Harbor:Prescribing

Prescribing medications for discharge

  • Either go to Place Orders and above search box click "Prescriptions" or
    • In the Admit/Discharge dialogue click the pencil next to "Orders/Rx" or
    • As part of your Provider Note, click "Launch Prescriptions" in the Discharge Plan section
  • Search for the medication you wish to prescribe
    • If you go through Admit/Discharge dialogue, there are frequently prescribed meds in the Peds ED folder
    • Carefully check the auto-calculated dose - there are no maximums set in Cerner
  • In the "Send to" drop-down all the way to the right, make sure an Rx printer is selected
    • If not, select one; if you don't see one, choose "Other" and select one from your Favorites or Other output devices

Prescribing controlled medications

  • e-prescribe

Sending prescription directly to pharmacy

  • Some patients will already have a favorite pharmacy
    • Choose "Find Pharmacy" in the drop-down menu under "Send to"
      • Click the tab "Patient Preferred"
  • To send to a Harbor pharmacy, choose "Find Pharmacy" in the drop-down menu
    • Put "HUMC" under Pharmacy Name and erase the city (the patient's city of residence automatically comes up)
      • OPD is the outpatient pharmacy in the Main hospital
      • N22 is the outpatient pharmacy in building N-22
      • FMC is the outpatient pharmacy in the Family medicine clinic on Lomita Blvd
    • For DHS patients it is highly preferred that we e-prescribe medications to a Harbor pharmacy
  • To send to another retail pharmacy, complete the appropriate search for name and city

E-Prescribing

  • Ask patient if they would like to pick it up at Harbor - convenient, low cost to patient, saves county $$$
    • Pharmacy hours M-F 7a - 10p, Weekend and Holidays 8a - 6p
    • x5434, 5433 - Call if discharging pt <1 hour from closing time so they know to fill the Rx
      • When selecting location ("send to"), choose "find pharmacy" instead of the default printer
      • In Pharmacy name, type "HUMC" and select "LA CO HUMC OPD" then sign and it is on its way to being filled before you even discharge the patient
  • If OOP, patients seen in the ED, clinics, or post-hospital discharge may fill their prescriptions at Harbor pharmacies, but they will have to pay out of pocket.
  • Changing a prescription that has already been transmitted:
    • 1. If a pharmacy calls asking for the script to be sent elsewhere, tell them to cancel the rx they received. If you receive the call from the patient, you will need to call the pharmacy. Cancelling in ORCHID does not retract the prescription once it has been transmitted.
    • 2. Use the “Cancel and Reorder” function in ORCHID to rewrite the prescription to the new pharmacy.


Lost Triplicate Prescriptions

If you find that your providers are missing prescriptions or are contacted from a pharmacy regarding suspected fraudulent prescriptions please do the following as required by the Department of Justice,.If you are unsure if you are missing any individual prescriptions, please assume that they have been stolen and report.

  1. The loss or theft must be reported by the physician to local law enforcement. The physician should take note of the law enforcement agency report number.
  2. The loss or theft must be reported by the physician to the Department of Justice Controlled Substance Utilization Review and Evaluation System (CURES) program. A law enforcement agency report number is required when submitting a report of lost or stolen prescription forms to CURES.
  3. The physician should notify the California State Board of Pharmacy.
  4. The physician should notify the Medical Board of California.
  5. In addition, to the above 4 steps please email Dr. Harrington at dharrington@dhs.lacounty.gov.

D. Harrington, 11/3/16

Safe Pain Medication Prescribing Guidelines

We will be shortly launching the implementation of the Safe Pain Medication Prescribing Guidelines, a Los Angeles county-wide project to decrease inappropriate opioid prescriptions from the ED and other settings. Patients will receive upon discharge a color pamphlet (English or Spanish) explaining the project, including messages about how stolen prescriptions need to be reported to the police, that the ED does not refill pain pills and that pain pills for chronic pain should really come from a single, continuity provider. Residents, NPs, and nursing staff got some in-depth lectures about this. (Dir Adult ED 10/14/14)


See Also

References