Click on the steps in the graphic below to view additional information and complete the BPMH in the patient's chart.
After opening the PharmaNet Profile, you will see the side-by-side windows. Remember the Patient Interview TipsPatient Interview Tips.
Ask about medications on the External Rx History (PharmaNet) list as well as over-the-counter medications, vitamins, natural health products, HIV/AIDS medications, recreational drugs, topicals, and any other medications they are taking. Document this information into the CST Cerner.
If patient says “No longer taking”, ask “Why did you stop?”
If prescriber advised patient to stop taking a medication: Do not enter the medication into the CST Cerner.
If patient decided to stop taking a medication without prescriber's advice: Enter the medication into the CST Cerner, with explanation in the Compliance tab.
We have sorted the list alphabetically by clicking the Order Name/Details column header.
Ensure the green check mark is present 
beside the date and time the PharmaNet reference list (Rx history as of) was opened in CST Cerner.
If necessary, click the Refresh icon for the most up-to-date PharmaNet data.
After the information is refreshed completely, the yellow triangle will disappear and a green check mark will appear with the date and time it was loaded.
As you update the BPMH (Document Medication Hx) you will likely need to add, modify and review medications as well as other actions listed below:
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WARNING: There is no lock for the Documented Medication Hx screen CST Cerner allows multiple users to simultaneously view add/or edit a patient’s External Rx History (PharmaNet) and Documented Medication by Hx (BPMH). There is a potential for duplicate or conflicted entries and will cause errors or omissions downstream. Ensure only one user edits the patient’s BPMH at any one time. Clinical areas using a tracking shell are encouraged to update the BPMH status and record events in a timely manner. |
When your patient is not taking any medications at home, select the No Known Home Medications check box.
The Medication Not Reconciled (star burst) icon 
indicates that this medication is not yet reflected in the patient’s profile in CST Cerner on the Document Medications by Hx side.
Enter the following medications that are No Longer Being Taking when:
Medications have been held temporarily (e.g. held prior to surgery)
Medications have been stopped by the patient on their own without Provider direction
You do not need to add Medications that have completed their course, such as antibiotics.
In your patient interview, you will confirm the new medications found in PharmaNet. The Medication Not Reconciled (star burst) icon indicates that the medication (e.g Diltiazem) is in PharmaNet Profile (left window) but is not yet reflected in the patient’s profile in CST Cerner on the right window (Document Medications by Hx).
Most medication order sentences will appear as single line items. However, some may appear as collapsed bundles. In these cases you will need to expand the bundles to view the medication order sentences:
Click black arrow 
next to a medication to Expand the bundle.
The prescription incidences displays and the arrow changes to point down.
Click the Scroll button 
to import medication from PharmaNet window (left) into the BPMH in CST Cerner window (right).
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WARNING: Do NOT click Convert Existing Sig as CST Cerner does not correctly perform this function.
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Select the most appropriate pre-set order sentence. If you cannot find an order sentence that exactly matches the order, select the order sentence closest to what you are looking for. Order details can be edited before medication is documented in BPMH. If no order sentence is listed (None), skip to Step 2.
Click OK.
In rare cases, there will be no pre-set order sentences listed.
If no pre-set order sentences load, click None to manually enter order details. Do NOT click Converting Existing SIG. Information from PharmaNet will not be imported in a way that is useable within CST Cerner.
You are required to manually fill in the required fields (i.e. dose, route, etc.).
If the system has selected Other prescription or Compounded Medication, this means the system does not recognize the medication and you can assist by manually selecting the medication.
Click Cancel.
Search for the correct medication manually using the 
button.
Select an order sentence. If the exact order sentence is not available, you can edit the details as needed.
Confirm all the details of the medication are correct in the Detail pane including Dose, Route of Administration and Frequency.
When the following information cannot be verified, delete any information in these fields: Duration, Dispense, and Refill.
Click the Compliance tab and fill out the appropriate information.
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NOTES: Document medications according to how the patient is actually taking them. Compliance information is used to document deviation from original prescription. Compliance Documentation flows into the notes to the GP who may have ordered the home medications. |
Select the Status on the Compliance tab (the default is Taking as prescribed).
Complete the Information Source and Last dose date/time fields.
Compliance Statuses for BPMHCompliance Statuses for BPMH
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Compliance Status |
Status Definition |
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Taking as prescribed |
Patient currently taking the medication as prescribed by their prescriber. It also includes medication that the patient actively takes without requiring a prescription (e.g. Over-the-counter medications, herbal supplements, etc.) |
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Taking, not as prescribed |
Patient currently taking the medication prescribed by their prescriber but takes it differently than originally prescribed (Document how it was originally prescribed in the Compliance comments) |
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Unable to obtain information |
Information on the compliance for this medication is not able to be determined from information sources at this time (Cannot be validated with patient, family, or other provider) |
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Investigating compliance |
Compliance information for this medication is under investigation and cannot be determined at this time (Needs to be validated with other providers or family) |
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On Hold |
Patient temporarily stopped taking the medication as directed by their prescriber due to various reasons (Document reason for hold in Compliance comments) |
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No longer taking |
Patient stopped taking the medication on their own without prescriber direction. Also other medications that the patient is currently not taking but deemed to be clinically relevant as per clinical judgement (Must document the reason for stopping the medication in the Compliance comments) |
Medications added to the Document Medications by Hx window on the right. They will temporalty fall under a Pending Home Medications section.
Notice that star burst indicator 
is no longer beside the medication on the External Rx History window (PharmaNet profile on left ). The medication has been reconciled with PharmaNet profile.
From your interview with the patient and/or family/caregiver, you may discover that a Medication in PharmaNet Profile needs to be modified in the BPMH (Document Medication by Hx) in CST Cerner.
For example, in the interview, you might be told that the patient is not taking the same Dose as documented in PharmaNet Profile and as in the BPMH (Document Medication by Hx) . You need to modify the BPMH (Document Medication by Hx) in CST Cerner .
Right-click the medication that needs to be modified on the BPMH.
Select Modify.
The medication order Details section opens at the bottom of the screen.
Modify the Dose and/or Frequency. In this example we are only changing the dose.
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WARNING: When modifying a documented home medication, only Dose and/or Frequency should be modified otherwise you will affect conversion to inpatient orders. |
Click the Compliance tab.
Update the Status as applicable.
You can enter a Comment.
Remember to click the Details downward arrow 
to see all of the PharmaNet medications.
CST Cerner uses the term Complete to indicate that a medication is no longer being taken by a patient. PharmaNet uses the status Discontinued.
Confirm with the patient and/or family/caregiver, that the patient no longer takes the medication (e.g. levonorgestrel-ethinyl estradiol one tablet twice).
Right-click on the medication in the Home Medication BPMH (Documented Medication by Hx window on right).
Select Complete. You will mark this existing medication as Complete to remove it from the BPMH (Documented Medication by Hx).
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WARNING: Do not use the Cancel/Discontinue action. This has implications on how the information will display in the patient’s discharge summary and it will stay in the BPMH unresolved forever. |
The Completed medication displays with a strikethrough line under the Pending Medications header.
Once you complete documenting the BPMH, the medication will be removed from the Document Medication by Hx window.
For Patient Admissions, see Remove Duplicate Entries from the Best Possible Medication History (BPMH).
PharmaNet does not record all prescription medications that a patient receives:
While in a hospital, designated mental health centre, 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)
Click the Add button on the Document Medication by Hx window.
Type or dictate the medication (e.g. atazanavir 100 mg IM).
Select the most appropriate medication and order sentence.
Click Done.
The Pending Home Medications lists the medication.
Under the Details section, confirm all the details of the medication:
Dose
Route of Administration
Frequency
Remove all extraneous information that you cannot verify with the patient.
Duration
Dispense
Refill
Start Date/Time
Click the Compliance tab and fill out the appropriate information, including the Status (i.e. Taking as prescribed), Information Source, and Last dose date/time.
Repeat the steps above to add more medications to the BPMH.
After updating all the medications on the BPMH, you need to complete the documentation.
Click Document History 
at the bottom-right of the page.
The Reconciliation Status will change to complete, indicated by a green check mark.
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NOTE: Updating BPMH through Documented Medication by Hx can be done at any time even if the Reconciliation Status for Meds History has a green check mark. If you clicked the Document Medications button before you finished the BPMH, right-click on the Meds History check mark and click Reset.
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You have completed the BPMH.
When the BPMH
is only partially completed, check the Leave Med History Incomplete-Finish
Later box and click Done.
Also see Unable to Verify Medication History below.
When the patient is unable to participate in an interview (for example, due to low level of consciousness), and there is no other person who can be interviewed to verify the medication on the PharmaNet profile, BPMH and Admission MedRec may be postponed and completed retroactively after the patient has already been admitted to an inpatient bed.
To proceed with entering the Admission Medication Orders PowerPlan without completing the BPMH and MedRec at admission, providers can review the patient’s PharmaNet profile, either through Excelleris or the Cerner External Rx History – View functionality, and decide what medications they want to order right away.
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NOTE: The VCH-PHC-PHSA MedRec policy sets a target that BPMH and MedRec at admission are done within 24 hours from time of decision to admit, therefore providing flexibility for cases when it’s not possible to complete the BPMH and MedRec right away as the patient is admitted. |
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WARNING: Do NOT perform a PARTIAL medication history with placeholder information (i.e. the first medication on PharmaNet). If unable to verify the BPMH, as this will falsely indicate the BPMH has been done, which will fail to flag anybody else to complete it, and cause problems for both Admission and Discharge MedRec. |
When the Document Meds by Hx screen is blank, with no medication history from previous encounters:
Select the Unable to Obtain Information check box at the top of the screen to indicate that there are no available sources of medication information. This will leave the BPMH blank and incomplete, as a reminder to complete it as soon as the patient or family can participate in verification.
Select all the medications that are older than 6 months.
Right-click and select Complete to remove them from the Document Meds by Hx screen. These will no longer be carried forward into the MedRec at Admission screen.
Select any medications within the last 6 months (if applicable).
Enter a compliance of Unable to obtain information to flag that all these medications are recent and may still be applicable, but must be verified with the patient or family at the earliest opportunity.
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NOTE: You can select multiple line items by holding the SHIFT (if consecutive) or CTRL keys (if non-consecutive) as you click, and then perform the same action on all selected items. |
Check the Leave Med History Incomplete-Finish Later box.
Click Done.
Initiate a consult with the clinical pharmacist (if available) to ensure that the medication history is reviewed and verified at the earliest opportunity.
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WARNING: Do not proceed to Admission Medication Reconciliation if the Meds History status is incomplete. |
Once the Medication History is complete, the Most Responsible Provider will then be able to access the Admission MedRec screen to reconcile medications. The clinical pharmacist can also access the Admission MedRec screen and reconcile in planned state for the provider to sign off.
Medications may not import from PharmaNet for a number of reasons, and CST Cerner will import these as Other Prescription. This is the most obvious sign of a failed import.
In the event that the Scroll button does not import the medication:
Click Cancel in the Order Sentences window.
Click the Add button on the Document Medication by Hx window to add the medication manually.
The Add Order window opens.
Type or dictate the medication in the Add Order Search field (e.g. Diltiazem HCL).
Select the most appropriate medication and order sentence.
Click Done 
at the bottom-right of the Add Order window.
Once you have added the medication it displays under the Pending Home Medications. section, below Home Medications.
Confirm all the details of the medication are correct in the Detail pane.
Dose
Route of Administration
Frequency
When the following information cannot be verified, delete any information in these fields
Duration
Dispense
Refill
Start Date/Time
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WARNING: Details for the medication such as Duration, Dispense and Refill and Start Date/Time will be copied onto future prescription order details. Ensure Dose, Route of Medication and Frequency are entered correctly. Delete the other information if not known. |
Click the Compliance tab and fill out the appropriate information.
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NOTES: Document medications according to how the patient is actually taking them. Compliance information is used to document deviation from original prescription. Compliance Documentation flows into the notes to the GP who may have ordered the home medications. |
Select the Status on the Compliance tab (the default is Taking as prescribed).
Complete the Information Source and Last dose date/time fields.
Compliance Statuses for BPMHCompliance Statuses for BPMH
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Compliance Status |
Status Definition |
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Taking as prescribed |
Patient currently taking the medication as prescribed by their prescriber. It also includes medication that the patient actively takes without requiring a prescription (e.g. Over-the-counter medications, herbal supplements, etc.) |
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Taking, not as prescribed |
Patient currently taking the medication prescribed by their prescriber but takes it differently than originally prescribed (Document how it was originally prescribed in the Compliance comments) |
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Unable to obtain information |
Information on the compliance for this medication is not able to be determined from information sources at this time (Cannot be validated with patient, family, or other provider) |
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Investigating compliance |
Compliance information for this medication is under investigation and cannot be determined at this time (Needs to be validated with other providers or family) |
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On Hold |
Patient temporarily stopped taking the medication as directed by their prescriber due to various reasons (Document reason for hold in Compliance comments) |
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No longer taking |
Patient stopped taking the medication on their own without prescriber direction. Also other medications that the patient is currently not taking but deemed to be clinically relevant as per clinical judgement (Must document the reason for stopping the medication in the Compliance comments) |
Medications added to the Document Medications by Hx window on the right. They will temporalty fall under a Pending Home Medications section.
Notice that starburst indicator is no longer beside the medication on the External Rx History window (PharmaNet profile on left ). The medication has been reconciled with PharmaNet profile.
Request a Best Possible Medication History (BPMH) in the Emergency Department (ED Providers)
Request a Best Possible Medication History (BPMH) in the Emergency Department (ED Nurses)
Best Possible Medication History Overview
Step One: Open CST Cerner BPMH (Document Medications) Page
Step Two: Import PharmaNet Profile Medications (Pharmacy, Nursing, and Provider)
Step Three: Update CST Cerner Using the PharmaNet Profile (Pharmacy, Nursing, and Provider)
Document No Known Home_Medications in BPMH
Modify Medications on BPMH_List
Remove Medications from the BPMH_List
Document Medications not found on PharmaNet in CST Cerner BPMH
Unable to Verify Medication History
Remove Duplicate Entries from the Best Possible Medication History (BPMH)
PharmaNet Integration Additional Information
PharmaNet FAQ/Troubleshooting Tips
Medication Reconciliation Overview
Ambulatory Medication Reconciliation
Admission Medication Reconciliation
Perform Admission Medication Reconciliation
Convert a Documented Medication to an Inpatient Order during Admission Medication Reconciliation
Transfer Medication Reconciliation
Discharge Medication Reconciliation
Add a Prescription During Medication Reconciliation
Medication Reconciliation Icons
Provider
Nurse
Pharmacy
BPMH
PharmaNet Profile
Update Medication List
Document Compliancy
Add Medications not in PharmaNet
Last Updated: August 6, 2025
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