If you need to prescribe a medication, taper, or action for a patient that isn’t already configured as Quick Order, you can create a Custom Order for the patient.
Required Permissions
Doctors, Nurses, Super Admins, and Records Admins can create Custom Orders.
Note: If you are using Rcopia/DrFirst, you will only create custom orders for medications already located at your facility. If you need to create an order for a pharmacy, click here for instructions.
Medication Orders
Let's review how to create a custom medication order.
- From the Patients tab, click on the desired patient tile.
- You will be taken to the patient’s Information tab. Click on Doctor’s Orders.
- Important: The Doctor's Orders tab can be renamed based on your organization's preference, so your facility may call this tab something else.
- Important: The Doctor's Orders tab can be renamed based on your organization's preference, so your facility may call this tab something else.
- Click on the Custom Order button.
- On the Medication tab, fill out all required fields indicated by an asterisk (*) and any of the additional fields.
- Medication*: Begin typing in the name of the desired medication, and then select the correct option from the drop-down menu. This field will also include the dosage form. It is recommended (but not required) that you select the medication from the drop-down to ensure that allergy notifications, drug interaction warnings, and other such features can function correctly.
- Route*: Once the medication is entered, a drop-down will appear in the Rout field based on the medication chosen. It will default to match the dosage form but can be changed by using the drop-down. If you are using eRx, do not free-type options. If you do not see the desired option, choose Custom, and a broader list will appear.
- Dosage Form*: Once you have set both medication and rout, select an option from the Dosage Form drop-down. It will default to match the dosage form but can be changed as needed. Once again, if you do not see the option you want, select Custom from the drop-down and choose the alternate method.
- Start Date*: Set the desired start date.
- Justification*: Free type the reason for prescribing this medication.
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Frequency*: Click on the Frequency drop-down to choose how frequently the medication is administered. Once you select a frequency, three additional fields will appear.
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Strength*: Enter the strength of the medication by selecting it from the drop-down.
- Important
If you choose to use a custom strength in the Strength field, you will need to include both the number value and the unit of measure (e.g.,10 mg not simply 10) or you will encounter an error message and be unable to proceed.
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Units*: Enter units by selecting them from the drop-down.
- Important
If you are ordering an Insulin product, this field will default to units.
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Quantity*: Enter the desired quantity. If you need to indicate that the medication has a variable dose range, you can select the different quantity options. In the image below the patient could take one 200 mg tablet or two 200 mg tablets so both 1 and 2 are selected. You can also type in any quantity.
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Dispense Amount*: Once you have entered the frequency, strength, and quantity values, the dispense amount will automatically calculate based on your selections.
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Strength*: Enter the strength of the medication by selecting it from the drop-down.
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Add Max Daily Dose: You can set a max daily dose amount by clicking on the carrot, typing in the maximum quantity and selecting choosing the correct option from the drop-down. Once the selected maximum quantity is reached within a 24 hour period, further doses will not be available in the MAR.
- In addition to the required fields, you have the following options:
- If you have added a medication by accident, or if you need to delete the medication for other reasons, click on the Trash icon
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- PRN: Check off this box if the medication can be prescribed to a patient as needed.
- Continue on Discharge: Check off if you wish the client to continue taking the medication after discharge.
- Notes: Free type any desired notes in this field.
- No Substitution: Check this box to prevent the substitution of a similar medication.
- If you wish to add more medications to the order, click on the Add Medication + button.
- If you have added a medication by accident, or if you need to delete the medication for other reasons, click on the Trash icon
Taper/Titration Orders
The medication section of a taper is filled out in the same manner as the medications above.
- Click on the Taper or Titration tab.
- Fill in all the required fields indicated by asterisks (*) and add as many days as needed by clicking on the Add Day button.
- Once you add a frequency in the Day Frequency drop-down(s), fields will appear for the strength, units, quantity, and checkbox for PRN.
- Important
If you choose to use a custom strength in the Strength field, you will need to include both the number value and the unit of measure (e.g.,10 mg not simply 10) or you will encounter an error message and be unable to proceed.
- Important
- You can add multiple tapers or titrations to a single taper or titration order by clicking on the Add Taper or Add Titration button.
Action Orders
If you need to add actions, click on the Action tab. Once again, fill in the required fields indicated by asterisks (*), in this case, Action (free type) and Date.
- Action: Name the action order. This name should be something that clearly indicates the details of the order.
- Start Date: Set the desired start date.
- Show in Med Log: Choose whether or not the action order should appear in the med log.
- PRN: Check off this box if the medication can be prescribed to a patient as needed.
- Duration (# of days): The number of days the action order should persist.
- Justification: Free type the reason for prescribing this medication.
- Notes: Free type any desired notes in this field.
- Continue on Discharge: Check off if you wish the client to continue taking the medication after discharge.
- Frequency: Click on the Frequency drop-down to choose how frequently the medication is administered. Once you select a frequency, three additional fields will appear.
To add additional actions, click the Add Action + button.
Submitting the Order
Once you have completed the order, click the Submit button. If you are a doctor, you will be asked to enter your signature.
Otherwise, you must select the doctor who prescribed the medication and the method by which they communicated the order to you from the appropriate drop-downs before you submit.
Once the order is submitted, it will appear in the Doctor’s Orders and Med Log tabs.
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