Overview

This article describes basic medication prescribing functionality, including:

For transmitting prescriptions to the pharmacy, see Transmitting Prescriptions via eRx, or Printable/ Faxable/ Saveable Prescription Form.



Details

You can prescribe standard and compounded medications (including scheduled medications) in Cerbo. The EHR includes a comprehensive standard prescription medication database. And you can add compounded medications to your prescription medication list so that they are prescribable just like standard medications.


Add Prescription

Prescriptions are generally added for a patient in the Plan of an encounter note. But can also be added outside of an encounter note by clicking on the plus sign at the top right of the Medications block. 


In the medication search bar, start typing to search for the medication by name, generic ingredient(s) and/ or strength. The system will preferentially return search results from your preferred shortlist. Inventory rxs will show at the top. 


To expand your search to the full drug database, add search term(s) or add a + to your search.


The Rx dosing window has three parts - (1) the Patient Sig, (2) Instructions for the pharmacy, and (3) Provider notes.


For any medication, you can fill out dosing information as you want, and then use the "Use Profile" drop down menu to save that as a default or secondary dosing profile. 


Patient Sig

Note that clinics who had saved dosing profiles prior to a January 2022 software upgrade will see that their saved dosing profiles all have "Freetext only"/ unstructured patient sig. This is because the structured options were not available prior to that upgrade, so all prescriptions (and saved dosing profiles) were "unstructured". To switch those as you're writing new prescriptions, select Structured sig and save over your default dosing profile for that medication.


Instructions for the Pharmacy

You can specify which pharmacy the prescription is for, if desired, by clicking on "Pt's Preferred Pharmacy". However, you would generally just select the pharmacy at the routing step - there is no need to also select it specifically in the dosing window. 


Click the Calculator icon to automatically calculate/ enter the Days' Supply based on the Frequency, Dispense amount, and Refills, or manually enter the expected Days' Supply as appropriate. This should be the expected number of days until the patient would be out of this medication/ may need a new prescription.

Provider Notes

These are internal notes that are not transmitted to the pharmacy or shared with the patient on the portal.


Checking "This is a chronic medication" will make it so that the prescription will remain on the patient's Medications mini block in their chart after expiration (even if Expired prescriptions are otherwise set to drop off the mini block and appear only in the expanded medication history).


Checking "Warn me when this dosing expires" will create an internal follow up task, either for the specific person who wrote the prescription or for all users in the clinic (depending on the clinic's settings).


Weight and Height on Pediatric Prescriptions

The eRx network requires, as of the January 2022 upgrade, for height and weight readings to be included with pediatric prescriptions (under 18 years old). A pediatric patient's most recent weight and height readings will populate automatically from their Vitals block for this purpose.


Editing or Deleting a Prescription

By default, prescriptions that are inside a signed encounter note cannot be edited or deleted without first unsigning the note. That is because the signed note forms part of a legal record, which should be a static. However, there is a setting that can be changed to allow editing a prescription that is inside a signed encounter note. Contact support to change this setting.


In general, a prescription should only be edited or deleted to correct a mistake (which is caught reasonably promptly). Otherwise, the prescription would be renewed, replaced, or discontinued, as appropriate, all of which preserve the record of the prior prescription and the adjustment.


Renewing a Prescription

To renew a prescription, right click on it and select Renew. This creates a new prescription, pre-populated with the previous prescription details, but with a new start date. 


You may renew multiple prescriptions at once by checking the boxes to their left in the Medications block, and selecting "Renew Checked Rxs" from the Manage Checked drop down menu.


Discontinuing or Replacing a Prescription

To discontinue a prescription, right click on it and select Discontinue. You will have the option to mark that as due to an Adverse Reaction, which would add that medication to the patient's Allergies, Intolerances, Discontinued Medications block. Or due to Other Reason. Discontinuing the medication strikes it through in their medication list. By default, discontinued medications will disappear from the mini Medications block, and be viewable only within the expanded Medication history.


If you are discontinuing a medication to replace it with another medication, you can instead Replace the medication. That marks the medication as discontinued and gives a shortcut to adding a different medication.


You can use Replace to adjust the dosage on a standard medication, as the dose strength is a core part of standard medication definitions. So you could replace a 10mg strength with the 20mg strength of the same medication, for example.




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