You can access via the External Rx History button viewable from the Medication List, the Document Meds by History (BPMH) list, or the Orders page. There is no single best way.

If the user’s position has not been configured for PharmaNet Integration, the External Rx History button will not show.

Check which position the user has been assigned and determine if it is the correct position for this user.

There is a list of approved PharmaNet Integration positions. These should all be configured for PharmaNet access. The list is available in Appendix A of this document.

If the user’s position is not on the list, the position has not been approved for External Rx History/PharmaNet Access.

If the user believes their position should be added to the approved list, CST Triage can review this change request.

If the user’s position is on the list, there is an issue with the position configuration, and this will likely impact other users with this same position.

The Core team can check the position privileges.

The Medication Management team can check the preference manager settings.

The CST Cerner Position Configuration guide can be found here: https://wiki.ucern.com/pages/viewpage.action?spaceKey=IsdHlth&title=Enable+Pharmanet+Viewer+in+External+Rx+History+%28privileges+and+preferences%29

If the user is given the wrong position:

The user can request a position change through their manager.

The user will need to complete the PharmaNet training module once they have their new position.

The difference between the two is that the View displays a list of PharmaNet medications and Import allows you to see PharmaNet medications side-by-side with the Documented Med by Hx list (BPMH). These lists can be compared when interviewing the patient. Import is recommended for documenting BPMH.

This could mean that the patient does not have a PharmaNet profile, PharmaNet is offline, or there may be a connection or server failure.  Please refer to the list of Error Messages later in this document.

If unable to access PharmaNet, the BPMH of a patient still needs to be documented. This can be done by accessing the Document Meds by Hx window in PowerChart.
 

Or, as a provider, via the Med History link in the Current Medications, Admission tab of Provider View.

No, the system stores the Keyword for 30 minutes to aid in patient care. After 30 minutes has elapsed, the Keyword will need to be re-entered. If a different user needs to access PharmaNet, the Keyword will need to be re-entered.

If the patient is unable to provide their Keyword (e.g. unconscious or semi-conscious, etc.) an authorized user must contact the PharmaNet help Desk by phone: 1-800-554-0225 (toll free) or 604 682-7120 (Vancouver) to have the patient’s keyword removed. The PharmaNet Help Desk is monitored 24/7 including stats, except on Christmas Day . The patient will be informed by HIBC that their Keyword was removed, and the patient will be able to re-establish it if they wish to do so.

No. The allergies on the PharmaNet viewer do not feed into the allergies on PowerChart. Neither do medical conditions. End-users who are within their scope to document this will need to document.

Click the Scroll button  to import medication from PharmaNet window (left) into the BPMH i n CST Cerner window (right).

A pop-up window with a list of order sentences associated with the imported product will appear.

Select the most appropriate order sentence and click OK. The details can be changed if the exact instructions are not available.

If no sentences load, click None to manually enter order details. Information from PharmaNet will not be imported in a way that is useable within CST Cerner.

To manually enter the order details, use the +Add button in the upper left-hand corner of the side-by-side screen to add medications to the Document Meds by History (BPMH) list. This is the same workflow as adding the medications directly to the BPMH.

Medications are grouped together based on medication name. You can see dispenses of the medication by clicking on the black arrow to the left of the medication name. The small number in brackets next to the arrow indicates how many dispenses are associated with this medication name.

These numbers are associated with the number of dispenses of this medication.

The system may not recognize the medication on the PharmaNet profile as it may not have a DIN (NPNs and PINs are not recognized), it may be a compound, may be an investigational drug/SAP or may not be a drug (medication review, insulin test strips, etc.).

Medications can be removed from the Document Meds by History (BPMH) list by right-clicking on the medication and selecting Remove. This can only be done before clicking Document History.

If the medication is already documented, then the order action Complete should be selected to remove the medication from the Document Meds by History (BPMH) list.

If there are no medications displaying on the Document Meds by History (BPMH) list, ensure that you are accessing the PharmaNet profile via the Import selection from External Rx History to see the side-by-side screen. The View drop-down selection only lists medications from the PharmaNet profile.

If this is the patient’s first visit to the hospital, there will not be any medications entered into the patient’s Document Meds by History (BPMH) list.

Six months is the recommended time-frame to use. However, the PharmaNet profile can be filtered in the side-by-side screen to show a longer time period. Since PharmaNet sends medication history for the last 14 months, the medication history can be viewed for this period. This can be filtered down to 12, 6 or 3 months.

The Ordering Details pane can be made smaller or larger as needed. It can also be moved around the screen in order to optimize screen real-estate to allow efficient documenting of medications during an interview.

If the ordering Details does not have a medication that you were searching for, you can use the non-formulary template by searching “non-formulary” and this will provide a template to order medications. Only use the non-formulary template for medications that you cannot find by searching.

No, only the known fields for the medication need to be entered. If there are extraneous fields that are pre-populated by order sentences, these pre-populated fields should also be removed.

If the side-by-side screen closes prematurely, simply re-access the PharmaNet profile via the External Rx History by the Import function.

Enter as much information as you have available. Click the check box next to Leave Med History Incomplete – Finish Later and click the button Document History. This will prevent the reconciliation status from displaying as completed.

Click Document History to save the work that you’ve done. When returning to the medication list window, right-click the green check mark next to Meds History in the reconciliation status (upper right-hand corner of the window) and select Reset.

If a printer needs to be selected, this means that you are trying to enter a “Prescription”. Cancel the order by right-clicking and selecting Reset then re-enter the medication from the Order Scratchpad (+Add)  by using medication type: “Document Med by Hx” (scroll icon). Do not use the prescriptions (pill bottle) medication type.

Ensure that you are accessing External Rx History via the “Import” selection in the drop-down. Click Continue through the demographics and allergies to the side-by-side screen. From this window you can add medications using the +Add button in the upper left-hand corner of the screen. This is the only approved method of adding medications to the BPMH. Any other functionality may cause downstream errors and conversion failures when a provider is completing MedRec.

This means that you are in the View screen (you must go to the Side-by-Side screen via Import). Do not use right-click to document medications in the BPMH.

Any other functionality may cause downstream errors and conversion failures when a provider is completing MedRec.

No, you can modify medication that is already documented by clicking right-clicking and selecting Modify in the BPMH window.

Route of Administration and Drug Form may require a different product. Documenting a new medication with the correct Drug Form and Route would be more appropriate. If the new medication is added, ensure that previously documented medication is marked as Complete to remove from the BPMH list.

Yes, you can modify medication that is already documented by clicking right-clicking and selecting Modify in the BPMH window.

Route of Administration and Drug Form may require a different product. Documenting a new medication with the correct Drug Form and Route would be more appropriate. If the new medication is added, ensure that previously documented medication is marked as Complete to remove from the BPMH list.

Right-click on the medication under Pending Home Medications in the BPMH window and selecting Remove.

 You can reactivate a medication that is set as Cancel/Discontinue or Complete by right-clicking the medication under Pending Home Medications in the BPMH window and selecting Reset.

This has implications how the information will display on the Patient Discharge Summary upon discharge. Only Complete should be used to remove medications from BPMH.

Yes. Highlight the medications in the Document Meds by History (BPMH) list, right-click, and select add/modify compliance.  Enter compliance details as needed. This will populate the compliance fields with the same compliance Status, Information source, and Last dose date/time.

The suspend functionality has been disabled enterprise-wide. The suspend order action is not to be used at this time.

Yes, both lists can be organized alphabetically or reverse-alphabetically. Click on the column title, Order/Name Details to sort the column

Medications should be documented in the Document Meds by History (BPMH) list as how the patient is taking them, not based on the original prescription. The PharmaNet profile must be confirmed by a patient interview.  Any discrepancies identified need to be noted in the Compliance tab and documented in the Comments field. This will flag the medication for the provider to review during medication reconciliation prior to ordering.

Not all medications that a patient is taking may show on PharmaNet. PharmaNet does not record all prescription medications that a patient receives:

while in a hospital, designated mental health center, or some long term care facilities (though emergency department physicians may update your record with information about drugs they provided, allergies, or adverse drug reactions)

through the BC Cancer Agency (i.e. oncology medications such as chemotherapy drugs)

through the BC Transplant Society (i.e. transplant-related drugs)

through the BC Renal Agency (i.e. drugs for kidney dialysis)

as samples from your health care practitioner (though physicians may
update your record with information about drugs they provide)

In order to view a patient’s profile as unprocessed data from PharmaNet, the View-Only Medications link on the Allergies screen must be clicked (light blue link found in the bottom left-hand corner of the screen). This will open the View-Only Medications screen and show complete data as received from PharmaNet.

This view displays warnings from PharmaNet such as when there are more than 999 medications that exist on the profile.

Medications should be documented in the BPMH using the approved criteria below:

All medications actively being taken, including:

Active treatment protocols, such as cancer treatment in progress

Intermittent medication (refers to medication that are prescribed on a defined cycle [e.g. every three weeks] for one or more doses [e.g. depot injections, chemotherapy])
 

The following No Longer Taking medications:

Medications that are temporarily on hold (e.g. held prior to surgery)

Medications that the patient has stopped taking on their own without Provider direction

The Ministry of Health is responsible for all PharmaNet patient profile corrections. If a medication error is discovered in the patient medication profile, the PharmaNet Data Quality Services Team must be advised by secure means (via phone toll-free: 1-844-660-3200 or fax:250-953-0486) and provide:

the PHN,

name of the patient, and

a brief description of the discrepancy

Printing the PharmaNet profile from PowerChart can be done through CareConnect on the Medications tab. 

The PharmaNet module on Learning Hub as well as the help topic Best Possible Medication History Overview.