From time-to-time MedicalDirector Customer Care receives enquiries informing us that medications in some patient records have "disappeared".
In reality, they have not disappeared as such, but rather they have been automatically completed and removed from the patient’s list of current medications (as found on the Current Rx tab of the patient’s record), in line with settings configured in MedicalDirector Clinical Options.
This guide attempts to explain MedicalDirector Clinical’s settings in regard to this, and the implications of modifying these settings.
MedicalDirector Clinical’s Prescribing Options are pre-configured to accommodate the workflows of the majority of customers. These options can be changed by users (if they have permission to do so) to meet their particular needs.
On the Prescribing tab of Options (Tools > Options) there are two check boxes that must be understood:
Default scripts to limited duration affects the intended duration of all prescription medications.
o If ticked, it will default all new prescriptions as ‘Limited’ duration.
o If un-ticked, it will default all new prescriptions as ‘Long-term’ duration.
This setting can be overridden during the prescribing process itself, by using the options located at the bottom-right of the Enter Dose window.
Limited duration elapse affects whether or not the practitioner is prompted at the time a ‘Limited’ duration medication elapses. If ticked, it will cause the following prompt to appear when a patient's record is opened at a time a ‘Limited’ duration medicine should have expired.
When prompted in this fashion, the practitioner has the following options:
o Continue the ‘Limited’ duration by entering a new end date.
o Make regular to switch the item into a ‘Long-term’ duration medication.
o Mark the course as Completed, at which time it will be removed from the Current Rx list.
o Remove the item, at which time it will be removed from the Current Rx list.
o Ignore the prompt on this occasion.
If the 'Limited duration elapse' check box in Prescribing Options is not ticked, the practitioner will not be prompted as above. In this case, the medication is automatically marked as ‘Completed’, and is removed from the patient's Current Rx list. This is intended behaviour for those who wish the software to behave this way.
Care should be taken where multiple practitioners access the same patient’s record, as ‘user settings’ will dictate the behaviour of the Current Rx list, and could differ depending on which practitioner is currently accessing into the patient’s record.