Exception Orders

Once a MAT Order has been entered, Exception Orders can be created to dispense additional doses to the patient, as needed. This allows you to dispense additional doses for patients who won't be on-site for a pre-approved reason, if the patient vomited their dose, if the order changed and the patient has already been given takeouts at a lower dose than ordered, or when the facility deliver doses to patients who are incarcerated or hospitalized.

There are a few things to note about Exception orders:

• Exception Orders can only be placed on a valid MAT Order for current or future dates.
• Exception Orders only support Standard (Daily) dosing type orders at this time.

Creating an Exception Order

From a patient chart, click on the MAT Order tab.

Special Takeout Orders

1. Click on the Special Takeout Order button. These orders are doses that the patient is scheduled to receive, and which they need to pick up in advance because they cannot come into the facility on the scheduled date(s) or when the facility deliver doses to patients who are incarcerated or hospitalized.
2. If the window dose(s) should be dispensed as take out doses, select the Dispense Window Dose as Take Out box.
3. Choose the reason for the special takeout from the Reason drop-down.  
• Vacation
• Family Emergency
• Travel for Work
• Facility Closed: This is used for unexpected closures. Holidays can be configured in the MAT settings, so there should be no need to create exception orders for holidays.
• Hospitalized
• Incarcerated
• Confined to Home
• Other: Provides an open text field for situations that don't fall within the default selections.

Add Doses 

1. Click on Add Doses. Doing so will create additional doses for the specified dates (in addition to doses already generated by the MAT Order). Use with caution. This is primarily used when a patient needs more medication, in addition to an already dispensed dose, for example after a dose is vomited or during a stabilization protocol.

1. Next, select the appropriate option from the Reason drop-down. These reasons vary based on the Exception Type selected.
• Vomit
• Add to Existing T/O: If the patient's order was increased after the Takeouts were already filled, this allows you to increase the T/Os.
• Replacement: Replace medication that was lost, stolen, spilled, or abused.
• Stabilization: Give additional medication to the patient to stabilize in their dose.
• Other: Provides an open text field for situations that don't fall within the default selections.

Both Order Types

Once you have chosen Add Doses or Special Takeout Orders and the reason, both processes are the same. 

1. Select the Start and End Date of the order. Both dates must fall within the active date range of the patient's current/active MAT Order.
2. The Dose field defaults to the current order's dose amount, but the number can be changed as required.
3. Type any additional documentation in the Notes section. There is no character limit for this field.
4. Doctor users can click Submit to sign and create the order. Other users will need to select the Ordering Physician from the Ordered By drop-down and the ordering method from the Ordered Via drop-down.
5. Under the Doses to Dispense section, the new Orders will appear and can be dispensed if the date today's date falls within the Exception order's date range.
   
6. The Exception Order appears in the Order History section with the Exception Type listed as the Order Type.