software (local system) must send a new prescription to the DIS which represents the quantity remaining on the local prescription prior to the dispense in question. The new prescription message must precede the dispense message, and the dispense message must include the newly assigned DIS prescription ID. 3.2 CP-UC1-SS1 Refill Prescription (Payor) Business Overview Refilling a prescription that involves a third party begins with first locating the client in the DIS, verifying their information for accuracy, updating and/or confirming their allergies/intolerances, and entering or updating their third party information if required. If the client has the prescription in hand (bottle or note), it can be located via the prescription number; otherwise the Pharmacist (PhC) or Pharmacy Assistant (PA) may review the prescription profile and/or the DIS, and identify which prescriptions have refills remaining and which prescription the client would like refilled. The PA (or PhC) proceeds to process the Rx on the local system which is automatically transmitted to the DIS. The PhC views and manages the DUR from the DIS and continues to send the claim information to the Third Party Payor. The PhC views and manages the DUR from the Third Party Payor, assesses the fiscal adjudication from them and begins the manual preparation of the Rx. Once the prescription has been prepared, the PhC then checks the medication and signs the hardcopy of the Rx and the medication is stored until the patient or agent comes to pick it up at which time the PhC counsels the client on the prescription they are receiving and the patient pays the co-pay if one exists. Volume 3(a): Technical Rules 14

4 3.2.2 Workflow Technical Rules The profile must be requested and viewed prior to dispensing; The local system must display both locally dispensed and externally dispensed prescriptions in the same view; Volume 3(a): Technical Rules 15

5 The local system must clearly indicate those prescriptions that were dispensed locally; The local system must transmit the dispense to the DIS prior to third party payors Jurisdictional Variations PE As defined in workflows CP-UC1-SS2 and CP-UC1-SS3, the vendor software (local system) must send a new prescription to the DIS when new paper prescriptions that do not already exist electronically in the DIS are first transcribed in the local system. Following an individual store s integration to the DIS, there exists the scenario where new prescriptions were transcribed prior to DIS integration and subsequent refills need to be dispensed. In these situations, an electronic representation of the original prescription does not exist in the DIS. For refills falling into this scenario, the vendor software (local system) must send a new prescription to the DIS which represents the quantity remaining on the local prescription prior to the dispense in question. The new prescription message must precede the dispense message, and the dispense message must include the newly assigned DIS prescription ID. 3.3 CP-UC1-SS2 Existing Patient, New Prescription Business Overview The process of dispensing a new prescription consists of first locating the client in the system, verifying their information for accuracy, updating and/or confirming their allergies/intolerances, reviewing the patient s medication profile/history, entering the prescription into the system and filling the prescription. Before the prescription is dispensed to the patient, it is signed off by the Pharmacist and the patient is counselled by the Pharmacist on the medications they are receiving. Volume 3(a): Technical Rules 16

6 3.3.2 Workflow Technical Rules The local system must make electronic prescription available for use by the user; The local system must respect and enforce the current status (stopped, etc) recorded on the DIS for the prescription; The local system must provide a field to capture the Prescriber on the prescription screen; The local system must send the Prescriber in the Author element of the message and the PhC (or PA) in the Data Enterer element of the prescription message; The profile must be requested and viewed prior to dispensing; The local system must display both locally dispensed and externally dispensed prescriptions in the same view; The local system must clearly indicate those prescriptions that were dispensed locally; The local system must transmit the dispense to the DIS prior to third party payors Jurisdictional Variations N/A Volume 3(a): Technical Rules 17

7 3.4 CP-UC1-SS3 New Patient, New Prescription Business Overview The process of dispensing a new prescription for a new patient begins with locating the patient within the DIS, updating and/or confirming the patient s allergies/intolerances, reviewing the patient s medical profile and medical history. Once the patient s profile has been created and updated, the PA (or PhC) can begin entering the prescription into the system and filling the prescription. Before the prescription is dispensed to the patient, it is signed off by the Pharmacist and the patient is counselled by the Pharmacist on the medications they are receiving Workflow Technical Rules The local system must search using the provided Client Registry messages; The local system must identify potential matches between local data and Client Registry data; The local system must provide a field to capture the Prescriber on the prescription screen; The local system must send the Prescriber in the Author element of the message and the PhC (or PA) in the Data Enterer element of the prescription message; The local system must establish a linkage between the Health Number and the locally stored patient; The local system must permit the user to selectively import the name, date of birth, gender, addresses, phone numbers, and coverage; The local system must permit updates to be selectively submitted to the Client Registry. Volume 3(a): Technical Rules 18

8 3.4.4 Jurisdictional Variations PE Updates to the Client Registry are not supported; PE Non-Residents cannot be allocated Health Numbers from pharmacies; PE Non-Residents that visited a Provincial hospital or care facility will have a Health Number allocated. 3.5 CP-UC1-SS4 Receive Prescription from Prescriber Business Overview The process of dispensing a prescription that is received directly from a prescriber requires the Pharmacist to first verify the authority of the prescriber and validity of the prescription, and if the prescription is received over the telephone, the PhC must document the details of the Rx (a paper copy is required by law). Once the details of the prescription are finalized, the PA (or PhC) can proceed by locating the client in the system, verifying their information for accuracy, updating and/or confirming their allergies/intolerances, reviewing the patient s medication profile/history, entering the prescription into the system and filling the prescription. Before the prescription is dispensed to the patient, it is signed off by the Pharmacist and the patient is counselled by the Pharmacist on the medications they are receiving Workflow Volume 3(a): Technical Rules 19

9 3.5.3 Technical Rules The local system must support storing a prescription for a future fill without transmitting it to the DIS; Jurisdictional Variations N/A 3.6 CP-UC1-SS5 Receive Prescription via Transfer Business Overview Receiving a prescription due to a transfer from another pharmacy requires the Pharmacist to first locate the client in the system, review their patient profile and then contact the transferring Pharmacist via telephone to record the details of the transfer on a paper hard copy. Once the Pharmacist has verified the details of the transferred Rx, they can continue to enter the prescription into the system and fill the prescription. Before the prescription is dispensed to the patient, it is signed off by the Pharmacist and the patient is counselled by the Pharmacist on the medications they are receiving. It is important to note that the transferring Pharmacist must maintain a record of the transfer on their local system by either making use of their transfer function or by inactivating the transferred Rx Workflow Volume 3(a): Technical Rules 20

10 3.6.3 Technical Rules The local system must support dispensing against a transferred prescription; The local system must support releasing a prescription as part of the prescription transfer process Jurisdictional Variations N/A 3.7 CP-UC1-SS6 Reversal of Transaction (CASH) Business Overview The process of reversing a cash transaction requires the PA (or PhC) to retrieve the Rx or transaction record on the local system. Once the Rx/transaction record is retrieved, the PA (or PhC) sends the reversal request to the local system which must automatically update the DIS. The PA (or PhC) may provide a refund to the Pt/agent if required and may restock the medication if able based on the regulations of the local Pharmacy Board Workflow Technical Rules The local system must cancel the dispense event on the DIS; Volume 3(a): Technical Rules 21

11 3.7.4 Jurisdictional Variations N/A 3.8 CP-UC1-SS7 Reversal of Transaction (Payor) Business Overview The process of reversing a Third Party Payor prescription requires the PA (or PhC) to retrieve the Rx or transaction record on the local system. Once the Rx/transaction record is retrieved, the PA (or PhC) must send the reversal request to the Third Party Payor. If the reversal is accepted*, the PA (or PhC) can proceed to send the reversal request to the local system which must automatically update the DIS. The PA (or PhC) may provide a refund to the Pt/agent if required and may restock the medication if able based on the regulations of the local Pharmacy Board. *It should be noted that in the case where a reversal is not accepted, the PA (or PhC) may be required to call the third party helpdesk for a manual reversal and then proceed with the local system and DIS reversal. Volume 3(a): Technical Rules 22

12 3.8.2 Workflow Technical Rules The local system must cancel the dispense event on the DIS; The local system must reverse the dispense event for each third party payor submitted; The local system must support manually marking a dispense as DIS cancelled and/or TPP reversed in the event that a cancel/reverse was not electronically possible Jurisdictional Variations N/A 3.9 CP-UC1-SS8 View/Enter Patient Record Business Overview Virtually all activities relating to providing the patient with service require that you first locate, and potentially create, a patient record within the system. Volume 3(a): Technical Rules 23

13 3.9.2 Workflow Technical Rules The local system must support Client Registry searching using any combination of Health Number, Name, Date of Birth, and Gender; The local system must support provision of a keyword for profile access; The local system must search both local and Client Registry for matching records; The local system must merge patient records based on the Health Number; The local system must clearly indicate in search results whether the displayed records are stored locally or not; The local system should support the provision of a reason using values from the standard CeRx vocabulary for accessing a profile; The local system should support a user or system configurable list of reasons for accessing the profile Jurisdictional Variations PE The first name will be identified with qualifier attribute value of CL. The value CL is not meant to determine the first name - according to HL7, it is defined as a CALL ME name. However, it will be used to distinguish the first name from the middle name. In situations where a person goes by their middle name, the first name will still be distinguished as the 'call me' name with the value CL qualifier attribute. Volume 3(a): Technical Rules 24

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