User Guide Pharmacy Access Medicines Manager Version 3.0.0 Release Date 01/03/2014 Last Reviewed 11/04/2014 Author Rx Systems Service Desk (T): 01923 474 600 Service Desk (E): servicedesk@rxsystems.co.uk Training Team (E): e-learning@rxsystems.co.uk
Table of Contents Introduction... 3 Accessing Medicines Manager... 4 Medicines Manager Admin... 6 Prescriptions Tab... 7 Repeat Requests Tab... 8 Registration Requests Tab... 9 Function Buttons... 10 Surgeries Manager... 11 Adding a New Surgery... 11 Editing an Existing Surgery... 11 Deleting a Surgery... 11 Patients Manager... 12 Patient Registration... 13 Consent... 14 Selecting a Surgery... 14 Registration Status... 15 Accessing the Current Medication List... 16 Patient Status Tab... 16 Patient Details Tab... 17 History Tab... 17 Requesting Repeat Medication... 18 Via Patient s PMR... 18 Via MedsManager Admin... 18 Checking the Status of Repeat Requests... 19 Viewing Accepted Repeat Requests... 19 Processing Repeat Requests... 20 Processing ETP Prescriptions... 20 Processing Repeat Prescriptions... 21 Other Features... 22 Amending a Registration... 22 Removing a Registration... 22 Registration History... 23 Printing the Prescription... 23 Setting Patient Reminders... 24 Patient Notes... 26 Active Notes... 27 Troubleshooting... 28 Continuing Professional Development... 29 Service Desk: 01923 474 600 2 Rx Systems 2014
Introduction The process of ordering a patient s repeat medication can be a laborious process, especially if there are potential problems with the wrong medication being ordered (or not ordered), incorrect strengths and dosages, use of inaccurate repeat forms, and so on. Rx Systems together with EMIS are launching Medicines Manager a feature available within the Pharmacy Access package. Medicines Manager is designed to simplify the process of ordering medications by enabling pharmacies to electronically request repeat medication directly into the GP surgery s EMIS Web system. This service is currently only available in England and users must be enabled for Electronic Prescription Service (EPS) Release 2. identifies patients who are eligible for the Medicines Manager service. Once registered for the service, the pharmacy uses the repeat medication list retrieved from the GP system to send electronic medication requests. Upon approval from the prescriber, a Medicines Manager prescription is issued and received in the Medicines Manager module as either: An electronic prescription sent via the NHS Spine if the surgery is EPS Release 2 enabled; A non-etp paper prescription if the surgery is not EPS Release 2 enabled; this will also be the case for non-eps items and controlled drugs. These Medicines Manager prescriptions are then processed using, allowing the pharmacy to prepare medication prior to receiving the prescription, whether this is a paper or electronic copy. Disclaimer Throughout the manual, you will notice that there are screenshots of patient, prescriber and pharmacy details. This data has been generated by EMIS as test patient data used for the purposes of testing. Service Desk: 01923 474 600 3 Rx Systems 2014
Accessing Medicines Manager Medicines Manager can be accessed via the MedsManager menu from: The Main Screen Within a patient s medication record (PMR) The Reprints screen using [F6 Reprints] The Overdue Scripts screen using [F8 Overdue Scripts] When you access the MedsManager menu from anywhere in (with the exception of the PMR), you are able to access the MedsManager Admin and display active notes. Additional features are enabled when the menu is accessed from within the PMR. The Medicines Manager Summary information will be displayed at the bottom of the Main Screen. You will be able to see: New prescriptions: these are the number of new prescriptions received in response to a request sent via Medicines Manager New rejected requests: these are the number of new repeat requests that have been rejected Active notes: these are the number of active notes that you have created for patients registered within Medicines Manager. These features will be explained in more detail later in the manual. Service Desk: 01923 474 600 4 Rx Systems 2014
Upon accessing a patient s PMR, the Register Patient option under the MedsManager menu will be enabled as well as Add Reminder and Patient Consent. Note: If the patient s NHS number is not populated, the Register Patient option will remain disabled. The Medicines Manager status is displayed here Note: If the patient is already registered for the service, the Register Patient option is disabled, and the Repeat Request and Show Active Notes options will be enabled. Service Desk: 01923 474 600 5 Rx Systems 2014
Medicines Manager Admin The MedsManager Admin is used for: Setting up surgeries; Viewing updated medication lists for registered patients; Sending and monitoring repeat requests; Viewing and managing Medicines Manager prescriptions; Viewing a patient s Medicines Manager history; Checking registration statuses; and Adding patient notes. To access it from the Main Screen, click on the MedsManager menu followed by MedsManager Admin : Information within the MedsManager Admin window is structured on three tabs: Prescriptions Repeat Request Registration Requests These tabs are explained in more detail below. Service Desk: 01923 474 600 6 Rx Systems 2014
Prescriptions Tab The Prescriptions tab is split into three sections: 1 2 3 Section 1: displays prescriptions received in response to a Medicines Manager repeat request; Section 2: displays the details of the items issued on the highlighted prescription; Section 3: displays the batch schedule for Repeat Dispensing prescriptions (if applicable). You can sort the results in Section 1 using the filters below: Filter by a specific patient s prescriptions View prescriptions issued over a specified number of days Display processed or cleared prescriptions Process prescriptions using this button; alternatively use the drop-down to mark them as processed or not dispensed Prints the highlighted prescription Add or view notes (including active) Identify the type of prescription Service Desk: 01923 474 600 7 Rx Systems 2014
Note: Cleared prescriptions are those that have been manually marked as not dispensed or processed using the [F4 Process] button from the MedsManager Admin window. Repeat Requests Tab The Repeat Requests tab is also split into three sections: 4 5 Section 4: displays active repeat requests where you can view the number of items requested and the date the request was sent. Selecting a request will display a preview of the requested items underneath. Requests older than 7 days will be highlighted in red. The Acknowledged tick box will be selected when the repeat request has been received by the surgery or has reached the surgery s inbox. Section 5: displays the number of any rejected requests, including the number of items requested and rejected. Selecting a rejected request will display a preview of the highlighted prescription underneath with details of the item(s) rejected. A rejection reason may be provided by the surgery. Service Desk: 01923 474 600 8 Rx Systems 2014
Registration Requests Tab The Registration Requests tab can be used to determine the status of a patient s registration request at the time the request was submitted (see Patient Registration: Registration Status): Note: If the status is Pending it does not necessarily mean that the patient is not registered for the Medicines Manager service. For the most up-to-date registration status, check the Patients Manager. Service Desk: 01923 474 600 9 Rx Systems 2014
Function Buttons These are available throughout the MedsManager Admin window: Send and/or receive local Medicines Manager information Tip: You can enable the Auto Screen Refresh option (located at the bottom of the window) and specify the interval at which your local messages are refreshed View the Medicines Manager activity history Tip: This option is useful as an audit trail and can help determine the stage of the repeat request. Accesses the Surgeries Manager window where you can add, edit or delete surgeries Accesses the Patients Manager window, where you can view a patient s registration status Service Desk: 01923 474 600 10 Rx Systems 2014
Surgeries Manager Before you begin registering patients to the Medicines Manager service, you will need to set up the surgeries. Currently these are only limited those using EMIS Web. In MedsManager Admin, select [F9 Surgeries Manager] to launch the Edit Surgeries window. From here you can add, edit or delete a surgery. Note that any changes made here may result in lost repeat requests. Please contact the Service Desk if you are unsure. Important: Prior to adding surgeries, you must ensure that you have received confirmation that the surgery has Medicines Manager activated. You can contact our Operations team to check this. Adding a New Surgery Select [F1 Add New Surgery] to display the window on the right. You will need to add in the required surgery details and select the system that is used. Editing an Existing Surgery Select [F2 Edit Surgery] to change the surgery details or to mark it as inactive. Deleting a Surgery Select [F3 Delete Surgery] to delete the surgery from Medicines Manager. The surgery cannot be deleted if there is any existing registration or request activity. If you no longer work with a surgery, simply mark it as inactive. Service Desk: 01923 474 600 11 Rx Systems 2014
Patients Manager Use [F10 Patients Manager] from the MedsManager Admin window to view the updated registration status for all Medicines Manager patients. You can filter patients by their name, NHS number, registration status or surgery: Note: Here, a status of Registered means that the patient has given consent for and is registered to the Medicines Manager service. The Surgery that is listed is the GP practice you have selected when registering the patient. Service Desk: 01923 474 600 12 Rx Systems 2014
Patient Registration displays a Medicines Manager status (Eligible, Pending or Registered) in the PMR for all patients who are eligible for and enrolled onto the service. This allows you to identify potential candidates who may benefit from using the Medicines Manager service. When you register a patient to Medicines Manager, you are also capturing nomination for EPS Release 2. Tip: If a patient registered with an EMIS Web surgery is signed up for Medicines Manager, they will also be nominated to your pharmacy for EPS Release 2. If their EPS nomination has already been saved, it will simply be recaptured. Patient registration can be done through the PMR, the Reprints screen and the Overdue Scripts screen. In order for a patient to use the Medicines Manager service, you must first ensure that: They are registered with a surgery using EMIS Web You have obtained their consent You have a valid NHS number saved in the Patient Details screen as well as their name and date of birth will carry out checks to ensure that the NHS number is valid and that there is only one patient on your pharmacy system with that NHS number. If there is more than one patient with the same NHS number populated, will display the warning alert displayed on the right: In order to proceed, you will need to correct the affected patient records. Service Desk: 01923 474 600 13 Rx Systems 2014
Consent The consent status for a patient can be updated via their PMR. Select the MedsManager menu and then Patient Consent where you will be able to print a consent form and save their consent status. Tip: This is the same consent form used for the ETP (Electronic Transfer of Prescriptions) and RMS (Repeat Medication Service) modules. If you attempt to register a patient whose consent status has not been captured and saved on, you will be prompted to do so. Selecting a Surgery When you register a patient for the service (access the MedsManager menu and select Register Patient ), you will need to select the surgery the patient is registered with. After selecting [F10 OK], a confirmation message is displayed to confirm that the patient is successfully scheduled for nomination. As mentioned previously, when you register a patient to Medicines Manager, you are also capturing nomination for EPS Release 2. In order to process any scheduled nominations, access the ETP module and process any pending nominations. You will need to do this even if EPS nomination has already been captured for your patients as this re-captures the nomination. Tip: You must process any pending nominations before using Medicines Manager to request repeat medication. If the patient is registered with the selected surgery and has repeat medication listed, you will receive an updated medication list immediately. Service Desk: 01923 474 600 14 Rx Systems 2014
Registration Status The patient s registration status can be viewed from the Patients Manager window which is accessible via the MedsManager Admin window. The Registration Requests tab in the MedsManager Admin window displays the status of the registration request at the time that the request was submitted. The registration statuses include: Pending where the request has been sent to the NHS Spine; Accepted for patients successfully registered to the selected surgery; and Rejected for patients who have not been successfully registered to the selected surgery. Note: Please be aware that the Acknowledged tick box will not be enabled for EMIS Web surgeries, even if they have received the registration request. You can use [F7 Send/Receive] to manually refresh your local messages to check if there are any new messages or confirmations sent by the surgery. If there are new messages, they will be downloaded and patient records will be updated accordingly. Tip: If you have sent a registration request and have not received a response from the surgery within 24 hours, first ensure there is no pending nomination in ETP and then resend the request (see Medicines Manager Admin: Registration Requests Tab). Tip: If the patient is not actually registered with the selected surgery, you will notice an active note created on their Medicines Manager record explaining this. This note will appear even if their registration status says Accepted. To find out how to amend a registration or to view the registration history, please refer to Other Features towards the end of this manual. Service Desk: 01923 474 600 15 Rx Systems 2014
Accessing the Current Medication List Once a patient has been successfully registered for the service, MedsManager Admin retrieves the current medication list sent by the surgery. Locate the patient s record in the MedsManager Admin window and double-click it to access the Patient s Details window. Within this window, you will be able to access the following tabs: Patient Status Patient Details History Patient Status Tab From this tab, you can view the registration status, surgery, the date the medication was last updated, and a patient review date (if specified). You can also view the patient s current repeat medication. Amend the patient s surgery by selecting the [Change Surgery] button located at the bottom of the tab. This will effectively change the Medicines Manager registration for the patient to a new surgery. Use [F2 Request Repeat] to send a repeat request to the registered surgery. This is explained in more detail under Requesting Repeat Medication. Service Desk: 01923 474 600 16 Rx Systems 2014
Patient Details Tab You can view the patient s details, such as NHS number, date of birth and address here. These details can only be amended from the patient s PMR via the [F1 Patient Details] button. History Tab You can view all messages and actions sent and received for this patient. This tab is also useful to view when the last repeat request was sent as well as the items that were requested. Service Desk: 01923 474 600 17 Rx Systems 2014
Requesting Repeat Medication You will be able to use the current medication list for your patients to request repeat medication on their behalf. Tip: If the medication list is blank or is not loading, we advise registering the patient again. From the Patient Detail s screen, select [Change Surgery]. Confirm you wish to change the surgery and then re-select the same surgery that the patient is registered with. A patient s repeat request can be sent from either: The patient s PMR The MedsManager Admin window Via Patient s PMR Click the MedsManager menu from the patient s PMR and select Request Repeat. The patient s Request medication window will be displayed. Tick the medication that has been requested using the Select tick box. Select [F10 OK] to then send the repeat request. Use this section if you have any messages you need to communicate to the surgery regarding the repeat request Via MedsManager Admin Access the MedsManager Admin window and double-click on the patient s record. The Patient s Details window will open on the Patient Status tab. Select the [F2 Request Repeat] button. The Request medication window will be displayed (as shown above) for you to then request the patient s medication. Service Desk: 01923 474 600 18 Rx Systems 2014
Checking the Status of Repeat Requests The status of submitted repeat requests can be checked by accessing the Repeat Requests tab in the MedsManager Admin window. Any requests that are still to be actioned by the surgery are displayed here: Details of the highlighted request are displayed here Double-click the request and click the Patient s History tab to view a list of requested items. Viewing Accepted Repeat Requests Once a request has been accepted, you will receive a prescription that can be viewed in the MedsManager Admin window under the Prescriptions tab: Service Desk: 01923 474 600 19 Rx Systems 2014
Processing Repeat Requests Once the surgery has accepted the repeat request, prescriptions received in response to these requests will be displayed under the Prescriptions tab in the MedsManager Admin window. These are ready to be processed. Tip: When accessing a patient s PMR, automatically checks to see if a prescription already exists within Medicines Manager. If there are any outstanding prescriptions for the selected patient, the user can launch Medicines Manager to view and process the prescription. Prescriptions are identifiable through the prescription status : E ETP: these are Release 1 and Release 2 prescriptions which should be processed via the ETP module R Repeats: these are non-etp Medicines Manager prescriptions which are processed in the PMR as an overdue script Processing ETP Prescriptions Highlight a prescription with an E status and select [F4 Process Prescription]. You will be reminded to ensure your Smartcard is inserted before being taken to the ETP module. If the prescription has not already been downloaded, it will be pulled down from the NHS Spine. If the prescription has been downloaded, it will open in the ETP module where you can then process it as normal. Service Desk: 01923 474 600 20 Rx Systems 2014
Tip: If the prescription is processed directly in ETP before it is processed in Medicines Manager, its status will be updated to Processed automatically. Processing Repeat Prescriptions A Repeat type prescription will be issued where: The surgery are not EPS Release 2 enabled The item does not have a SNOMED DM+D code (i.e. the code that allows it to be prescribed electronically) The prescription contains a Schedule 2 or 3 Controlled Drug In these cases, you will still need to collect the prescription from the surgery as per your usual procedures. Highlight a prescription with an R status and select [F4 Process Prescription]. You will be taken into the patient s PMR where the script type defaults to MedsManager Script. This creates an overdue script entry into the patient s PMR. You may need to manually select each item on the prescription and complete the dispensing process as normal. When you receive the paperbased prescription, you will need to redeem the MedsManager Script via the PMR or the Overdue Scripts screen. Service Desk: 01923 474 600 21 Rx Systems 2014
Other Features Amending a Registration You are able to change the selected surgery for a patient very easily. For example, you may have registered a patient to an incorrect surgery or the patient may decide to change surgeries. Access the Patient s Details window by double-clicking on the patient in the MedsManager Admin window: Click on the [Change Surgery] button and you will see a confirmation alert: Once you have selected [Yes], you will then be prompted to select the surgery. Select the updated surgery and click on [F10 OK]. Removing a Registration If a patient no longer wishes to use the Medicines Manager service, you can effectively de-nominate them. You will need to remove their ETP nomination (in order to remove Medicines Manager registration). Access the ETP module, click on [F9 Nominate Dispensary] and ensure the patient s details are populated before selecting [F10 OK]. Service Desk: 01923 474 600 22 Rx Systems 2014
From the Nominate Dispensary window, select [F1 Show Additional Information / Remove Nomination] to remove the Medicines Manager registration. You must then re-nominate the patient to your dispensary to continue receiving their EPS Release 2 prescriptions Registration History You are able to display the MedsManager registration history for a specific patient within the MedsManager Admin window. Simply double-click on the relevant patient record to display the Patient s Details window, where you can then select the History tab (see Accessing the Current Medication List). Use [F8 Show History] if you wish to see general actions such as registrations, requests, receiving acknowledgements, responses from surgeries, and so on. Printing the Prescription You can print the received prescription message to assist you in your dispensing processes by selecting the [F5 Print Prescription] button in the MedsManager Admin window. You will be shown a print preview before you print the medication list: This is the recommended method if you are processing R type prescriptions. Note: If you wish to print this to a dispensing token, you will need to ensure you manually select the correct printer tray from the Print Options. Service Desk: 01923 474 600 23 Rx Systems 2014
Setting Patient Reminders In Medicines Manager, you are able to set reminder dates that can assist you in managing the repeat requests. For example, you can set a reminder to contact the patient and offer to request their repeat on their behalf. To set up a patient s reminder, first access their PMR. Select the MedsManager menu and then click on Add Reminder. The Add Reminder box will open: The Reminder Title, Reminder Type and Patient Name fields are auto-populated but can be amended. You will need to set a Reminder Date and Time and add any notes if necessary. You can also set a recurrence pattern for the reminder by selecting the [F9 Show Recurrence Options] button which will then display the available options: Service Desk: 01923 474 600 24 Rx Systems 2014
The next time you launch, any reminders that are due will be displayed: Use [F2 Edit Reminder] to change the highlighted reminder s details. Use [F1 Request Repeat] to open the patient s details window and request the repeat. You can set the snooze interval in minutes; selecting [F3 Snooze] will then postpone the reminder alert for the time specified. Use [F4 Dismiss] to ignore the reminder and it will not be displayed again. You can view, edit and delete the reminders you have set in Medicines Manager in the same way that generic reminders are done in. Simply access the Utilities menu and select Reminders. Service Desk: 01923 474 600 25 Rx Systems 2014
Patient Notes You can manage any notes that were added for a patient in Medicines Manager. Double-click on the patient s record within the MedsManager Admin window to access the Patient s Details window. Use [F4 Add] to add a note; you will be able to see when the note was last edited and by whom: Use this tick box to mark a note as active or inactive You can edit a note by highlighting it from the patient s list and selecting the [F5 Edit] button. If you wish to delete a note, highlight the note from the list and select the [F6 Delete] button and you will see the following prompt: Note: In the MedsManager Admin window, you will be able to see the total number of notes (i.e. 4) and the number of active notes (i.e. 2): Service Desk: 01923 474 600 26 Rx Systems 2014
Active Notes This feature is particularly useful in communicating messages between staff working in your pharmacy. If you have marked a patient note as active, the note will be displayed upon entering that patient s PMR: Alternatively, you can view all active notes by selecting the MedsManager menu from the Main Screen and then selecting Show Active Notes. Service Desk: 01923 474 600 27 Rx Systems 2014
Troubleshooting Question 1: On the Main Screen, the Medicines Manager Summary Box is displaying -1 figures. Why is this? Answer: The reason for this is that the Medicines Manager service on your PC has stopped. This service should be re-started on the server machine only. To re-start this service: Go to My Computer (this can be accessed from the Start menu) Navigate to C:\Program Files\MedsManager\Server Tip: You can copy this and paste it into the folder address bar: Double-click on MedsManagerServer Admin and click on the [Start] button Question 2: My patient is already nominated for EPS. I have registered them for Medicines Manager and received a confirmation that they are successfully scheduled for nomination. Why can t I see their current medication list? Answer: If the patient has been successfully scheduled for nomination, you need to ensure that you have processed any outstanding nominations in the ETP module. Question 3: Why is my patient s current medication list empty? Their Medicines Manager status says Registered. Answer: First you will need to ensure that the patient is registered to the correct surgery in Medicines Manager. If you are certain that they are you will need to contact the surgery to check that items are flagged as repeat items. Service Desk: 01923 474 600 28 Rx Systems 2014
Continuing Professional Development evaluate identify CPD record plan act What have I learnt from this training session? How will these things improve my current or future performance in my job? What opportunities do I have or need to practise what I have learnt? What help or support will I need and from whom? How and when will I (and others) measure how well I have put my learning into practice at work? Service Desk: 01923 474 600 29 Rx Systems 2014