This feature will require the Swedish e-prescription feature activated as well as set up. Please see the setup article to see how this can be done.
E-prescriptions can be done from either the consultation or from the patient page directly, depending on the settings. This guide will cover both of these cases. There are two different workflows for adding an e-prescription, this guide will show the simplified workflow. E-prescriptions done using the default workflow can be done in the same manner, but the creation dialogue is slightly different. Differences can be seen from the Swedish e-prescription setup article.
Creating an e-prescription from a consultation
You can create e-prescriptions from the treatment items' section on the consultation page. Click on the blue plus button to bring up the creation dialogue.
The E-prescription dialogue is split into three parts: the base information, adding an item and the list of already added items.
The base information includes the prescriber, the pharmacy and client information.
The prescriber is automatically selected to be the active user, and that cannot be changed. Also, the person sending the e-prescription has to be the same person as the one creating it.
The e-prescription can be targeted to a specific pharmacy, or it can be sent as an open e-prescription to an inbox where most pharmacies have access, and the client can pick up the medicine from any pharmacy.
For client details, most fields are automatically filled from the client record. All mandatory fields are highlighted in yellow. For client ID, there are options to either use the client’s ID, date of birth or organization number for companies.
NOTE: If no pharmacy is selected, the client’s ID number is a piece of mandatory information to be added, no other identification method is allowed.
- The prescriber needs to be correct, and the sender needs to be the same as the prescriber.
- The pharmacy should be selected.
- Client ID needs to be input.
The second part is adding items to the e-prescription. It is possible to add medicines or supplies. The search utilizes a ready-made list of most medicines and supplies available on the Swedish market. The search can be filtered to only include registered items, approved or non-approved and only veterinary or also human medicines. It is also possible to use previously created prescriptions as a base for a new one.
The search is started by typing in the search word, and it’s done automatically. The search results show the name, preparation and strength, as well as is it approved for use and is it a veterinary medicine. Also, by clicking the medicine name, it is possible to see full FASS information of the medicine in a new window. The medicine can be inserted into the e-prescription by clicking the green checkbox at the right edge.
Once a medicine is selected, the search closes, and now the details of the e-prescription for that particular medicine can be added. First off, the name of the medicine can be seen. After that, the dosage instructions can be added. The blue FASS button will open an excerpt from FASS regarding the dosage instruction where the relevant portion can be manually copied. It is also possible to use the clinic's own text templates. Finally, the language of the e-prescription itself can be selected. If no language is selected, it will default to using the currently active language.
Next is the main information of the e-prescription.
Package size: Package size of the selected medicine.
Number of packages: How many packages will be available in the prescription.
Amount of dispenses: How many packages are allowed to be dispensed from the pharmacy at once.
Interval time value: Interval of dispenses as a number.
Interval time unit: Definition of what the previous number represents: days, weeks, or months.
Latest dispensing: When was the medicine last dispensed.
Valid until: How long the prescription is valid.
Patient identity type: Individuals (specifically selected patients), group, herd.
Lastly, it is possible to define the withdrawal periods of the medicine. A new one can be added by pressing the highlighted button. It adds a new field where the type and duration of the withdrawal period can be defined. If the withdrawal is until further notice, the duration can be left as zero (0). Once done, the green checkmark at the bottom will save the input information and close the dialogue.
The prescribed items list the items already added to the e-prescription. The items can be edited if needed or deleted. There has to be at least one item in the e-prescription so the last item cannot be deleted. Add a new item first, and then delete the old item if a wrong item was added by mistake the first time.
Finally, the e-prescription can be either saved as a draft from the 'Save' button or saved and sent for approval from the 'Save and send' button. Drafts can be still edited. Once the e-prescription is sent, it cannot be edited anymore.
After sending the e-prescription, the authentication of the prescriber is needed. There are three options: SMS, email or password authentication. SMS and email mean that the password is sent to the user’s phone or email. Password authentication means that the user has to have a predetermined password for the authentication. Select the authentication method and press 'Select'.
Input the received authentication code, which is a 6-digit code and press 'Authenticate'. The window will inform you to which email or phone number the authentication was sent.
Next, the system begins sending the e-prescription. This usually takes just a few seconds.
If the e-prescription was approved, the system will give a notification.
The e-prescription is now available for the client to use. You can also see the status of the e-prescription in the table. The details of the e-prescription can be viewed from the eye button, but the e-prescription is no longer editable.
If the settings for a notification SMS message are enabled, the client will receive a notification message to their phone or email if no phone number is provided, informing that the e-prescription is ready to be used at the pharmacy. Contents of the message can be defined in the settings.
If the settings for adding default items into an e-prescription are enabled, the items are added automatically to the consultation. This is most commonly used to cover prescription fees for creating the prescription.
E-prescription outside of consultation
It is also possible to add a prescription without a consultation. This needs to be enabled from the settings with the setting 'Allow creating E-prescriptions as counter sales without consultation'. Once that is enabled, it is possible to create e-prescriptions from both the client page as well as the patient page. Both of those have similar sections about previous e-prescriptions as well as adding a new one. The patient page lists the patient's previous e-prescriptions as well as the possibility to add a new one. The client page lists all of the client’s different animals’ e-prescriptions.
The creation process is the same as in a consultation, except for one new field in the dialogue above the save buttons. By checking this box, when sending the e-prescription, the system will create a new counter sale invoice for the client and add the default items specified in the settings. This invoice can then be billed from the customer, usually covering the prescription fees.
It is possible to see all e-prescriptions done in the system from the 'E-prescriptions' tab from the 'Clients & Patients' area. From this function, you can search for any created e-prescriptions and use the various filters to find specific e-prescriptions.
E-prescription of licensed pharmaceutical preparations
To prescribe an unregistered product for which there is a valid license, select the article Licensläkemedel e-förskrivning. Ensure that the filter is set to Non-approved.
Next, fill out the required fields as specified below. The name of the product is typed in the box named Supplimentary information. The license motivation should be done via KLAS, the E-health agency's web tool, beforehand. The license number of the approved license is inserted in the field License ID.
Continue by saving the item by pressing the green checkmark. The e-prescription can now be sent and authenticated as described in previous sections.
E-prescription of extempore preparations
Many extempore preparations can be found as APL articles. To find these, write the name of the substance in the Add medicine-field, or write APL and scroll through. NB that filters have to be set on Non-approved and Human and veterinary medicines.
If the proper substance or preparation is missing you can create your own by writing extempore or the appropiate ATC-code in the Add medicine-field. Select the article and write the complete recipe for the preparation in the Instructions-field. The prescription is then saved and sent as described in previous paragraphs.