Creating Prescriptions

This article covers how to use the Medication Prescriber screen in HealthTrack to write prescriptions, manage PBS and authority medications, use favourites, and record externally issued medications.

Opening the Medication Prescriber

There are two ways to open the Medication Prescriber from the patient's Clinical Summary tab:

• Click the New button above the Current Medications list, or
• Click the Prescription button on the right-hand side panel.

The Medication Prescriber screen displays the patient's name, date of birth, Medicare number, and DVA number at the top. The left panel is for searching medications, and the main area is for entering prescription details.

Writing a Prescription

1. Search for the medication using the Search tab on the left. You can search by drug name, generic name, or drug class.
2. Select the medication from the results. The available variations (form, strength, pack size) appear in the top table.
3. Select the appropriate variation. The details will populate the fields below.

4. Fill in the prescribing details: Dose, Frequency, Instructions, and any other required fields.
5. Click the Add button to add the medication to the New Prescription list.
6. Repeat steps 1-5 to add additional medications to the same script if needed.
7. When all medications have been added, click the Prescribe button to generate the prescription.

How medications are split across scripts

When you click Prescribe, HealthTrack automatically splits your medication list across the correct number of printed scripts, following Medicare and PBS rules. You do not need to work this out yourself. The rules are:

• Up to three medications print on a single script.
• Authority and Streamlined Authority medications always print on their own individual script. They are never grouped with other items.
• PBS or RPBS items and non-PBS items are never mixed on the same script form.
• Medications marked Brand Subst. Not Permitted are grouped separately from those that allow substitution.

Sites with the hospital prescription layout enabled can print up to ten medications per script and are prompted to choose the layout when prescribing.

Key Prescription Fields

PBS Status and Authority Medications

The PBS Status is set automatically based on MIMS data and the patient's Medicare or DVA details:

• If MIMS lists the medication as PBS and the patient has a valid Medicare number, PBS is selected.
• If the medication is listed as RPBS and the patient has a DVA number, RPBS is selected.
• If MIMS provides no status, or the patient has no valid Medicare/DVA details, it defaults to Non-PBS.

Streamlined Authority

Streamlined Authority medications do not require a phone call to Medicare or DVA, but you must enter an authority code. HealthTrack displays the required information in the Indications For panel.

1. Select the medication. The authority information and codes appear in the Indications For panel on the right.
2. Click the Request Approval button.
3. Enter the Authority Approval Code and click Save.
4. The medication can now be added to the prescription.

Authority Medication (Phone Approval)

For medications requiring full authority approval, you will need to call Medicare or DVA.

1. Select the medication and click the Request Approval button.
2. In the Authority Approval Details dialog, click Get Authority Prescription Number to retrieve the number Medicare/DVA will need.
3. Call Medicare (1800 888 333) or DVA (1800 552 580) and provide the prescription number.
4. Enter the authority approval code they provide and click Save.

Drug safety warnings (MIMS)

If your site has MIMS enabled, HealthTrack checks each medication as you prescribe and warns you about four types of safety issue:

• Drug interactions with the patient's other current medications.
• Duplicate therapy, where the patient is already on a medication from the same class.
• Drug-allergy conflicts with allergies recorded on the patient.
• Drug-disease contraindications against conditions recorded on the patient.

Warnings are ranked by severity, so the most serious issues stand out first.

Why a warning may not appear

If you expected a warning and none showed, check the following:

• MIMS is not enabled at your site. All four checks depend on a MIMS subscription. Contact HealthTrack support if you are unsure whether MIMS is active.
• The allergy is recorded as free text. Only allergies recorded against a coded allergen from the allergy list are checked against MIMS. Free-text allergy entries still display on the patient record, but they are not drug-checked. See How to Manage Patient Allergies for recording coded allergies.
• Drug-disease checking is a separate option that your site may not have switched on.
• Your user preferences hide lower severities. Go to User Preferences > Personal Details and Startup and check MIMS Drug-Drug Interactions Severity Filtering. If it is set to Only show Moderate and Severe drug interactions, milder interactions are not shown. Set it to Show all interactions however severe they may be (the default) to see every interaction.
• You are prescribing in HealthTrack Web. Drug safety checking runs in the desktop application only.

Prescribing Information and CMI

If your site has a MIMS subscription, you can view detailed prescribing information directly in the Medication Prescriber.

• Click the Prescribing Info tab (next to Medication Detail) to view abbreviated or full prescribing information from MIMS.

• Click the View CMI button on the Medication Detail tab to open the Consumer Medicine Information as a PDF, which can be printed for the patient.

Blank Scripts

• To prescribe a medication that is not in the MIMS database, click the Blank Script button. This unlocks the medication fields so you can enter the details manually.

Currently Prescribed Medications

• The bottom section of the Medication Detail tab shows all currently prescribed medications for the patient. Select Show Past Medications to include historical prescriptions.

Reprinting a prescription

To reprint a prescription, select the medication in the Currently Prescribed Medications list and click the Reprint button. The reprinted script is labelled REPRINT of Script No. followed by the original script number, so pharmacies can tell it apart from a new script.