The Rx Ability is used to create, manage, print, and refill prescriptions, and to enter current medications for patients.
While ePrescribe is accessed from the Rx Ability, utilizing ePrescribe is a distinctly different process. If you are seeking more information on how to use ePrescribe, we encourage you to refer to the ePrescribe article as this article will be focused exclusively on using the Rx Ability to create and print paper prescriptions.
The Rx Guide contains the following topics:
- Setting Up Rx
- Using Rx
Setting up Rx
There are a few steps you will need to take before using Rx.
Selecting a Medications Coding Database
First, you'll need to determine what Medications Coding System you'll want to set. This determines what list of medications will be accessible when you are in the Rx Ability. This option can be found in the MacPractice Menu > Preferences > Coding. You can select from FDB, RxNorm, and Custom.
FDB: Stands for First Data Bank. If your office has purchased ePrescribe, you will have this option available and will need to set this, as our ePrescribe system is designed to work with the FDB list.
RxNorm: RxNorm Codes are a common standard identifier for prescriptions. If you do not have ePrescribe, this is a solid option that contains most common medications.
Custom: If you have a need to add custom medications, this option will pull the Medications added in References > Medications (Custom).
You can read more about these Medication References here.
In short, if you have ePrescribe, select FDB. If not, select RxNorm. And if you need to use Custom Medications, you can select Custom.
Setting a Default Rx Form
Next, you'll need to select a default Rx Form that will be pre-set when you create a new Prescription for a Patient. This will eliminate the need to select the desired form every time you prescribe a medication.
The drop down in Preferences > Forms for RX Form will display all "Active" Prescription Forms in References > Forms. If you don't see a form that you are looking for, you may need to activate it.
To activate a Form, simply navigate to References > Forms and select the form you wish to activate. The "Form Active" checkbox is to the right of the Form Version field, visible in the screenshot below.
You can also preview the layout of the form by clicking on the "View" button.
The standard forms for Prescriptions are:
- Prescription [4 per sheet]
- Prescription [Half Page]
- Prescription [Narcotic]
Each of these forms are essentially the same, just formatted differently. It is important to note that the 4 per sheet and Half Page can print multiple prescriptions for one patient, but not for multiple patients. We'll address this later in the Create a Prescription section.
Adding Medications via Medications Manager (4.4 and earlier)
Prior to build 6.1 of MacPractice, the software did not contain a database of Medications in the same way. References contained the FDB database for ePrescribe, and also contained a Medications (NDC) folder that was used for offices without ePrescribe.
In order to populate the NDC Medication Reference folder, offices running 4.4 and earlier can use the Medications Manager, accessible from the Managers ability.
This section will break down the elements of the Rx Ability and guide you through the workflow.
The Rx Sidebar contains three folders for all of your patient prescriptions, separated into status categories. A fourth folder provides access to the ePrescribe module, which is addressed in the ePrescribe article.
If no patient is selected, each of these categories will display all medications that belong in that category for all patients in the database.
If a patient is selected, only that patient's medications will be displayed in each category.
You can also move medications from category to category by dragging and dropping them into the desired category.
- Pending Meds: You will only see this category if you have ePrescribe. This category contains medications that have been ordered in ePrescribe but haven't yet been transmitted, printed, or cleared out.
- Active Med List: This category contains all medications that the patient is currently taking. It will include all meds that were created in MacPractice and all meds created in the ePrescribe node.
- Inactive Meds: This category contains any medications that the patient used to take but is not currently taking right now. A prescription can be moved from Active to Inactive by simply dragging and dropping the record in the sidebar into the Inactive Meds folder.
- ePrescribe: This node will access the ePrescribe ability.
- Prescription Discount Card: This node provides a link to a printable card provided by Rx for Miracles for prescription discounts.
Creating a Prescription
To create a Prescription, you will first select the Patient you wish to prescribe a medication for, then click the Green Plus in the sidebar with the appropriate node selected for what kind of medication record you'd like to create.
- If this is a prescription you are writing for the patient right now, you'll choose Active Meds.
- If you're simply adding history for the patient, you can add this under Inactive Meds. You can use the Non-Printed Notes field to indicate who wrote the initial prescription. This is best done when creating a record of a prescription created by another provider.
You'll then fill out the required fields and any other fields you deem necessary. Prescription Fields are described in the following section.
Once you have filled out the required fields and any other fields, you can save the record by pressing Command-S. Once saved, the patient's name will show in the sidebar under the Prescriptions node. A Created label will appear at the bottom to indicate which MacPractice user created this prescription.
You can also print off the Prescription by clicking the "Print Rx" button in the lower right. Please note that once a prescription is printed, most fields will lock and prevent editing.
If you have several prescriptions you need to write and want to print them all in one batch, you can use the "Add to Queue" and "Print Queue[x]" buttons. The Print Queue button will indicate how many items are in the queue by the value in the [ ]'s. We'll explain the Print Queue later in this article.
If you are using the "Half Page" or "4 per page" Prescription forms, it is important to note that these forms will only print multiple prescriptions on the same page if the patient is the same.
Not all fields in Rx for a prescription are required. Required fields are marked in Red.
- Medication: This is a field that, when clicked, will allow you to search all medications from the database indicated by your Coding Database in Preferences > Coding.
- Route: This field allows you to select the method of taking the medication by a drop down menu. This field should automatically update based on the selected medication, but should be checked to confirm regardless.
Following that, we strongly recommend you select entries for the following fields:
- Incident: All prescriptions fall under a particular Incident in the patient's Clinical Summary. This selection defaults to the most recently used Incident.
- Provider: This field indicates the Provider that prescribed the medication. By default, this should automatically populate from the Provider set in the Patients Ability > Patient Tab for the currently selected patient.
- Office: This field indicates the Office where the prescription was written. This should automatically populate based on the Office set in the Patients Ability > Patient Tab for the currently selected patient.
- Form: This field allows you to select the prescription form that will be used. This is automatically set to the Default Rx Form that you have set in Form Preferences.
The remaining fields can be filled out at your discretion. Please note that some fields are solely used internally in MacPractice and do not have an impact on how the prescription is printed or recorded.
- PRN Checkbox: Latin for "pro re nata"; indicates a medication should be taken as needed or as necessary.
- May Substitute Checkbox: Indicates a pharmacist may substitute a generic medication for a brand name one.
- Take: The amount of medication per dose.
- Drug Form: The form of the medication, such as tablet, pill, capsule, etc.
- Frequency: How often the medication is taken.
- Duration: How long the medication should be taken.
- Dispense: Total amount of the medication to be prescribed.
- Refills: Number of refills the pharmacist should allow.
- Additional Sig: Special instructions for the patient or additional information regarding the prescription; will appear on the prescription label.
- Special Instructions/Note to Pharmacist: Further information for the pharmacist regarding the prescription or patient; will not appear on the prescription label, but will appear on the printed prescription.
- Non-Printed Notes: Notes associated with the prescription that are internal to MacPractice only.
- National Drug Code: Used to search and tie the NDC number to the current medication.
- Prescription Order Number: Used to notate the order number; internal to MacPractice.
- First Record of Order: Used to indicate this is the first record of this prescription being written for the patient- that it was written within MacPractice and did not exist on paper or elsewhere first.
- Administered During Visit: Used to indicate that the medication was given to the patient at the visit; restricts the prescription from being printed.
- Package Description: Indicates the package, bottle, or container based on the NDC code; internal to MacPractice.
- Dose Calc: Indicates the method of dose calculation; internal to MacPractice.
- Unit Qualifier: Indicates the units for the overall prescription; internal to MacPractice.
- Ordered Date: Date that the prescription was originally requested.
- Prescribed Date: Date that the prescription was created for the patient.
- Dispensed Date: The date that the pharmacy dispensed the medication to the patient.
- Started Date: Date that the patient should start taking the medication.
Printing, Reprinting, and Managing the Print Queue
The Print Queue allows the user to queue prescriptions, refills, and reprints to print in one batch.
To add a prescription to the Print Queue, click the Add Queue button in the lower left of a prescription record. If this is a new prescription, it should automatically add to the queue. If this is an existing prescription, you'll be prompted whether to Renew or to Reprint the prescription.
- Reprinting a Prescription will print a duplicate of the selected prescription. This will not add a new line to the patient's clinical record.
- Renewing a Prescription will duplicate the information of the selected prescription and it will create a new prescription in the sidebar. It will also add a new line in the patient's clinical record.
If successful, you'll see the number in the brackets of the Print Queue [ ] increase, like so:
This number indicates how many items are to be printed. When clicked, a list will appear indicating all the prescriptions to be printed. Clicking OK will bring up your print interface where you can print all checked prescriptions to the desired printer.
If all prescriptions in the queue are using the same form, such as the Prescription [4 per sheet] form, multiple prescriptions can be printed to the same page, as long as they are for the same patient.
Multiple patients will be split to their own prescription pages regardless of the form set.
Note: The Prescription [Half-page] form does not pull two prescriptions onto the form. It will only print a single prescription.
If you navigate away from the Active Med List with items left in the Print Queue, you'll bel prompted whether you'd like to clear the queue or continue to a different view. Typically we recommend that you print off your queue prior to leaving the Rx Ability just to make sure you don't forget to resolve your prescriptions. You can also choose to Cancel and remain in the Active Meds node.
Tracking a Prescription
Once prescriptions have been added to a patient's record, you will be able to track them using a variety of tools.
- First, all prescriptions for a patient will appear in the Patient's Clinical Ledger, accessible from the patient's ledger in the Ledger Tab of the Patients Ability. You can use the View Options menu to display Rx records.
- Prescriptions are also viewable for a patient in the Clinical Summary in the Clinical Ability (Or the Clinical Tab of the Patients Ability in Builds older than 11 of MacPractice). These will be located in the Medications widget (or sub-tab in older builds)
There are also two reports that can track prescriptions.
- The Patients by Medication report, found in the Reports Ability under the Clinical category, will list all patients with medications. You can filter by specific medications, and this report can be organized either by Medication or by Patient.
- Prescriptions will also be listed in the Patient Clinical report, also under the Clinical category of the Reports Ability.