Configuring Medication Reconciliation

Commure Pro Medication Reconciliation™ provides an easy way for physicians to reconcile their patients’ home medications and hospital orders when evaluating a course of treatment for admission, transfer, and discharge. Reconciling medications during transitions in patient care prevents inconsistencies in administering a patient’s medications throughout this transition. This chapter includes information about enabling the Medication Reconciliation feature for your institution, and then provides instructions for configuring the Med Rec application for Admission Med Rec (AMR), Discharge Med Rec (DMR), and Transfer Order Reconciliation.

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Enabling the Medication Reconciliation Feature

You must enable the Medication Reconciliation feature for your institution before you can configure the individual Medication Reconciliation applications (AMR, DMR, or Transfer Order Reconciliation) for locations and users within your institution. To enable the Medication Reconciliation feature for your institution:

1. Under the Admin tab, select the Institution tab.
2. From the Edit Settings drop-down menu, select Site Administration.
3. Locate and enable the Medication Reconciliation setting.
4. Click Save. The Medication Reconciliation feature is enabled and ready for configuration of the AMR, DMR, or Transfer Order Reconciliation applications. For more information, see Configuring Admission Medication Reconciliation, Configuring Discharge Medication Reconciliation, or Configuring Transfer Order Reconciliation.

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Enabling Medication Reconciliation for Handheld Devices

Before users within your institution can access and use Medication Reconciliation (Med Rec) on their handheld devices, you must configure an additional preference that specifically activates the Med Rec handheld module. Though enabled separately from Med Rec on the portal, note that the rules you use to configure Med Rec applications (AMR, DMR, or Transfer Order Reconciliation) for locations and users within your institution apply equally to your users, whether using Med Rec on the portal or on their handheld device. You can restrict Med Rec handheld usage by enabling the Med Rec module on a per-user basis, or you can enable this functionality for a larger group of users (including all users) by configuring the Bulk User Edit feature. To enable handheld Medication Reconciliation for a specific user:

1. Under the Admin tab, select the User tab.
2. Select the user you want and click the Edit button.
3. From the Edit Settings drop-down menu, select Device.
4. Locate the setting Active Handheld Modules and click the associated Edit link.
5. From the Active Modules list, locate the MedRec module and enable the check box under the Active column.
6. Click OK to save your changes. Medication Reconciliation is enabled on handheld devices for the specified user.

You can enable handheld Med Rec for a larger group of users (including all users) from Bulk User Edit (Admin > Bulk User Edit > Preference Settings pane). After defining a group of users, locate the Device section from the Preference Settings pane, enable the Add Modules setting, and then enable the MedRec module from the dynamic list that displays. For more information about using the Bulk User Edit feature to configure preferences for one or more defined groups of users, see the Commure Pro Administration Tools User’s Guide. Medication Reconciliation Institution Settings Enabling the Medication Reconciliation feature involves configuring the following CPOE institution preference (Admin > Institution > Edit Settings [Site Administration]). Medication Reconciliation (Web, Apple) Determines whether to enable or disable Medication Reconciliation at the institution level. Enabling the Medication Reconciliation feature is a prerequisite for configuring the individual AMR, DMR, and Transfer Order Reconciliation applications. For more information about configuring these applications, see Configuring Admission Medication Reconciliation, Configuring Discharge Medication Reconciliation, and Configuring Transfer Order Reconciliation.

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Restricting Medication Reconciliation to a Provider’s Authorized Facilities

You can configure CPOE, Medication Reconciliation, and ePrescribing so that providers are restricted to entering, reconciling, and electronically prescribing orders only at authorized facilities (as defined in MEDITECH back-end systems only). For more information, see Restricting Order Entry to a Provider’s Authorized Facilities.

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Configuring Admission Medication Reconciliation

Admission medication reconciliation involves reviewing the patient’s complete medication regimen at the time of admission and comparing it with the regimen being considered for the new setting of care. Before your clinicians can reconcile medications during patient admission into your institution or facility, you must enable and configure the admission medication reconciliation application (AMR). Configuring the Admission Medication Reconciliation application is a process requiring completion of the following basic steps.

1. Enabling Admission Medication Reconciliation at one or more locations within your facility. For more information, see Enabling Locations to Use Admission Medication Reconciliation.
2. Configuring the AMR application, such as defining how the application responds to matching orders during the reconciliation process, and determining whether to require clinicians to reconcile all medication orders belonging to the order session being reconciled. For more information, see Configuring How Matching Orders are Handled in AMR and Enabling Partial Reconciliation of Medications in AMR.
3. Enabling the AMR application for users within your facility or institution. For more information, see Enabling Admission Medication Reconciliation for Users.

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Enabling Locations to Use Admission Medication Reconciliation

You can enable the AMR application for entire facilities within your Facility Group, or for one or more individual units within those facilities. Note that you must enable the Medication Reconciliation feature for your institution as a prerequisite step to enabling locations to make use of the various Medication Reconciliation applications. For more information, see Enabling the Medication Reconciliation Feature. To enable AMR for locations within your facility group:

1. Under the Admin tab, select the Location tab.
2. To enable AMR facility-wide, select the facility. To enable AMR for a particular unit, expand the facility folder and select the unit to configure. Note that unit-level configurations override configuration settings applied at the (parent) facility level.
3. Click the Edit button.
4. Locate and enable the Enable Medication Reconciliation setting. Upon enabling this setting for the facility or unit, additional options display enabling configuration of the various Med Rec applications.
5. Enable the Admission option only.
6. Click Save. Your selected location is now enabled for Admission Medication Reconciliation.

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Configuring How Matching Orders are Handled in AMR

You can configure how the AMR screen responds when matches are detected between home medication orders and existing hospital orders during the medication reconciliation process. You can configure this screen to either:

• Automatically enable the Continue / Change option whenever matches are detected, or
• Require users to make a selection between the settings Stop and Continue / Change (normal behavior) whenever matches are detected. Note that when Order Definitions specify a single route and the Route field does not display, the associated home medication inherits this same Route value when matching of the two orders occurs. Any additional route choices for orally-administered medications are ignored by this logic; if all Routes except for one are configured under the CPOE preference Additional Route Choices (for oral drugs), the home medication inherits the one Route value that is not configured as part of this preference.

When Order Definitions specify more than one route, users continuing the associated home medication are prompted to assign the correct Route when they continue the associated medication order. If there are no home medications in the (back-end) system or if the patient was unable to provide a current list of home medication orders, these limitations are sometimes reported to clinicians during the reconciliation process (only in environments using MEDITECH back-end systems). In such cases, the status “Unable to obtain home medications” displays both on the printed order sheet and on the “Previously Reconciled” tab (for both the AMR and DMR screens). Hospital orders that are associated with manually-created Order Definitions are also eligible during reconciliation and are paired with home medications in AMR. In cases where multiple hospital orders are found to correspond with a home medication, the PRN flag is used as a tie-breaker to match hospital orders to the best home medication. If filtering by PRN flag results in two matches, the Dose value is used as a second tie-breaker to assign the best matching order (in both AMR and DMR). To configure how AMR handles matching orders:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate the setting Auto-continue Home Med/Active Hospital Med matches and select:
   • Yes: To configure the AMR screen so that the Continue / Change option displays each time that a match is found between a home medication order and a hospital order.
   • No: To configure the AMR screen so that users must choose between the actions Stop or Continue / Change each time that a match is found between a home medication order and a hospital order.
5. Click Save. Your changes are applied to the AMR screen of all users belonging to the selected Facility Group.

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Configuring the Display of “One Time” (1x) Unreconciled Medications in AMR

Administrators can configure AMR so that unreconciled “one time” (1x) home medications and any STAT orders are removed from the right-hand side of the AMR screen to prevent providers from mistaking these orders for continued hospital orders. This feature serves as a safeguard to ensure that attending physicians evaluate all 1x and STAT orders thoroughly to determine whether to continue any such medications for the duration of the patient’s visit (since these orders are often entered to serve as a temporary measure when patients are first admitted from the ER). To configure AMR so that unreconciled 1x medications are removed from the right-hand side of the AMR screen:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and disable the setting Match Existing One-Time Hospital Orders to Home Medications in AMR?.
5. Click Save. Both back-end and Commure Pro orders will be removed from the right-hand side of the AMR screen whenever hospital orders are matched to unreconciled 1x home medications.

When this setting is set to Yes, unreconciled one-time or STAT home medication orders display as reconciled with hospital medications.

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Enabling Partial Reconciliation of Medications in AMR

By default, clinicians are required to complete the entire reconciliation process on all medications in a session before they can submit these orders. However, you can configure AMR to allow clinicians to reconcile and submit only some medications from a session, in case they need to follow-up on unanswered questions pertaining to other medications from the same session. When clinicians submit reconciled medications before completing the AMR process in a system enabling this feature, they are given the choice to submit their partially-reconciled list or instead, to return to the AMR screen to continue reconciling additional medications. If they choose to return for more reconciliation, clinicians will notice that the medication list displays only the remaining medications needing reconciliation; any orders reconciled earlier are organized under a “Previously Reconciled” tab. When clinicians leave part of an order session unreconciled, you can configure CPOE to remind them of medications that remain unreconciled during order entry. If configured (by user preference), users are prompted (upon click of the Enter Orders button) with the option to complete the reconciliation process. A link lets users navigate from this prompt directly to a list of all unreconciled medications. For more information, see Prompting Clinicians to Address Unreconciled Home Medications During Order Entry. Partially-reconciled order sessions are also reflected on the printed order sheet, where all home medications still needing reconciliation are organized under a dedicated section identified by the header “Previously reconciled”. Note that you must update your order print-out template to obtain these additions. For more information, contact your Commure Pro representative. To configure the AMR screen to allow for partial reconciliation of medication orders:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and enable the Allow Incomplete Admission Med Rec setting.
5. Click Save. Clinicians can now reconcile and submit a partial list of their orders from an AMR session. In print-outs from this session, all reconciled orders from this session are organized in a dedicated section of the order form, identified by the header “Previously reconciled”.

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Prompting Clinicians to Address Unreconciled Home Medications During Order Entry

You can configure CPOE to check for and alert clinicians of unreconciled home medications each time they enter orders. Users with this option enabled are then prompted (upon click of the Enter Orders button) with the option to complete the reconciliation process. They can respond to the prompt and reconcile remaining medications (clicking yes leads them directly to the AMR screen) or they can proceed with order entry and leave these orders unreconciled. You can configure this behavior for individual users or for a larger group of users (including all users) from Bulk User Edit (Admin > Bulk User Edit > Preference Settings pane > CPOE section). For more information about configuring multiple users at once, see the chapter “Editing User Settings in Bulk” in the Commure Pro Administration Tools User’s Guide. To configure how individual users with unreconciled orders are prompted during order entry:

1. Click the Admin tab and then the User tab.
2. Select the specific user you want to be prompted and click Edit.
3. Select CPOE from the Edit Settings drop-down list.
4. Locate and enable the View Unreconciled Home Meds Alert Upon Entering Orders setting.
5. Click Save. Whenever the selected user attempts to submit an order session, the system checks for unreconciled home medications. If there are one or more unreconciled medications, this user is prompted with the option to reconcile these medications.

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Notifying Clinicians of Unreconciled Home Medications from the Patient List

You can configure CPOE to notify clinicians of unreconciled home medications from the Patient List header. When you enable this option for one or more selected users, these users are reminded of the need to follow-up on these orders with a link (‘unreconciled home meds’) that displays prominently at the top of their Patient List (in red banner). Clicking this link produces the Unreconciled Home Meds window, which lists all visits with pending home medications. Each session with unreconciled activity is listed, identified by the patient name, the visit description, and the list of medications remaining unreconciled. Users can select the action AMR (Admission Med Rec) to complete reconciliation of home meds for each patient on this list. You can configure this behavior for individual users or for a larger group of users (including all users) from Bulk User Edit (Admin > Bulk User Edit > Preference Settings pane > CPOE section). For more information about configuring multiple users at once, see the chapter “Editing User Settings in Bulk” in the Commure Pro Administration Tools User’s Guide. To notify users of unreconciled medications from the Patient List header:

1. Click the Admin tab and then the User tab.
2. Select the specific user you want to be prompted and click Edit.
3. Select CPOE from the Edit Settings drop-down list.
4. Locate and enable the Enable Banner Alert for Patients on List with Unreconciled Home Meds setting.
5. Click Save. This user is notified of any unreconciled home medications from the Patient List header and can respond to this notification by clicking the associated link and choosing from a list of sessions that include home medications still needing to be reconciled.

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Enabling Admission Medication Reconciliation for Users

Authorized administrators can enable the AMR application for individual users through configuration of CPOE user preferences, or for groups of users through configuration of Bulk User Edit. To enable Admission Medication Reconciliation for specific users:

1. Under the Admin tab, navigate to the User tab to select a user, and click Edit.
2. Select CPOE from the Edit Settings drop-down menu.
3. Set the Enable Admission Med Rec preference to Yes. Alternatively, you can enable this setting for groups of users through Bulk User Edit configuration. For more information, see the Commure Pro Administration Tools User’s Guide.

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Admission Medication Reconciliation Settings

Options are provided for configuring Admission Medication Reconciliation at the location level and at the facility level. Also, user preferences let you restrict AMR usage to individual users or groups of users.

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AMR Location Settings

Configuring AMR involves the following CPOE location preferences (Admin > Location): Enable Medication Reconciliation When enabled, this setting displays a list of options for enabling individual Med Rec applications (including the Admission option to enable AMR). You can use this setting to configure AMR facility-wide, or for individual units within a facility. For more information, see Enabling Locations to Use Admission Medication Reconciliation.

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AMR CPOE Preference Settings

Configuring AMR involves the following CPOE preferences (Admin > Facility Group > CPOE Preferences): Allow Incomplete Admission Med Rec When set to Yes, this setting configures the AMR screen to allow clinicians to submit some reconciled orders before completing reconciliation of all medication orders belonging to the Admission Med Rec order session. When set to No, this setting configures the AMR screen to require clinicians to complete reconciliation of all admission medication orders before they can submit these orders. For more information, see Enabling Partial Reconciliation of Medications in AMR. Auto-continue Home Med/Active Hospital Med Matches When set to Yes, this setting configures the Med Rec screen to enable the Continue / Change option each time matches are found between a home medication order and a hospital order. When set to No, this setting configures the Med Rec screen so that users must choose between the actions Stop or Continue / Change each time that a match is found between a home medication order and a hospital order. For more information, see Configuring How Matching Orders are Handled in AMR.

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AMR User Preference Settings

Configuring AMR involves the following CPOE user preferences (Admin > User > Edit Settings [CPOE]): Enable Admission Med Rec This setting enables and disables the Admission Medication Reconciliation functionality for individual users. Administrators seeking to enable AMR for a larger group of users or for all users across their facility can enable this setting under Bulk User Edit. For more information about configuring users in bulk, see the Commure Pro Administration Tools User’s Guide. For more information, see Enabling Admission Medication Reconciliation for Users. Add Home Medications This setting determines whether to display or hide the Add button that lets clinicians enter home medications directly from the AMR window. When this setting is configured to Yes, an Add link displays in the Home Medications header. Clinicians can click this link and search for medication orders from the Search for order window. You can disable this setting to hide the Add link from one or more clinicians, for a variety of reasons. For example, you might to remove this option from the AMR screen to prevent nurses from entering new home medications that have not been verified.

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Configuring Discharge Medication Reconciliation

Configuring the Discharge Medication Reconciliation feature is a process requiring completion of the following basic steps.

1. Enabling Discharge Medication Reconciliation for one or more locations within your facility. For more information, see Enabling Locations to Use Discharge Medication Reconciliation.
2. Configuring behavior of the DMR application, such as whether clinicians can partially reconcile orders during patient discharge, or disallowing specific medications from the DMR workflow. For more information, see Enabling Partial Reconciliation of Medications in DMR and Excluding Specific Order Definitions from Discharge Medication Reconciliation.
3. (Customers using MEDITECH back-ends only) Configuring how the DMR application works in conjunction with DMR plans that are finalized in the back-end (MT) system. For more information, see Configuring How Discharge Plans Finalized in MEDITECH Display in DMR.
4. Enabling Discharge Medication Reconciliation (DMR) for users within your facility or institution. For more information, see Enabling Discharge Medication Reconciliation for Users.

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Enabling Locations to Use Discharge Medication Reconciliation

You can enable the DMR application for entire facilities within your Facility Group, or for one or more individual units within those facilities. Note that you must enable the Medication Reconciliation feature for your institution as a prerequisite step to enabling locations to make use of the various Medication Reconciliation applications. For more information, see Enabling the Medication Reconciliation Feature. To enable DMR for locations within your facility group:

1. Under the Admin tab, select the Location tab.
2. To enable DMR facility-wide, select the facility. To enable DMR for a particular unit, expand the facility folder and select the unit to configure. Note that unit-level configurations override configuration settings applied at the (parent) facility level.
3. Click the Edit button.
4. Locate and enable the Enable Medication Reconciliation setting. Upon enabling this setting for the facility or unit, additional options display enabling configuration of the various Med Rec applications.
5. Enable the Discharge option only.
6. Click Save. Your selected location is now enabled for Discharge Medication Reconciliation.

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Enabling Partial Reconciliation of Medications in DMR

By default, clinicians are required to complete the entire reconciliation process on all medications in a session before they can submit these orders. However, you can configure DMR so that clinicians can reconcile and submit only some medications in a session, in case they need to follow-up on unanswered questions pertaining to other medications in the same session. When clinicians submit reconciled medications before completing the DMR process in a system enabling this feature, they are given the choice to submit their partially-reconciled list or instead continue reconciling other medications in this same session. If they choose to return for more reconciliation, clinicians will notice that the medication list displays only the remaining medications needing reconciliation; any orders reconciled earlier are organized under a “Previously Reconciled” tab (which includes reconciled medications from any previous order sessions). Partially-reconciled order sessions are also reflected on the printed order sheet. Below any medications still needing reconciliation (grouped into distinct sections for home and hospital medications), the order print-out lists all discharge orders that have been reconciled. Note that you must update your order print-out template to obtain these additions. For more information, contact your Commure Pro representative. To configure the DMR screen to allow for partial reconciliation of medication orders:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and enable the Allow Incomplete Discharge Med Rec setting.
5. Click Save. Clinicians can now reconcile and submit a partial list of their orders from an DMR session. In print-outs from this session, all reconciled orders (from both this session and any previous sessions) are organized in a dedicated section of the order form, identified by the header “Previously reconciled”.

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Requiring a Signed Admit Order for Medicare Inpatient Discharge

You can configure DMR to ensure that Medicare inpatients always have a properly authorized admit order (one that was either entered or signed by a provider with admitting privileges) before users can submit their discharge orders. This restriction is enforced to ensure that a patient’s admission is formally accounted for in the system (either Commure Pro or the back-end system). When this restriction is enabled, users discharging Medicare patients from DMR cannot complete patient discharge unless the visit has a signed admit order. If there is either no admit order or an unsigned admit order, users are notified that they must address this requirement to continue with discharge, including during change status orders. Users are also prevented from entering an admit order if one already exists for the current visit, and are prevented from placing discharge orders that are older than 24 hours, and are notified to discontinue the order and re-enter it. In all such cases, users can proceed with the medication process of DMR but they are prevented from submitting their non-medication discharge orders. To configure DMR to enforce admitting provider co-signature:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate the Defined Admission Orders setting and click the associated link to search for and select the admission order that will be used to enforce admitting provider co-signature. Typically, admission orders are defined and pulled over from a back-end system such as MEDITECH.
5. Locate the Financial Class for Two Midnight Alert and Hard Stop in DMR setting and use the menu to select the financial class. (It is expected that the financial class will typically be set to MEDICARE).
6. Click Save. When users in this facility group submit DMR orders, they are prevented from discharging Medicare patients from an inpatient visit unless the patient’s visit has an admission order that was either entered or signed by an authorized admitting provider.

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Excluding Specific Order Definitions from Discharge Medication Reconciliation

You can exempt selected Order Definitions from displaying on the Discharge Medication Reconciliation (DMR) screen. This configuration is accomplished by enabling the Exclude from DMR property on the Edit Order Definition screen. Note that this option is only available to orders that are manually created in the Commure Pro CPOE application. When this value is set to Yes for a particular Order Definition, all instances of the order (including any associated strings) are excluded from the left-hand side of the DMR screen during the discharge medication reconciliation process. For more information about configuring Order Definitions, see Editing Order Definition Properties.

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Enabling Finalization of Discharge Plans in DMR

In systems interfacing Commure Pro DMR to a MEDITECH back-end, the process of finalizing DMR plans is part of the discharge medication reconciliation work flow that involves authorizing discharge plans to be acted upon by nursing staff and any other clinicians during the patient discharge process. Authorized administrators can control whether clinicians within a specified facility can finalize patient discharge plans from within the Commure Pro DMR application. In facilities enabling finalization, clinicians are given the option to finalize discharge plans once they complete reconciliation of all home medications during the discharge medication reconciliation process. Once they finalize a discharge plan, clinicians can only make further edits to this plan if their facility is configured to allow further editing of plans considered finalized. Note that a particular bridge configuration is a required prerequisite to accessing the Allow Restricted DMR after Finalization setting. For more information, consult your Commure Pro representative. To enable finalization of discharge plans directly from Commure Pro DMR:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and enable the Allow physicians to finalize DMR setting for either home medications only or for finalization of both home and hospital medications.
5. (optional) If you want to customize the finalization message, locate the setting Message for finalization and make any changes that are applicable to your deployment situation (more specifically, to your back-end system).
6. (optional) If you want to enable clinicians to make further edits to finalized DMR plans, locate and enable the preference Allow Restricted DMR after Finalization. When you configure your system to allow for restricted DMR, users can continue to manage discharge orders from Commure Pro DMR instead of getting locked out when discharge plans or other activities (such as new prescriptions or renewed home medications) are finalized in MEDITECH. When you allow for restricted DMR, a specific screen (Manage Discharge Orders) lets users make additional changes to finalized discharge plans but restricts this activity to either adding or deleting discharge orders. For additional information targeted toward end-users, see “Making Changes to Finalized Discharge Orders” in the Commure Pro Medication Reconciliation User’s Guide.
7. Configure the interfaced (MEDITECH) Destination Group to receive the submissions specifically formed to transmit finalized DMR plans by enabling the setting Create Submissions if No Orders in the Session (Admin > Facility Group > Destination Groups > [select interfaced MEDITECH group] > Edit). For more information, see Create Submission if No Orders in the Session.
8. Click Save Your DMR configuration changes are saved.

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Configuring How Discharge Plans Finalized in MEDITECH Display in DMR

(MEDITECH only) Facilities using both the Commure Pro DMR and MEDITECH DMR applications have control over how Commure Pro handles finalized DMR plans that are interfaced from a MEDITECH back-end. When DMR plans are finalized in MEDITECH, the extent to which providers using Commure Pro DMR can edit and view data from these plans is configurable. Authorized administrators can configure how the Commure Pro DMR application works in conjunction with DMR plans that are finalized in MEDITECH. You can configure Commure Pro DMR to either allow or fail discharge order submissions that users send after discharge plans have been finalized in MEDITECH. If you configure Commure Pro DMR to work in conjunction with DMR plans that have been finalized in MEDITECH, additional options let you configure whether discharge orders from finalized DMR plans display on (or are hidden from) discharge order lists in Commure Pro. Note that these preferences (described in the following procedure) only display when Commure Pro CPOE is interfaced with a MEDITECH back-end system. For more information about configuring how Commure Pro DMR application works in relation to finalized DMR plans in MEDITECH, consult your Commure Pro representative. To configure how finalized DMR plans from MEDITECH are handled in Commure Pro DMR:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences pane displays by default.

2. If your institution uses multiple Facility Groups, select the correct Facility Group from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and configure the preferences Allow Restricted DMR after Finalization and Show Discharge Orders after finalization (CPOE,NW). For more information about configuring these preferences, see Allow Restricted DMR after Finalization and Show Discharge Orders after finalization (CPOE, NW).
5. Click Save Your DMR configuration changes are saved.

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Hiding Selected Fields from Displaying During DMR

If there are certain fields that only pertain to orders when used in an inpatient setting, you can configure these fields to be hidden during any Discharge Medication Reconciliation work flow. For more information, see Hiding Fields During Discharge Medication Reconciliation.

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Enabling Discharge Medication Reconciliation for Users

Authorized administrators can enable the DMR application for individual users through configuration of CPOE user preferences, or for groups of users through configuration of Bulk User Edit. To enable Discharge Medication Reconciliation for specific users:

1. Under the Admin tab, navigate to the User tab to select a user, and click Edit.
2. Select CPOE from the Edit Settings drop-down menu.
3. Set the Enable Discharge Med Rec preference to Yes. Alternatively, you can enable this setting for groups of users through Bulk User Edit configuration. For more information, see the Commure Pro Administration Tools User’s Guide.

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Requiring Users to Obtain Co-Signature When Submitting DMR Orders

Administrators (level 2 and above) can configure providers at the individual user level to require co-signature on one or more orders in a DMR session. The settings that control a provider’s co-signature rules is provided on the User tab, which (access permitting) displays among the tabs included under the Admin tab. Note that you must configure co-signature independently for providers when submitting orders in CPOE. For more information, see Requiring Users to Obtain Co-Signature for CPOE Orders. To require a user to obtain co-signature before they can enter one or more orders:

1. Click the Admin tab, followed by the User tab. The list of available users displays.
2. Select the user who you want to require to obtain co-signature on one or more orders and click the Edit button.
3. On the Personal Preferences screen, select CPOE from the Edit Settings drop-down menu.
4. Locate and configure the setting DMR Co-Signature Required to define the scope of co-signature rules as they apply to Order Definitions.
5. If choosing to require co-signature of scheduled medications, configure the related setting DMR Scheduled Meds Requiring Co-Signature.
6. Locate DMR Co-Signer Sent in ePrescription as and set this preference to:
   • Supervisor: The current user is identified as the prescriber and the co-signing provider is identified as the supervisor. Users requiring a co-signer are informed with the message “One or more discharge orders requires approval. Select a supervisor.”
   • Prescriber: The current user is identified as the prescribing agent and the co-signing provider instead is identified as the prescriber. Users requiring a co-signer are informed with the message “One or more discharge orders requires co-signature. Select co-signing provider:”. Note that when ordering providers are configured to require co-signature and when this preference is set to Prescriber, the prescriber name is included in the printed DMR report (above the provider signature) provided you are using the most recent template. For more information about obtaining an updated template, contact your Commure Pro representative.
7. To restrict co-signature rules for your defined scope of orders to one or more providers or departments, click Edit for either the Restrict Co-Signature to Providers or Restrict Co-Signature to Department setting and define the group of users to be subject to these co-signature rules.
8. Search for and select the individual providers or departments to define a restricted list of providers who are authorized to provide co-signature, and click Save in the Quick Details box.
9. Click Save at the bottom of the screen to save your co-signature configuration. The selected user is now required to obtain co-signature for the specified orders.

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Discharge Medication Reconciliation Settings

Options are provided for configuring Discharge Medication Reconciliation at the location level and at the facility level. Also, user preferences let you restrict DMR usage to individual users or groups of users.

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DMR Location Settings

Configuring DMR involves the following CPOE location settings (Admin > Location): Enable Medication Reconciliation When enabled, this setting displays a list of options for enabling individual Med Rec applications (including the Discharge option to enable DMR). You can use this setting to configure DMR facility-wide, or for individual units within a facility. For more information, see Enabling Locations to Use Discharge Medication Reconciliation.

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DMR CPOE Preference Settings

Configuring DMR involves the following CPOE settings (Admin > Facility Group > CPOE Preferences): Allow physicians to finalize DMR (for customers using MEDITECH only) Determines whether providers have the option to finalize DMR plans from directly within the Commure Pro DMR application. Configuration options allow for finalization of both home and hospital medications or restricting finalization to home medications only. When this preference is enabled, all providers within the selected facility group are given the option to finalize DMR plans once they complete reconciliation of all qualifying medications (either home meds only or home and hospital meds, depending on configuration) during the discharge reconciliation process. This option is provided in the form of a Finalize DMR check box that displays at the bottom of the DMR screen, to the left of the Reconcile and Submit button. Once they finalize a DMR plan, providers cannot reverse the finalization process (they are unable to de-select the finalize DMR check box). However, if their facility allows it, providers can make further edits to DMR plans after they are finalized. For more information, see Allow Restricted DMR after Finalization. Allow Incomplete Discharge Med Rec Determines whether providers have the option to reconcile a portion of the medications belonging to a DMR session. The configuration options are:

• Yes: to enable providers to reconcile and submit some medications in a DMR session prior to reconciling all medications belonging to the session.
• No: to require providers to reconcile all medications in an order session before they are allowed to submit the order session. For more information, see Enabling Partial Reconciliation of Medications in DMR.

Allow Restricted DMR after Finalization (MEDITECH environments only) Determines whether providers can access and edit DMR plans considered finalized in MEDITECH DMR while using Commure Pro DMR. When this preference is disabled, a message displays to inform providers that the selected discharge plan is finalized an unavailable for further editing. The configuration options are:

• Yes: to enable providers using Commure Pro DMR to access and edit DMR plans considered finalized in MEDITECH DMR.
• No: to block providers using Commure Pro DMR from accessing DMR plans considered finalized in MEDITECH DMR. Instead, a message displays informing providers that the selected discharge plan is finalized and unavailable for further editing. Show Discharge Orders after finalization (CPOE, NW) (MEDITECH environments only) Determines whether discharge orders from finalized DMR plans display on discharge order lists in Commure Pro (including both on the physician portal and on the standard discharge summary in NoteWriter). The configuration options are:
• Yes: Displays discharge orders from finalized DMR plans on all discharge order lists in Commure Pro (including both the physician portal and on discharge summaries created in NoteWriter), just as they ordinarily display (when not part of finalized DMR plan).
• Yes with message: Displays discharge orders from finalized DMR plans on all discharge order lists in Commure Pro (including both the physician portal and on discharge summaries created in NoteWriter), but includes a note directing users to refer to MEDITECH for the finalized DMR plan.
• No: Discharge orders from finalized DMR plans do not display on discharge order lists in Commure Pro. Instead, a note directs users to refer to MEDITECH for the finalized DMR plan. For more information, see Configuring How Discharge Plans Finalized in MEDITECH Display in DMR.

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DMR User Preference Settings

Configuring DMR involves the following CPOE user preferences (Admin > User > Edit Settings [CPOE]): Enable Discharge Med Rec This setting enables and disables the Discharge Medication Reconciliation functionality for individual users. Administrators seeking to enable DMR for a larger group of users or for all users across their facility can enable this setting under Bulk User Edit. For more information about configuring users in bulk, see the Commure Pro Administration Tools User’s Guide. For more information, see Enabling Discharge Medication Reconciliation for Users.

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DMR Co-Signature Settings

The following settings are used to configure co-signature rules that can apply to departments or individual users. These settings are available to level 1 and level 2 administrators only. DMR Co-Signature Required Defines the scope of the co-signature rules. You can configure the scope of these rules to apply to any of the following:

• All: To require the selected user to obtain co-signature on all orders belonging to all Order Types.
• Marked Order Defs: To require the selected user to obtain co-signature on all orders that have been specifically marked to require co-signature. For more information, see Marking Order Definitions to Require Provider Co-Signature.
• All Medications: To require the selected user to obtain co-signature on all medication orders.
• Scheduled Medications: Enable this setting to require co-signature on scheduled medications and then configure the following related preference to restrict co-signature to a specific schedule. DMR Scheduled Meds Requiring Co-Signature When you restrict co-signature rules to scheduled medications, this setting lets you further define which controlled substances require co-signature. You can apply these co-signature rules to a defined group of providers or departments using the configuration preferences Restrict Co-signature to Providers and Restrict Co-Signature to Department, both described below.
  • C-II only
  • C-II, C-III
  • C-II, C-III, C-IV
  • C-II, C-III, C-IV, C-V
  • C-II, C-III, C-IV, C-V, C-VI (enforced upon setting DMR Co-Signature Required to All Orders) DMR Co-Signer Sent in ePrescription as Determines how co-signature rules will be enforced for ePrescribing activity. You can configure this preference to specify either:
• Supervisor: The current user is identified as the prescriber and the co-signing provider is identified as the supervisor in the electronic prescription sent to the pharmacy and also the prescription print-out sent to printer Destinations. Users requiring a co-signer are informed with the message “One or more discharge orders requires approval. Select a supervisor.” On the prescription sent to the pharmacy, the co-signing provider displays above the provider signature, identified by the label “Supervising Physician”.
• Prescriber: The current user is identified as the prescribing agent and the co-signing provider instead is identified as the prescriber in the electronic prescription sent to the pharmacy and also the prescription print-out sent to printer Destinations. Users requiring a co-signer are informed with the message “One or more discharge orders requires co-signature. Select co-signing provider:” On the prescription sent to the pharmacy, the co-signing provider is used as the provider name (instead of the mid-level provider required to obtain co-signature), which is printed below the Provider Signature line. This setting is typically set during configuration of the ePrescribing application. For more information, see To Register Individual Users for ePrescribing.

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Configuring Transfer Order Reconciliation

The process of reconciling orders is as important during transfer of patients as it is during patient admission or patient discharge. Each time that a patient transitions to a different level of care, it is recommended that providers review the orders to decide which ones to continue and which ones to stop. For more information about how providers reconcile orders during patient transfer, see the Commure Pro Medication Reconciliation User’s Guide. From an administration perspective, the transfer reconciliation process differs from discharge reconciliation in that, during the transfer process, the patient’s visit may or may not require a discharge/re-admit, depending on where the patient is being transferred from and where the patient will be transferred to. If transfer orders are for the same visit, then the orders (Continue, DC, or New) will be immediately applied to the current visit. If the transfer requires a discharge/re-admit, however, then the transfer orders will be treated as Discharge orders, intended for the new visit. The distinction between transfers for the same visit vs. a new visit is made by comparing Transfer Location Types. The implementation of the Transfer Order Reconciliation feature requires the configuration of Transfer Location Types. Examples of these types include “Surgical Floor”, “Medical Floor”, “Intensive Care”, “Behavioral Health”, or “Skilled Nursing Facility”. Each Transfer Location Type is associated with an “In Facility” property that is set to either Yes or No. Not only will a provider select a Transfer Location Type upon transfer, but an administrator will map every nursing unit (where transfers are performed) to a specific Transfer Location Type as a prerequisite to using the Transfer Order Reconciliation function. (This mapping is performed under Admin > CPOE > Location > Nursing Unit.) For example, each medical floor should be mapped to a Transfer Location Type of “Medical Floor”. The system treats a transfer from a nursing unit associated with an “In Facility = Yes” Transfer Location Type to another “In Facility = Yes” Transfer Location Type as a transfer for the same visit. Conversely, the system handles transfers with an “In Facility = No” Transfer Location Type as requiring a discharge/re-admit. Another prerequisite to using the transfer function is to build transfer order strings that are associated with each Transfer Location Type. For each Transfer Location Type that you plan to configure in CPOE, you must associate a corresponding order string. This will serve as the provider’s transfer order for this specific Transfer Location Type. Configuring the Transfer Order Reconciliation feature is a process requiring completion of the following basic steps.

1. Creating and configuring all Transfer Location Types. This process involves the following steps:
   1. Creating Transfer Location Types in Commure Pro CPOE that correspond with each level of care to which patients in your facility might be transferred. As prerequisite to this step, your facility should already have created order strings that represent the provider order for this transfer to take effect.
   2. Configuring each of these Transfer Location Types to specify a transfer Order String and to indicate whether the Location Type is configured to have the “In Facility” attribute set to yes or no.
   3. Mapping locations to Transfer Location Types. For more information, see Preparing for Configuring Transfer Order Reconciliation, Creating and Configuring Transfer Location Types, and Enabling Locations for Transfer and Mapping Locations to Transfer Location Types.
2. Enabling Transfer Order Reconciliation for one or more locations within your facility. For more information, see Enabling Locations for Transfer and Mapping Locations to Transfer Location Types.
3. Configuring behavior of the Transfer Order Reconciliation application, such as whether clinicians can partially reconcile orders during patient transfers, excluding “in progress” orders from transfer, or excluding specific orders from the Transfer Order Reconciliation workflow. For more information, see Allowing Partial Reconciliation of Orders During Patient Transfer, Excluding “In Progress” Orders from Transfer Order Reconciliation, and Excluding Specific Order Definitions from Transfer Order Reconciliation.
4. Enabling the transfer order reconciliation feature for one or more users within your facility or institution. For more information, see Enabling Transfer Order Reconciliation for Users.

Procedures for these basic steps are provided below, and are organized to be followed sequentially if you are configuring the Transfer Order Reconciliation feature for the first time.

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Preparing for Configuring Transfer Order Reconciliation

The process of reconciling orders is as important during transfer of patients as it is during patient admission or patient discharge. Each time that a patient transitions to a different level of care, it is recommended that providers review the orders to decide which ones to continue and which ones to stop. For more information about how providers reconcile orders during patient transfer, see the Commure Pro Medication Reconciliation User’s Guide. From an administration perspective, the transfer reconciliation process differs from discharge reconciliation in that, during the transfer process, the patient’s visit may or may not require a discharge/re-admit, depending on where the patient is being transferred from and where the patient will be transferred to. If transfer orders are for the same visit, then the orders (Continue, DC, or New) will be immediately applied to the current visit. If the transfer requires a discharge/re-admit, however, then the transfer orders will be treated as Discharge orders, intended for the new visit. The distinction between transfers for the same visit vs. a new visit is made by comparing Transfer Location Types. The implementation of the Transfer Order Reconciliation feature requires the configuration of Transfer Location Types. Examples of these types include “Surgical Floor”, “Medical Floor”, “Intensive Care”, “Behavioral Health”, or “Skilled Nursing Facility”. Each Transfer Location Type is associated with an “In Facility” property that is set to either Yes or No. Not only will a provider select a Transfer Location Type upon transfer, but an administrator will map every nursing unit (where transfers are performed) to a specific Transfer Location Type as a prerequisite to using the Transfer Order Reconciliation function. (This mapping is performed under Admin > CPOE > Location > Nursing Unit.) For example, each medical floor should be mapped to a Transfer Location Type of “Medical Floor”. The system treats a transfer from a nursing unit associated with an “In Facility = Yes” Transfer Location Type to another “In Facility = Yes” Transfer Location Type as a transfer for the same visit. Conversely, the system handles transfers with an “In Facility = No” Transfer Location Type as requiring a discharge/re-admit. Another prerequisite to using the transfer function is to build transfer order strings that are associated with each Transfer Location Type. For each Transfer Location Type that you plan to configure in CPOE, you must associate a corresponding order string. This will serve as the provider’s transfer order for this specific Transfer Location Type.

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Creating and Configuring Transfer Location Types

Prior to enabling the transfer order reconciliation feature, you must create and configure Transfer Location Types for each level of care. To create and configure Transfer Location Types:

1. Click the Admin tab, then the Facility Group (or CPOE) tab and click the Transfer Location Types link.
2. Click the Add Transfer Location Type button The Add CPOE Transfer Location Type window displays.

From the Add CPOE Transfer Location Type window, enter the name and abbreviation of the transfer location and (optionally) a description. For example, you could enter “ICU” for both the name and abbreviation, to represent the Intensive Care Unit as one of your facility’s transfer locations.

3. From this same window, configure the In Facility preference to specify either:
   • No: Transfers to and from this Location Type typically require a discharge/re-admit.
   • Yes: Transfers to and from this Location Type typically do not require a discharge/re-admit, unless a patient is being transferred from a location where the Transfer Location Type is set to “No”.
4. Locate the Order Prototype setting, click the Add/Replace Order button, and use the search field to locate the transfer Order String that represents the patient transfer to this Location Type. Typically, this order will be named in a way that is easy to identify as an order that relates to patient transfer. For example, “Transfer to ICU”.
5. Click Save.
6. Repeat steps 3 through 6 until you create a transfer location type for each level of care. When you are done adding transfer location types, you are ready to enable Transfer at the location level and associate these Transfer Location Types to specific nursing units.

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Enabling Locations for Transfer and Mapping Locations to Transfer Location Types

Under the Admin tab, navigate to the Location tab and configure each unit by completing the following steps.

1. Expand the facility to view all units within the facility.
2. Select the unit from the list of units that displays on the left-hand side of the screen.
3. Click the Edit button.
4. Locate and enable the Enable Medication Reconciliation setting. Upon enabling the Medication Reconciliation feature for a particular unit, a sub-menu displays that lets you choose from three types of reconciliation. Locate and enable the Transfer option. (Alternatively, from the Location tab, you can enable Transfer at the facility level for all locations in the facility. keep in mind that any configurations of the Enable Medication Reconciliation setting at the unit level override all settings at the facility level.)
5. Locate the Transfer Location Type setting and use the drop-down menu to select the appropriate transfer location for this unit.
6. Repeat the above steps for each unit, until you assign a Transfer Location Type to each of the units belonging to the facility for which you are enabling the Transfer Order Reconciliation feature.
7. When you have finished enabling and assigning Transfer Location Types to the individual units within your facility, click Save.

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Allowing Partial Reconciliation of Orders During Patient Transfer

By default, clinicians are required to complete this entire process on all orders before these orders can be submitted. However, as with both the AMR and DMR applications, administrators can configure Transfer Order Reconciliation to allow clinicians to submit orders prior to completing the reconciliation process. When clinicians submit reconciled medications before completing Transfer Order Reconciliation process in a system enabling this feature, they are given the choice to submit their partially-reconciled list or instead, to return to the Transfer Order Rec screen to continue reconciling additional orders. If they choose to return for more reconciliation, clinicians will notice that the order list displays only the remaining orders needing to be reconciled; orders reconciled earlier are organized under a “Previously Reconciled” tab. Partially-reconciled order sessions are also reflected on the printed order sheet, where all remaining orders needing reconciliation are organized under the dedicated section “The following orders had no action taken”. Note that you must update your order print-out template to obtain these additions. For more information, contact your Commure Pro representative. To configure the Transfer Order Reconciliation screen to allow for partial reconciliation of orders:

1. Click the Admin tab and then the Facility Group or CPOE tab.

The CPOE Preferences screen displays by default.

2. If your institution uses multiple Facility Groups, select the Facility Group you want to configure from the Facility Group drop-down list.
3. Click the Edit button.
4. Locate and enable the Allow Incomplete Transfer Order Rec setting.
5. Click Save. Clinicians can now reconcile and submit a partial list of their orders during the Transfer Order Reconciliation process. In print-outs from this session, remaining orders needing reconciliation are identified with the section header “The following orders had no action taken.”

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Excluding “In Progress” Orders from Transfer Order Reconciliation

The Transfer Order Reconciliation screen excludes the display of any lab and radiology orders that remain in progress at the time of order reconciliation. In the case of labs, orders in progress include specimens that have already been collected from the selected patient. In the case of radiology results, orders in progress include images that have already been obtained from the selected patient. In both cases, display of these orders is unnecessary, since it is too late for clinicians to stop or continue these orders from the Transfer Order Reconciliation screen. Orders that are defined as “in progress” orders in CPOE are all orders with an order status that maps to the CPOE back-end order status “In Progress”. In CPOE, this mapping assignment is defined using the Order Status (ORDER_STS_CD) reference list, which authorized administrators can access and configure under the System Management tab (Admin > System Management > Reference Lists). In the following example, orders with the status “Pending Lab” have been mapped to the back-end status “In Progress”; all orders with this status will be excluded from the Transfer Order Reconciliation screen at the time of order reconciliation For more information about mapping order status, see Defining How Medications are Mapped to the Back-End System.

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Excluding Specific Order Definitions from Transfer Order Reconciliation

You can limit the scope of orders that are available during patient transfer by excluding selected Order Definitions from the Transfer Order Reconciliation screen. For example, you might choose to exclude one or more admission orders that are typically ordered only once, at the time of patient admission. This configuration option is available from the Edit Order Definition screen, by enabling the ‘Exclude from Transfer’ property. When this value is set to Yes for a particular Order Definition, all instances of the order (including any associated strings) are excluded from the list of orders that is available from the Transfer Order Reconciliation screen. For more information about configuring Order Definitions, see Editing Order Definition Properties.

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Updating Your Order Print-Outs to Include Transfer Orders

Note that use of the Transfer Order Reconciliation feature requires that you update your order print-out to properly handle the display of all transfer orders. The updated print-out identifies the transfer target location, and all orders from the patient transfer process (including their associated details and fields) are identified within a well-defined border on the order print-out If you do not see all of the transfer orders and their associated details and fields, you might need to update your standard template with the latest version. For more information about obtaining and loading the latest order form template to support Transfer orders, contact your Commure Pro representative. In addition to updating your order form template, you may need to create new or modify existing route actions so that these updated order print-outs get routed to the appropriate destination(s). For more information about routing all of your orders that make use of this updated form template to one or more of your facility’s Destinations, see Configuring Order Routing.

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Enabling Transfer Order Reconciliation for Users

Authorized administrators can enable Transfer Order Reconciliation for individual users through configuration of CPOE user preferences, or for groups of users through configuration of Bulk User Edit.

1. Under the Admin tab, navigate to the User tab to select a user, and click Edit.
2. Select CPOE from the Edit Settings drop-down menu.
3. Set the Enable Transfer Med Rec preference to Yes. Alternatively, you can enable this setting for all of your users under the Bulk User Edit tab. For more information about Bulk User Edit, see the Commure Pro Administration Tools User’s Guide.

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Transfer Order Reconciliation Settings

Options are provided for configuring Transfer Order Reconciliation at the location level and at the facility level. Also, user preferences let you restrict Transfer Order Reconciliation usage to individual users or groups of users.

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Transfer Order Reconciliation Location Settings

Configuring Transfer Order Reconciliation involves the following CPOE location settings (Admin > Location): Enable Medication Reconciliation When enabled, this setting displays a list of options for enabling individual Med Rec applications (including the Transfer option to enable Transfer Order Reconciliation). You can use this setting to configure Transfer Order Reconciliation facility-wide, or for individual units within a facility. For more information, see Enabling Locations for Transfer and Mapping Locations to Transfer Location Types.

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Transfer Order Reconciliation CPOE Preference Settings

Configuring Transfer Order Reconciliation involves the following CPOE preferences (Admin > Facility Group > CPOE Preferences): Allow Incomplete Transfer Order Rec When set to Yes, this setting lets clinicians reconcile and submit orders in a reconciliation session prior to completing reconciliation for all orders belonging to the session. When this setting is configured to be No, clinicians are required to reconcile all orders in a session before they can submit the order session. For more information, see Allowing Partial Reconciliation of Orders During Patient Transfer.

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Transfer Order Reconciliation CPOE User Preference Settings

Configuring Transfer Order Reconciliation involves the following CPOE user preferences (Admin > User > Edit Settings [CPOE]): Enable Transfer Med Rec This setting enables and disables the Transfer Order Reconciliation functionality for individual users. Administrators seeking to enable TOR for a larger group of users or for all users across their facility can enable this setting under Bulk User Edit. For more information about configuring users in bulk, see the Commure Pro Administration Tools User’s Guide. For more information, see Enabling Transfer Order Reconciliation for Users.

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Configuring CPOE to Allow for Continuation of Home Medications in Emergency Departments

The Continue Home Medications feature lets emergency room (ER) physicians continue or change a patient’s home medications and enter additional orders during the ER visit, while still maintaining the complete list of home medications for the admitting physician. The admitting physician can then reconcile all home medications including any that were continued or changed in the emergency room for a patient’s admission using Admission Medication Reconciliation.

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Enabling Users to Continue Home Medications in an ED Setting

Authorized administrators can enable individual users to continue home medications for patients in an emergency department (ED) or emergency room (ER) setting. To enable specific users to continue home medications in an ED:

1. Under the Admin tab, navigate to the User tab to select a user, and click Edit.
2. Select CPOE from the Edit Settings drop-down menu.
3. Set the Continue Home Meds? preference to Yes. Alternatively, you can enable this setting for groups of users through Bulk User Edit configuration. For more information, see the Commure Pro Administration Tools User’s Guide.

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Continue Home Medication Settings

Configuring CPOE to allow for continuation of home medications in the ED involves enabling the following CPOE user preference (Admin > User > Edit Settings [CPOE]): Continue Home Meds? Determines whether selected clinicians can access the Continue Home Medications screen. This screen is primarily used by clinicians in the ER to add selected medication orders without the need to perform a full medication reconciliation. As an alternative, clinicians can now perform partial reconciliation during patient admission, transfer, or discharge. For more information, see Enabling Partial Reconciliation of Medications in AMR. When set to No, this setting configures the DMR screen to require clinicians to complete reconciliation of all discharge medication orders before they can submit these orders.

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Monitoring Medication Reconciliation Activity for Promoting Interoperability

For information about running reports to obtain Promoting Interoperability compliance data for Commure Pro applications including Medication Reconciliation, see “Reporting on Promoting Interoperability Compliance” in the Commure Pro Administration Tools User’s Guide.