Introduction:

• Current Medication is invoked from facesheet. The face sheet displays the current medication values in multiple ways along with the Rx Date individually for each drug.
  The drugs displayed in the face sheet cell will have a yellow background if the Drug is coming over from previous encounters. Drugs with background color light green are the drugs entered in the current encounter (from current medication screen or from prescription).
• The Current Medication screen is divided in two sections: Current Medication and Transition of Care section. Transition of Care section consists of drugs that have been entered via the [+] button, and/or the Medication History, and/or drugs imported through CCD files. If the CCD file has been imported in an encounter of the patient then the details of these imported drugs is displayed on the Transition of Care section from the next encounter onwards.

Current: The drop-down list value displays drugs from past encounters which have upto date greater than encounter date or has 'Long Term' checked or 'PRN' Checked or the property, rx.keep.in.cm set to 'Y'. The list ignores all drugs marked as 'Over' or 'Stopped' or 'Deleted' in this encounter. Shows drugs Prescribed / Added in current medication of current encounter.

Stopped: Drugs which have been stopped in this or previous encounter.

Past Rx: Displays a list of Stopped drugs, Old Med drugs, and Current drugs (including the ones added and dispensed). The field: No. of days depends on the property: rx.pastrx.days which implies, the number of previous days up to which the drugs will be selected in Past Rx. Also, the option: Unique drug id, depends on the property: rx.pastrx.uniqueDrug which implies, a drug can be prescribed in multiple encounters. To display all entries set to N. To display only the latest entry of a drug set to Y.
Note: For PastRx and Current list box selection all three actions (i.e. Continue, Edit dosage, Stopped) is enabled.

On Start: Drugs which were in Current Medication on start of the encounter, before the provider prescribed him anything. This will include drugs carried forward from earlier encounter which the patient is supposed to be taking, as well as new ones told by the patient.

•  Includes drugs added under current medication screen.
•  Ignores drugs marked as over.
•  Drugs marked as stopped will be included.
•  Drugs prescribed in this encounter will not be included.
•  If a drug is edited (by clicking on the Rx button), the old value will be displayed.
•  The new / edited value will be displayed under "Current" option.

Note: If the stop date added on current medication is less than encounter start date, the record will not be seen even under "On Start" list box option. If the stop date is >= encounter date, it is not seen under "Current", but seen under "On Start".

On Start: Drugs which were in Current Medication on start of the encounter, before the provider prescribed him anything. This will include drugs carried forward from earlier encounter which the patient is supposed to be taking, as well as new ones told by the patient.

Old Med: Makes a list of all drugs ever prescribed to the patient. The drugs in Current option are ignored, the remaining are displayed here. In other words, drugs which were prescribed earlier, but were marked over / stopped and not re prescribed are listed here.

All: Displays original entry of drug from Prescription / Current Medication for the Patient. Includes drugs which are Stopped or marked Over. If the details were edited they are not displayed. Does not display drugs entered from Current Medication which do not have an assigned strength.

+Rx: Add to Prescription - If selected adds the drug to the prescription. The option is available in the Current and Past Rx selection to add the drug to the prescription.

Continue

• It is applicable to all rows which has the dispensable drug Id, irrespective if it came from current medication entry or from prescription. It is NOT applicable for drugs prescribed in the current encounter.
• Here the provider explicitly tells the patient to continue the drug he was taking. Note: Provider is not re-prescribing the drug.

• is provided on current medication screen to edit the details. Typically the user selects a generic drug to be added to current medication.
• Provider selects this option to edit the dosage details for dispensable drugs.
• Alternately, the provider can edit the dosage for drugs carried forward from previous encounters. e.g. the provider may suggest that the patient take 20mg dosage instead of 40mg or suggest only a change in freq from twice a day to once a day

• is provided on current medication screen to stop the medication if required. A provider at times do not want to be forced to enter stop reason. This is mostly true with specialty physicians. The Reason can be entered as “Default” or “No Specific Reason”.
• Here the provider explicitly tells the patient to stop the drug he was taking. This will not appear in the Current list box, but will be present under On Start, Old Med, Past, and ALL. This is the default case. However the program considers the stop date, if it is less than encounter date then it will not be seen even On Start.

• A drug in current encounter could be coming from past encounter.
• So it could be present by default when the patient walks in.
• On enquiry patient may tell the provider that he is no longer taking the drug, because it was over.
• The provider will mark this accordingly.
• This will not appear in the "Current" list Box, but will be present under, 'On Start'; 'Old Med'; 'Past Rx'; 'ALL'.

Note: On patient's first visit or encounter the option remains disabled, it is enabled from the next encounter onwards so as to allow the user to mark any medication as 'Over' after consultation with the patient and for the current encounter.

Warning: Displays drug interaction related warning messages (if any).

No Known Current Medication: The option when selected marks that the patient has no known current medication.

Transition of Care section - The following field description of Transition of Care is equally applicable to the Current Medication section

Add Drug: This will display the search for generic drugs (without strength) except the compound drugs and supplies. Inactive drugs will always be displayed.

Med History: With proper consent taken (either from the patient/parent/guardian/physician) the up-to-date patient specific medication history and pharmacy benefit information are routed electronically (RxHub) and displayed.
Med Hist: Displays the medical history of the patient.

• On clicking 'Med Hist' button the medical history details of the patient is displayed in a popup.
• On this popup, there are checkboxes provided with each drug row so that the user can select the drug and add it to Current Medication.
• The checkboxes are enabled for Open Encounters if NDC code is present for that drug.
• If patient consent is not available then there is an option to send the consent and then Medication History will be available for the patient.
• If the medication history has been discussed in another format with the patient then an option 'Have you reconciled Medication list provided by patient in other format?' checkbox is present at the bottom of the popup.
• If this checkbox is checked then it is grayed out as selected and a check mark is displayed on the Medication History button. This indicates that the medication reconciliation is done. The check mark on the Medication History button is displayed also when Medical History is present.

Status of Transition of Care: The status of transition of care done or not done in the current encounter is displayed or selected from the drop-down list.. Following is the list of values and its description:

1. Transition of Care (New Patient) – is displayed as default if the encounter started is patient's first encounter. Applicable also for a new patient who's CCDA has been imported.
2. No Transition of Care – is displayed as default if patient is an existing patient and there was no import of CCD.
3. Transition with Summary of Care – is displayed as default if any CCDA was imported in the last encounter.
4. Transition without Summary of Care – User has to manually select the value if the patient has transitioned from a clinic without a summary of care.

No Known Transition of Care: The option is selected if the patient has transitioned without medication. Note, selecting the option would indicate that though there are no medications to reconcile but the reconciliation action has been performed and would be considered in the MU calculations.

Del: Delete - if selected and saved then the records is deleted. The option remains enabled only for drugs added from the Current Medication screen; for all the prescribed drugs the options remains disabled.

RxDate: The date is editable for drugs added from current medication screen in the current encounter. For all the prescribed drugs this date is always set as the encounter date.

Drug Name: Can be edited for drugs added from current medication screen in this encounter. Once edited, user cannot enter the dispensable details, if they were already entered, they will be now initialized.

Upto Date: The 'Upto Date' is an editable field for drugs added from current medication screen in this encounter.

Refills: Number of refills is displayed next to the Upto Date column. It represents the number of times refill for medication can be taken from the pharmacy without seeing the doctor

Note: This Refill information displayed is the one entered on Prescription screen. Comments: The column displays the specific drug dosage along with the comments entered by the provider in the pop-up: Edit Drug Details.

Long Term: Displays the status - Yes/No; if the drug has been marked as a 'long term' drug.

Source: The drop-down list displays various sources from where the drug has been added. It is a mandatory field.

•  The following table lists out these sources and its description:

Reconciliation: The drop-down list by default displays value, ‘Add' for drugs added via [+] and Medication History, whereas it displays value, ‘Select' for drugs imported via CCD. To add drugs to the patient's current medication list from Transition of Care section, User has to select the Reconciliation action as ‘Add' on the drug. To remove drugs from Transition of Care section, User has to select the Reconciliation action as ‘Remove' – this entry is not added to the current medication. Once a drug has been reconciled then that entry is removed from Transition of Care section.

Last Modified: Last Modified field displays information such as the latest modified date, time, and time zone of clinic location.

Edu icon: On click the icon displays Patient Education popup. User has the option to either take print of the material and give patient print copies or send the same as email to patients.

Indication: The SNOMED or ICD code indicated as diagonosis and available in CCD-CCR is displayed here; the display of description is optional.

Status: Displays 'Done' status as available on CCD CCR file.

Notes : Any additional note with respect to the current medication is added here. Also, pre-defined notes are available that can be added for convenience.

save button: On click saves the details.

close button: On click closes the Current Medication screen.

history... button: All the user performed actions in the current medication screen are traced and logged. The button history when clicked displays this Current Medication history.

print button: On click prints the clinic details as header followed by the patient details and the patient's current medication history details.