Prescribing

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. 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 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.

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.

Medisecure

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.

eRx

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.

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.