Writing Prescriptions: Quick Guide

This article explains how to write prescriptions in MediRecords, covering standard scripts, drug recipes, and more complex workflows such as authority items and Schedule 8 medicines. It covers creating a new prescription, adding instructions, drafting, electronic prescriptions, private prescriptions, and PBS/RPBS and Closing the Gap (CTG) co-payments. This applies to Providers and Clinicians prescribing within MediRecords. 

Contents:

1. Creating a Prescription - General
2. Adding Instructions
3. Prescribing a Drug Recipe
4. Creating a Draft Prescription
5. Electronic Prescriptions
6. Private Prescriptions
7. Troubleshooting
8. Further Reading

Creating a Prescription - General

1. To prescribe a new medication, open the patient's record, go to the Clinical tab, click Medications, select Current Rx, then click New Rx to open the new script screen.
   
    

2. From the New Script screen, you can see a patient's demographic summary and allergies at a glance, and their medication history by clicking over the Rx History button.
    

3. Click the Search box and enter the first few letters of a medication name to bring up a list of prescribable medication and select the medication from the list.
   Note: If you only want to view PBS/RPBS drugs, tick the PBS/RPBS Listed tickbox to filter your list. 
    

4. Click the Tick-Box next to the medication you wish to prescribe, which will bring up the medication information in the field below. Any noteworthy interactions are visible from the top right under Interactions. 
    

5. To view the Product Information (PI) or Consumer Medicines Information (CMI), click on CMI or PI, which will open in a popup window. 
   You will need to have popups enabled in your browser for MediRecords to access this feature. 
   
   NOTE: PI and CMI is provided courtesy of the medication supplier. If the PI or CMI information is not available, please reach out to the MediRecords Support team. For more information on PI & CMI documents, please see Consumer Medicine Information (CMI) & Product Information (PI) Documents.
    

6. Click Next to proceed.
    

7. Enter in the Dose, Frequency, Food and Instruction, which will update the Medication Summary below the Patient Name. 
   
    
8. If you are unable to find a suitable Instruction in the preset list, you can create your own by clicking on New, inputting the instruction you would like, and clicking Save. This new Complex Instruction will be saved for your own future use. Simply click into the Complex tab of the Instructions field to load it again in future.
    
9. Fill in the remaining details required and click Next.
10. If required for the prescription, you can enter information about the patient's Condition using the fields provided. Add any further details about the Condition treated, including if you'd like the condition added to the patient's Past Medical History (Add to PMH) or to make it Confidential.
     
11. Click Prescribe to create a script and exit or click Save and New to add a new medication to the script in progress.
12. The medication will be selected and visible from the Current Rx screen.

Adding Instructions

Once the Product or Recipe has been selected from the prescribing screen and Next is selected, you are now presented with the screen to enter the required directions, here you can either make a selection or use free text to prescribe your dose and instructions. To create a new instruction:

1. Select New

2. Enter your directions in the instruction box provided for e.g., 1 tab daily for 3 days and cease.

3. Underneath is a small text box for you to name your instructions and Save. For e.g., PRED:
   
   
    

4. When you want to use the new instruction on a new script, you will be able to select it from the Complex tab within the Instruction pane.

Prescribing a Drug Recipe

The steps to prescribe a Drug Recipe are very similar to those mentioned above, with one key difference. On the first page of the prescribing window, change the drop-down menu to Recipes to view all Recipes shared with your user:

The rest of the prescribing workflow remains the same as if you were prescribing from the list provided by MediRecords, however some additional information is sent to eRx about the prescription.

The Annotations field will be prefilled with the names of the ingredients added to the prescription. You may still add extra text around this, but we would not recommend removing the information as the pharmacy relies on this for dispensing. 

Creating a Draft Prescription

If you do not have all of the information needed to create a prescription but have started the process, you can save the prescription as a Draft which will allow you to save and return later to finalise it.

1. Create the prescription using the steps in Creating a Prescription - General but stop after completing step 13.

2. Click the Prescribe menu and select the relevant option:
   
   Save Draft (Paper) will save a Manual copy of the Draft which can later be printed when finalised, and given to the patient.
   
   Save Draft (eRx) will save a Paperless copy of the Draft which can later be printed when finalised, and the token will be sent once you confirm the recipient (see below).
   
   
   Notes: 

   • If you are unable to see the eRx related options, then the patient may not have an IHI Number entered that is in Active and Verified Status. See this article for more information: Electronic Prescribing FAQs

   • Once a draft has been created, it cannot be converted to another prescription type. For example, a Manual Draft cannot be turned into an electronic prescription. Be careful when selecting which type of Draft prescription you would like to create.
      

3. When you have the final information needed for the prescription, select it within the patient's Current RX grid, and click Edit.

4. Make the necessary changes as required.

5. On the last page, click Prescribe and then Save.

6. You will be returned to the patient's Current RX grid.

7. Select the prescription in the list, and click the Printer icon. This will finalise the prescription, and move it into Printed Status.

8. If the prescription is a Draft (eRx), a Confirm Recipient window will appear before the token is sent. It is pre-filled with the patient's default contact details, and lets you confirm or change the recipient for this prescription only, choosing between Patient, Carer, Partner, or Pharmacy. Changing the recipient here does not update the patient's saved contact details. Confirm the details and click Send to finalise the prescription and send the token.

Creating Electronic Prescriptions

To create an electronic prescription for a patient, they must have an IHI Number entered in their Patient Settings, and it must be in a Verified Status, and ePrescribing must be enabled for the patient and the practice.

You can quickly view a patient's IHI Status from within the prescribing window, in the preview section:

If you need to communicate a message with the pharmacy without alerting the patient, you can use the Annotations field within the prescribing window for this purpose. The message will be sent to the pharmacy but will not be available on the token or printed prescription details for the patient to view.

When finalising the prescription, be sure to select one of the ePrescribe options from the Prescribe menu to generate a token, and confirm you have the correct patient contact details in the token window provided:

The patient will be emailed or will receive an SMS with their electronic prescription token, and the script information will be sent through the eRx Script Exchange. 

A summary of electronic prescription will pop up - there is no requirement to print this as it is not a manual prescription, however, it can be printed and given to the patient if requested.

You can simply close this window if the patient does not request it to be printed.

You will know the token has been successfully sent if the status of the prescription = Printed.

The patient will receive their electronic prescription via email or SMS, sent by eRx:

If an electronic prescription cannot be generated, MediRecords will attempt to create a paper script (creating a paper prescription with the eRx barcode), and if an eRx prescription cannot be generated, MediRecords will create a Manual script. 

There are 3 prescription types relevant to electronic prescribing which are visible on the Medications grid:

1. Paperless = Electronic script sent to the patient via a token (email and SMS)

2. Paper script = Paper script that is printed with an eRx barcode

3. Manual = Traditional paper script with no eRx barcode 

Note: If a prescription has been created as a Manual Draft, it cannot later be converted to an electronic prescription. 

Private Prescriptions

When creating a Private Prescription, the patient will not receive the PBS subsidised cost for their prescription, and the prescriber may increase the default Repeats or Quantity value for the prescription without triggering an Authority workflow.

Troubleshooting

eRx Options Not Visible When Creating a Draft Prescription

Cause: The patient does not have an IHI Number entered in Active and Verified status, or ePrescribing has not been enabled for the patient or the practice.

Resolution: Confirm the patient's IHI Number is entered and shows an Active and Verified status in Patient Settings, and check that ePrescribing is enabled for both the patient and the practice. See Electronic Prescribing FAQs for more detail.

Escalate when: The IHI Number is confirmed Active and Verified, ePrescribing is enabled for the patient and the practice, and the eRx options still do not appear.

Medication Cannot Be Found in the Search List

Cause: The medication name may be entered with unusual spelling or an abbreviation the search does not recognise, or the PBS/RPBS Listed tickbox filter is limiting the list to PBS/RPBS items only.

Resolution: Check the spelling of the medication name entered in the Search box, and untick PBS/RPBS Listed if you are prescribing a private-only item.

Escalate when: The medication still cannot be found after checking the spelling and the PBS/RPBS Listed filter.

Patient Has Not Received Their Electronic Prescription Token

Cause: The contact details confirmed in the token window may be incorrect, or the electronic prescription may not have generated successfully.

Resolution: Check the prescription's status on the Medications grid. If it shows Printed, the token was sent successfully; ask the patient to check their email junk folder, or confirm their mobile number is correct. If the status does not show Printed, reopen the prescription and confirm the contact details in the token window before resending.

Escalate when: The status shows Printed, the contact details are correct, and the patient still has not received the token.

Further Reading

Medications is a very big space, with lots of different workflows & conformance requirements. To assist with this, we have documented several pieces of information that intersect with creating a prescription in separate articles. You may wish to review the following topics after learning how to create a prescription:

Medispan Clinical Decision Support & Interactions Service
MediRecords uses the MediSpan Clinical Decision Support and Interactions Service for generating alerts and warnings during prescribing, based on a number of different demographic and pharmacological factors. 
Medications: MediSpan Clinical Decision Support & Interactions Service

Real-Time Prescription Monitoring

Real time prescription monitoring in MediRecords helps prescribers check for risk signals before issuing monitored medicines. When you write or edit a script for S8 or other high risk items, MediRecords pings the relevant state portal based on your practice location and shows a clear status notification.
Real-Time Prescription Monitoring (RTPM): Configuration & Quick Guide.

Re-Prescribing a Medication

Quick methods for duplicating a current prescription for prescribing again.
Re-Prescribing a Medication

PBS/RPBS Medications & Prescribing

If the patient has a Medicare card and/or DVA card entered, and the provider has selected a PBS/RPBS drug from the list, then the patient will receive a subsidised cost on their prescription at the pharmacy. 
For more information on prescribing PBS/RPBS medications, please see PBS/RPBS Prescriptions.

Prescribing Authority Medications

For information on creating an authority prescription, please see Authority Prescriptions & State-Based Authorised Reference Numbers
 

Prescribing Schedule 8 Medications

Schedule 8 Prescriptions Due to legislative requirements, the Schedule 8 workflow requires some additional information to be entered during the prescription workflow. You can read more about this in Prescribing Schedule 8 (S8) Monitored Medications.

Closing the Gap Co-Payments (CTG)

The CTG PBS Co-payment program was established on July 2010 to improve access to affordable PBS medicines for Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease, and who in their Provider’s opinion would experience setbacks in the prevention or ongoing management of chronic disease if they did not take the prescribed medicine and would be unlikely to adhere to their medicines regimen without assistance through the program.

To enable CTG for your patient record, please follow the steps in Prescribing & Closing the Gap Co-Payments (CTG).