An important prescribing issue has been reported by a small number of customers on Genie v9.3.6 and earlier versions of v9.3.7 when using a particular workflow pattern, which has been detailed in this announcement. If you are currently running these versions please ensure that you update to the latest Genie v9.3.7 dated 11 September 2020.
Prescribing your patients the appropriate medication can be a complex process. It can be difficult attempting to navigate the maze of generic and brand name drugs available, keep on top of the constant changes to medications and the thousands of different interactions between these medications, not to mention any allergies or conditions each patient may have. Thankfully, along with Genie's intuitive clinical window, our Prescribing module allows you to quickly and easily search for the best drug for every circumstance, with the confidence that Genie is also helping you make sure this will be a safe course of treatment for your patient.
Before you begin
Before you start prescribing you will need to ensure that prescribing has been configured as appropriate for your practice. If this has not yet been done, please review our Configuring Genie for Prescribing article.
Did you know? If you are running Genie v9.3.4 and above, your patients' date of birth will now print on all prescriptions.
The Prescription area is alongside and below the Quickscript drop-down menu.
The column order in the prescription list can be changed by clicking on the title of the column and dragging to required position. Column width can be adjusted by positioning the cursor on the divider between column titles until a double arrow appears, then clicking and dragging the column to the desired width.
A single click on a medication in the list will display the MIMS Abbreviated information in the display area, provided you have the large patient window
A double-click on a drug will open the MIMS annual entry in a web browser window which includes drug images.
To modify the reason, dose, frequency, instructions or repeats, slow double-click in the area you would like to modify.
These changes are shown in the display area along with the MIMS Abbreviated when a medication is clicked as well as in the Info button. However, these changes are not retroactive. Changes are only tracked for drugs linked to MIMS, and which are not marked as 'once-only' (i.e. category S).
Clicking on the Info button will also allow you to select Deleted Prescriptions. This window includes non-S category (non-single use) medications that have been deleted. The deleted prescriptions are listed here with their respective Reason for deletion (e.g. Adverse Reaction).
Right-clicking on the Category, Medication and Reason columns will display contextual popups depending on which column you right-click.
|Category Pop Up|
|Medication column Pop-Up|
|Reason Column Pop- Up (populating from Current Problems and Past History)|
The QuickScript button allows you to quickly prescribe a medication for a patient. To add to this list see Adding to QuickScript in Adding a New Prescription.
|The QuickScript button allows you to quickly prescribe a medication for a patient. To add to this list see Adding to QuickScript in Adding a New Prescription.|
|The Blue plus button is used to add new prescriptions to the patient’s current medication list. Alt+clicking on this button allows you to quickly add medications the patient is taking without having to specify strengths and dosages. This is useful for specialists who simply want to record the patient’s medications without intending to actually print a prescription for them.|
|The Information button, tracks any changes made to the prescription dose, reason etc. It shows the Type of Change, Dose and Reason. You can insert a reason by right-clicking in the reason column for a list of common reasons or slow double clicking to add your own. Alt+clicking on the Information button displays the Progressive Medication History information.|
Alt+clicking on this button will select or deselect all the prescriptions.
Ctrl+Alt+clicking allows you to backdate a prescription.
The Batch button batches the selected prescriptions for later printing. GPs might use this when printing nursing home prescriptions. You would batch each patient’s prescription rather than printing them immediately. Subsequently, select Print Batch from the Patients menu and all the prescriptions will be printed at once (Open > Patients, Patients > Print Batch).
Note: Authority prescriptions cannot be batched.
|The Medication Review button allows you to perform a review of all the patient’s current medications, which can subsequently be printed or saved as a consultation record.|
The CMI button will display Consumer Medicine Information for the selected medication, if it is available. CMI information is supplied by MIMS and is not currently available for all medications.
On a network, this information is stored on the server in a folder called CMI in the Genie folder. The files are stored as Acrobat PDFs. When you select a particular item, the pdf is automatically copied from the CMI folder on the server to a CMI folder on the client machine so that the next time you view that particular CMI it is opened directly from the client machine.
Note: On Windows, you must have Acrobat Reader installed on your machine to open, view or print these files.
The Medication Sheet button allows you to print a six week nursing home sheet, a 2 week medication sheet for hospitals both with or without dates entered. Additionally you can print prescription labels for the Compact Business System.
Provided you have NPS RADAR Alert ticked in your User Preferences, this button will become active when an NPS RADAR review is available for the drug you have selected, as well as a RADAR summary popping up the first three times you prescribe a medication with a current NPS RADAR review. The NPS RADAR is updated either through the Special menu or through the Genie CD updates.
The Garbage can button will delete the selected medications. If only one medication is selected there is no warning. If more than one medication is selected you will be asked to confirm the delete command. You can delete multiple prescriptions at once by Shift+clicking or Ctrl+clicking and highlighting the required prescriptions. When deleting a medication, you are asked for a reason but only if the medication is not 'once-only' (i.e. assigned a category of 'S'), and it has previously been printed, otherwise it will be deleted immediately. You can also choose to create a class allergy to this medication when deleting the prescription. This reason can be accessed through the Info button Info button next to script archive and the MIMS Quarterly display. If you re-prescribe a previously deleted medication, the old prescribing history, as well as the reason for stopping the medication will be displayed again.
The Reset button can be used to restore the default prescription display if you have re-arranged the columns for example.
Ticking the Reg 24 checkbox will print the Regulation 24 request on prescriptions i.e.“Regulation 24. Please dispense all repeats.”
The TPG button will display a list of generic equivalents for the selected medication, allowing you to change the current medication to the equivalent without having to delete and re-prescribe it.
The Strength button allows you to change the strength of the selected prescription without having to delete and re-prescribe it.
Checking the Certificate checkbox will print a sick certificate in the lower right area of the prescription.
Checking the Drug List checkbox prints the list of current medications in the lower left area of the prescription.
Note: If you would like to print a certificate without actually printing a prescription, you can create a new drug called 'Certificate' and enter it in your QuickScript menu. Then when you need a certificate 'Prescribe' the drug called certificate and print! Alternatively, create your own sick certificate using a merged letter template.
Now that you have installed the prescribing data and set up your preferences, you will need to familiarise yourself with the prescribing area. Whether you're wanting to prescribe a medication, print a previously prescribed medication, or simply review your patient's current medications, you'll need to navigate to their clinical window.
The prescription display area, outlined below, is the main location within Genie where you can prescribe, print, and review any medications your patients may be on.
To add a new prescription for the patient, click the blue plus icon in the prescribing area highlighted above. This will present you with the new prescription window. You can also open the same window using the button within a consult window or a Current Pregnancy window. After doing so, the new prescription window shown below will open:
In the top left hand corner of this window is your search field. Genie will begin searching your entire drug database after the third letter that has been typed. You can narrow the selection down by continuing to type.
The three buttons to the right of the search pane will allow you to narrow or expand your search. uses the listed indications within the MIMS annual information. The button allows to search on your drugs by the company associated with each drug.
Lastly, you can navigate the entire prescribing data by selecting the button. This can be particularly useful if you're looking for a specific medication to treat a condition.
After performing your relevant search, you can expand the categories by clicking the arrow icons pointing to the name of the category. To select one of the displayed drugs, simply double-click or use the up and down keys on your keyboard to highlight and click to prescribe the medication.
Customising the prescription
Once you've selected the relevant medication, you can go ahead and make a number of changes to how the medication needs to be taken.
If the Dose, Frequency, Instructions, or Reason you've added are common modifications made to all your prescriptions, you can add this into the drop-down list by selecting the Add to menu option. For any future prescriptions requiring this information, you can then easily select the option you added from the drop down menu.
If you've selected Use Meal Time for Scripts under your User Preferences the dosing information will appear slightly different. From the new prescription window, you can modify your preferences at anytime by clicking the button at the top of the window.
The Repeats field automatically defaults to the maximum number permissible. To change this to Nil repeats enter '0' or 'n' in this field.
The Category field allows you to assign a category to the prescription. Prescriptions marked as Single Use (S) are automatically deleted from the patient's record once they are more than 30 days old. Deletion occurs during the Cleanup process when the last user quits Genie. Additionally, prescriptions marked as Single Use (S) and Hide (H) will not be referenced in the 'Current Medications' expression in Referral/Reply Letters. Antibiotics, vaccinations, and cough mixtures are some of the medications that will be automatically marked as a Category S medication.
The Memorise Dose checkbox will 'remember' the dose, frequency, and instructions for the selected medication, so that the next time you prescribe it in this window, the Dose, Frequency, and Instructions fields will be filled automatically.
Once you've selected the appropriate medication, and made any relevant modifications to the script, click the button to add this to the patient's record. This will then appear as a current medication within the Prescription window for that patient.
Genie's Prescription module allows you to easily and quickly prescribe commonly used medications using our QuickScript functionality. The QuickScript menu stores your most commonly prescribed medications, allowing you to quickly prescribe any item in the menu for any patient. In order to add a medication, the associated Dose, Frequency, and Instructions to your QuickScript menu, click on the button once you've selected and customised the prescription appropriately within the new prescription window.
Once you've built up your QuickScript list, you can use this to quickly prescribe medications to your patients. To do this, simply select the QuickScript drop down menu within the prescription window and select the appropriate medication.
If you would like to remove options from the Quickscript menu, please refer to our article about removing options from a drop down menu.
If you aren't subscribed to use MIMS Prescribing data, or want to add a new medication that isn't currently listed with MIMS, you can do this through the button within the new prescription window. You will receive the prompt below:
If you're wanting to add a new drug into Genie, either because you don't use MIMS Prescribing data or you need to add a drug that has no record within the MIMS list of medications click New.
You'll then need to enter the appropriate information for this medication in the subsequent window:
Once all the relevant information has been entered hit Save.
If the new drug you're wanting to add is a copy of an existing medication with some minor modifications, such as a change in Quantity and subsequently a change in the Code from PBS/RPBS to Authority - PBS/RPBS, you can hit the Copy button after clicking on Add New Drug. You'll need to make sure the drug you want to copy is highlighted within the new prescription window.
After hitting Copy you'll be presented with the subsequent window:
Make the relevant adjustments and hit .
You can review, delete, and add new user added drugs through the User Added Drugs list, which you can access via the button in the new prescription window.
Once a drug is selected to be prescribed, provided it is part of the MIMS Prescribing data, Genie performs an allergy and drug interaction check.
If Genie detects an interaction with another drug in the patient's current medication list, an interactions window will appear.
This window contains an explanation of the interaction and indicates the severity. You can still prescribe the medication by clicking the button if the interaction is not consequential.
As mentioned at the start of this article, you can alter the degree of interaction checking within your User Preferences to suit your desired level.
If the patient has been marked as allergic to the selected drug or its class, Genie will display an allergy warning. It is important that these allergies have been entered as a drug allergy within the patient's clinical record, as opposed to a non-drug allergy. All drug allergies will be listed as red under the Allergies menu. You will need to be using MIMS Prescribing data to add drug allergies, otherwise the allergy will be listed in blue, as a non-drug allergy.
Once you have completed your prescription and saved the drug to the patient's record, the print tick box within your medications window will become ticked automatically.
Before hitting the printer icon, ensure you have loaded your tray with prescription paper. If you have a printer with multiple trays and you wish to guide the prescriptions to a particular tray, ensure you have set this within File > Printing Preferences. While in the Preferences window, you’ll notice at the bottom of the page the option to Adjust the Print Area. This will give you the ability to move the position of prescription if it does not line up correctly on your prescription paper.
Once you've printed your prescription, the printed date will be entered into the list of medications under the Printed column. If you need to re-print a current medication, simply tick the Print box for the desired medication and click the icon.
Quick tip: In order to print a prescription (or multiple prescriptions) for more than one patient, you firstly need to add the prescriptions required to your QuickScript list. You would then search for the list of patients required. For post-operative medication for patients on a theatre list, perform these steps:
- Navigate to Open > Patients and continue through the search window
- Next choose Patients > Today's Appointments
- Select the day and the doctor and then tick Display Procedures Only
- Again go to Patients, but choose Print Prescriptions
- You will be prompted to confirm the creation of scripts for the selected patients and regarding interactions
- Click OK
- Your QuickScript list will be displayed. Select the prescription(s) and click on OK
- The prescriptions will be created. You will then be prompted as to whether you wish to print them now or later through Patients > Print Batch
It is important to remember that you can do this with other searches. All you have to do is generate a list within the Patients window then navigate to Patients > Print Prescriptions.
Prescriber Number Alert when Reprinting Scripts
When trying to reprint a script, you may receive an alert "You haven't entered a Prescriber Number in your User Preferences".
This is because the user does not have a Provider Type set in their User Preferences. For a practitioner you will need to choose your Provider Type and Speciality. You will then need to ensure that your Prescriber Number is also entered. If you are not a practitioner but work in an administrative capacity, you will need to select Receptionist under Provider Type.
Electronic Transfer of Prescriptions is a tool designed to promote a connected healthcare system and limit the potential for inconsistency between the pharmacy community, patient, and prescriber. There are currently two Prescription Exchange Service systems operating in Australia – eRx Script Exchange and MediSecure. Each of these have been approved by the Commonwealth and is required to meet specified standards relating to security and privacy. A Genie practice may be connected to one or both systems. However, it is rare to use both. Once you've registered to use MediSecure or eRx these services will help configure their service in Genie for you.
If you are registered with MediSecure for the Electronic Transfer of Prescriptions, at the time of printing the script, an electronic copy is sent to the MediSecure database. The script will also print with a barcode which the pharmacist will scan on receiving the prescription from the patient. This will then allow the pharmacist, if also registered with MediSecure, to download the details of the prescription from the MediSecure database.
If you are registered with eRx for the Electronic Transfer of Prescriptions, enter in the details as per the instructions below the eRx Host Platform field. At the time of printing the script, an electronic copy is sent to the eRx database. The script will also print with a barcode which the pharmacist will scan on receiving the prescription from the patient. This will then allow the pharmacist, if also registered with eRx, to download the details of the prescription from the eRx database.
Setting Up User Preferences
Once you've registered with either eRx or Medisecure, to configure this in Genie you can navigate to File > All User Preferences, and double click on the provider/s who will performing the prescribing. Under the Clinical tab, you'll find the Electronic Transfer of Prescriptions section.
For Medisecure, click the Send to Medisecure radio button which should populate the Host URL and Port Number fields automatically.
For eRx, click the Send to eRx radio button which will populate the Host URL and Port Number fields. You will also need to enter your Sender ID, which will be provided to you by eRx when registered. Once you have entered this, select if you are using a Windows or Mac host platform, and click the Ping button to attempt to connect to eRx.
If the Enable NPS RADAR Alert option is ticked in File > User Preferences > Clinical for the logged in user, then you'll be able to review and use the NPS RADAR to help you make appropriate clinical decisions with regards to new medications when using the Prescription module within Genie.
Prescribing new medications
With this alert enabled, whenever prescribing a new medication that is listed within the NPS Radar documentation you'll receive the following alert:
If you want to see the full RADAR document for the relevant medication, click the button which will open the complete RADAR document.
This alert will appear on the first three occasions you prescribe this medication, after which you will not continue to receive the RADAR alert.
NPS RADAR review when prescribing
If you've prescribed a medication that has had a recent NPS RADAR Review, but you've prescribed this more than three times, you can open the medications review in one of two ways.
If you're in the process of prescribing the medication, after selecting the relevant drug within the new prescription window, the NPS RADAR button will become active at the bottom of this window. Simply select this option to open the NPS RADAR Review for this medication.
If you've already prescribed a medication, and you want to review the relevant NPS RADAR Review, you can do this by highlighting the medication in the list of your patient's current medications, then selecting the icon.
Genie will only show NPS RADAR Review for medications that have had a review within the past twelve months. If you're wanting to see a list of all current NPS RADAR documents, you can find this by navigating to Open > NPS RADAR Documents. You'll then be presented with a list of all current NPS RADAR Reviews.
For more information on this topic, refer to the NPS and Genie article.
If you regularly prescribe medications together, Genie has made this process streamlined and intuitive with our Medication Sets window. Medication sets work similarly to QuickScripts, but rather than only prescribing the one medication, you'll be able to add multiple medications to your patient at once.
Before creating your medication sets you'll need to ensure you've added the medications required for the set into your patient's list of current medications. Once you've done this, click the little icon next to QuickScripts, then select Edit Sets...
Within the Medication Sets window, click the icon to add a new set, and type the desired name for the set within the Request window.
Once you've created your new medication set, you can add the relevant medications to this by highlighting the set on the left, then adding the appropriate medication via the Add prescription to set... drop down list at the top of the window.
This list will only show medications listed in the patient's current medications. Once you've selected the relevant medications, these should be listed on the right-hand side under Prescriptions.
One you've created the medication set, you can then select this to prescribe in the prescriptions area of the clinical window by using the sets icon.
Genie allows you to quickly search the database for:
- All patients taking a particular drug.
- All patients on two or more particular drugs.
- All patients on more than any particular number of drugs i.e. Polypharmacy.
For example, to search for all patients taking an ACE-Inhibitor:
Open the Patients list by selecting Open > Patients.
Click on the Rx button Rx button in the patient list to open the following window.
This window allows you to search by Brand Name, Generic Name or Class. To search for ACE-Inhibitors, click on the Class radio button and enter the Brand Name of any ACE-Inhibitor and click OK.
This will enter the Class to search for in the previous window as shown below:
Click OK, and all patients on an ACE-Inhibitor will be displayed.
Note: To display all patients NOT on an ACE-Inhibitor, tick the Find Exceptions checkbox.
You may then want to find all patients who are on the ACE-Inhibitor and Warfarin. To do this, click on the Rx button again. This time, click on the Generic radio button and enter Warfarin in the search field.
Tick the Search Current Selection Only checkbox. This tells Genie to only search amongst the list of patients already displayed.
You can use this function in combination with other searches. For example you may want to find all diabetics who are NOT taking an ACE-Inhibitor. To do this you would first search for diabetics through Records > Search. Then do the ACE-Inhibitor search, ticking both the Search Current Selection Only and Find Exceptions checkbox.
You can also limit the search only to those prescriptions which have been printed on or after a particular date.
In this same window you can search for patients taking more than x number of prescriptions. To do this, click on the Polypharmacy tab and enter the number of prescriptions in the search field.
Note: You can also limit this search to just the current selection patients.
If you are running Genie v9.3.5 or above as a GP or Obs/Gynae/IVF Specialist, you can prescribe directly from a patient's Current Pregnancy record.
In the Current Pregnancy record, simply click the button at the bottom of the window to add a prescription. For more information, please see our Obstetrics History and Pending Births article.
You can find all previously printed prescriptions within the Script Archive of a patient's clinical file.
The Script Archive is accessible within the Checklist/Script Archive tab of the small clinical window, or the Other tab of the large clinical window.
The Info button will display all changes made to a selected medication. If the same prescription has been printed several times, it will appear several times in the archive. Prescriptions can be removed from this list by clicking the trash can icon , or by performing a Cull Script Archive. For more information, please see our Archiving and Culling article.