Ideas to improve the Medication List
The medication list is the life blood of my practice. I see you have disabled the list. While I am in the chart note, or any part of the chart for that matter, I would like to drop down the medication list like a shade from the top of the page. It should be a full screen list all the way across. It should include all medications with dates updated and prescribed. I want to have better tracking of medications, which ones were tried, why they didn't work, why they were discontinued, etc. I know the information is available, but I would like to see it instantly while I am talking with the patient without drilling down to each medication.
Hi everyone—as you’ve all noticed, we reintroduced the medication list into the chart note. You’ll also be able to see duplicates and previous prescriptions easier, as of December 2015.
More information about this workflow can be found at this knowledge base article:
Return the old Rx list, it was hugely beneficial in speeding up our practice. We need to be able to view on one screen in a list format all scripts and the details of each time is was prescribed. sig, quantity & refills.
Also the Erx tab was incredibly beneficial, now you can only look it up by individual providers. Bringing back the practice wide option of Erx's sent would be very helpful
Dr Lulua Mandviwala commented
It would be nice to also to be able to associate a medication with multiple diagnoses if need be (for example -- singulair for both asthma AND allergic rhinitis)
also currently while in encounter am entering a diagnosis and then in that window am entering a medication. once that med is entered, cannot add multiple meds for that diagnosis (nasonex and zyrtec for allergic rhinitis), it shuts out and goes to a diagnosis section that does not allow me to choose from previous diagnoses, only to search for a diagnosis... so i have to exit the medication window, scroll back up to the diagnosis section and start all over.
I would like to be able to view the weight and height of the patient at the top of the page regardless of where I am in the encounter. when entering medication, sometimes to view the weight of the patient (I'm a pediatrician) I have to exit the meds viewing and search for the weight to then calculate how much to dose the meds (weight based usually).
to tie it in with that, having a button easily accessible from the med window to use a calculator would be nice too! Or if the current weight was available in the meds window that would be nice.
It would also be helpful if we could enter the patient's medications the same way we currently enter "Allergies" - with an "add another" field, so that one doesn't have to close and re-open the medication search field for every single medication.
Keely Godwin, MD commented
I definitely would like to see the reason for discontinuing a medication, but ONLY if it's something other than "course of treatment ended." Obviously if someone was on an antibiotic for a short period of time, it's obvious that the 10 day course ended and that's why it stopped (which speaks to a previous request for automatic stop dates for acute, short term meds or the ability to put a quit date in the prescription as we're creating it).
But if someone stopped a medication due to side effect or reaction, I'm not likely to try again. if they stopped due to cost, they may be able to afford it later or get it through an assistance program and it may be worth trying again. It would be nice to see that annotated in the med list.
Dr Vanessa Rodriguez commented
I like the new feature of ordering multiple medications at once and works great for new medications but there is one problem. I am refilling meds, if I want to do them at once, it creates medication again as a new Rx. When I look at med list once I am done, the ones I refilled are listed twice. I suggest when refilling, it would give me an option to chose from current meds rather than creating again.
Dr Faiq Hasan commented
Along similar lines, It would be good to have pt's allergies visible while adding new meds.
Sylvia Fong commented
Want to see last refill and date to assess compliance. If erx, patient changes pharmacy, should be associated with medication.
Ms Rhonda Roy commented
Unless I am missing something, I cannot tell by looking at the medications I prescribe, how many refills were written at the last appointment.
Daniel Gutstein commented
This is a great list. I am currently struggling over the medication reconciliations, and how they don't integrate with the medication lists. I have one new patient for whom I wanted to build my list by reconciling, but the system will not allow me to add the medications that way. When reconciling, fills of a given medication should get listed under that medication in the list instead of generating multiple listings for the same medication. For any of these multiples I have mistakenly added, there should be a bulk delete option. It would also be great to be able to view medications grouped by diagnosis, with and without past meds.
And as long as we're discussing medications, one more plea for EPCS for a lonely Illinois solo doc.
Thank you - the notes are more stable since you removed the medication list. I am looking forward to the reintegration.
These are all great ideas. I'll reiterate; the med list must be able to be pulled down with one click from anywhere/anytime with prescription name, dose, sig, #, refills and last refill. The new "upgraded" EHR actually slowed down ordering meds amazingly enough. ((But the new 1-click refills are AWESOME!!!!)) Sending multiple meds should be easy; we do it all the time....why can't we just send the med list to the pharmacy with one click if we have no changes. (The defaults should be to how we wrote it last time, not to blank fields.)
I would like the last prescription of each med to be at the top of the list of that med's refills, not the bottom.
I'd like to be able to print the current med list without the past meds. It confuses patients.
I'd like to be able to print a "translation" at the top or bottom of the page saying things like "QD = daily, QHS = every night at bedtime, ...." since in Rx's with long sigs where I'm fighting the character limit, I end up using these abbreviations and then I have to write in the translation on the printed list for every patient. I hit the character limit a lot (titration schedules etc.) so I have to write this translation on most printouts.
I'd like a one button option (maybe on far right of med list) for discontinuing the med with today's date as the stop date.
I'd like old doses of the med to group together with that med so I can see at a glance how long they have been on this dose and which doses they have tried before.
When I stop a med and restart it later I'd like each start and stop date recorded instead of it looking like they've been on it the whole time based on a single start date and "current medication." And I'd like to edit those dates later if patient admits they never actually took the med, or they forgot they were supposed to stop it, etc.
I'd like it to default to Dx, Comment, and Last Rx "on" and if I turn those off for one patient it still defaults to "on" the next time I open a chart. I turn those off for printing the list and that's it.
I'd like check boxes that don't do anything (or a click to highlight option or something) for each med on the list, so during med reconciliation a patient can tell me what they take and I can check it off to keep track of which meds they've mentioned and at the end I can see what's left. This way I can do reconciliation in their order which is usually far more accurate than if I try to do it in my order.
I'd like the med list to have the button for "med reconciliation done in today's visit" so I can check it there when I do it, and not have to remember to put that in the encounter note later.
I'd like to be able to view the PDF of previously printed Rx's. This is important if I have a printer jam and need to reprint an Rx without making it look like I gave the patient two copies of it, especially for schedule II rx's.
I'd like to be able to strikeout an Rx to show it was destroyed. If the patient brings back a schedule II rx they never filled I'd like to be able to easily see that I destroyed that Rx when I look through their past refills.
I'd like to be able to have current meds (including OTC meds) that I manage all grouped at the top, and current meds managed by other providers all grouped below that, and I'd like to be able to sort those lists independently of each other. That way I can see what I'm doing at a glance without trying to visually sort through what the other providers are doing.
I'd like to be able to print meds sorted by when the patient takes them. So TID medications would be on the list three times, once for each time of day. I'd be ok if I had to manually enter some data for this printout every time I do it. I wouldn't be printing it every day, but for some patients it would be extremely helpful. I have to manually make these lists on paper for them and it takes a while.
I'd like to be able to group certain supplements together if they are combined into one pill. Currently if a patient takes a single supplement with GABA + l-theanine + melatonin I have to enter these separately and put a note that they are in the same pill, and then when they stop the pill I have to individually stop each one and there's the possibility of missing one. This is a real problem with patients who take a lot of supplement combination pills.
I'd like an easily locate-able button to display all drug interactions including the ones I've dismissed.
I'd like to be able to see the full sig on past Rx's, whether by showing multiple lines or by having a scroll bar.
Thank you very much for letting us know that re-ordering the chart note is upcoming. Please include this sort of information on the upcoming features page! I'm more excited about that than any other upcoming feature.
I agree. The old version of the Rx list was faster to read so you can see at once all the meds and last refill dates. Current version makes you click on individual Rx and then scroll to the bottom before you can see when it was last prescribed. The e- prescription tab is not as helpful because not all prescriptions are e- scribed. Also, I would like the last prescribed quantity to be the default when ordering a new prescription. Now you have to type in the quantity every time you send a new Rx. I would also like the same default for type of med - capsule or grams or inhaler, etc. It would save on less clicking.