MAT Overview

  • Updated

The MAT section of the knowledge base covers how to set up and use MAT-specific functionality within your Kipu EMR Instance. MAT articles have been broken out into the following sections based on MAT workflows.

MAT Pump Workflow

The MAT Pump workflow is designed to make it easy to manage the daily pump processes, change medication, and maintain optimal pump performance.  

  • Start of Day: Prior to dispensing, each user must prepare the pump by emptying the cleaning solution, opening the medication, and priming the medication.
  • Calibration: This optional process allows you to verify that the proper amount of medication is being dispensed. 
  • Change Bottle: Simultaneously close and open MAT medications when the quantity remaining is low. This feature can also be used to transfer the remaining medication to a different bottle.  
  • Transfer In: Transfer liquid methadone from one bottle to another.
  • End of Day: At the end of the treatment day, empty the medication and clean the pump.  
  • Setup Tab and Troubleshooting: Troubleshoot pump connection issues, missing pump tabs, and update pump mode.

MAT Order and Dispensing Workflow

The MAT Order tab on the patient chart allows providers to create MAT Orders, which are essentially prescriptions for MAT medications. There are four different types of MAT orders that can be created, each with its own set of dosing requirements. You can also dispense MAT medication from the Orders tab, deny a dose, or re-dose a patient, as needed. 

MAT Order Types

Providers can create the following MAT Order types for the patient based on their treatment needs. 

  • Standard MAT Order: Standard Orders provide a consistent dose per day. 
  • MAT Titration Order: Titration Orders allow you to create a MAT Order with an increasing dose. 
  • MAT Taper Order: Taper Orders allow you to create a MAT Order with a decreasing dose.
  • MAT Interval Order: Interval dosing allows a medication to be dispensed at a specific interval. This is commonly used for medication like Vivitrol, where the injection only occurs every 28 days.
  • Signing MAT Orders: If an order is created in the EMR by a user who isn't a provider, the order will require a signature. These orders can be reviewed and signed from the Physician Dashboard.

Dispensing Workflow

  • Dispense the Ordered Doses: A current and active MAT Order is required to dispense doses. The available doses appear in the Doses toDispensesection of the patient's MAT Order.
  • Deny a Dose: You can deny administering a dose as needed. Common scenarios include if the patient has an abnormal lab result or patient comes into the facility visibly intoxicated. 
  • Re-Dispense Doses: If there was a problem with dispensing, a spill, or another type of issue, doses recorded as dispensed can be re-dispensed until midnight on the day of dispensing.
  • MAT Flags: Flags applied to the patient chart can prevent the medication from being dispensed until the flag has been resolved or indicate the patient is due for a drug screen. 

Manage MAT Orders

  • Navigating MAT Orders: Learn how to navigate the MAT Order tab on the patient chart and review key order details. 
  • Exception Orders: Once a MAT Order has been entered, Exception Orders can be created to dispense additional doses to the patient, as needed.
  • Change a MAT Order: Create a Change Order to update the patient's current MAT Order.
  • Discontinue a MAT Order: Discontinuing a MAT Order essentially cancels the order and prevents future dosing. After discontinuing an order, the provider can create a new order, if needed. 
  • Manage Patient Phases: Phases are a set of requirements that are assigned to the patient to allow them to build trust with the facility. As patients progress through their MAT treatment phases successfully, they can be given more responsibility by allowing them a greater number of take-home doses.
  • MAT Log: This report lists all MAT dosages dispensed, denied, and re-dispensed across patients, allowing facilities to view reports from specific time frames and export them as needed.
  • Troubleshooting MAT Orders and Dispensing: Resolutions for common issues with orders and dispensing. 

MAT Inventory

This section provides information on managing your MAT medication inventory and non-pump medication workflows within the Kipu EMR. 

  • Receiving MAT Inventory: Learn how to receive pump and non-pump medications into your MAT inventory. Medications received as MAT Inventory has special characteristics that differentiate them from non-MAT medications.
  • Non-Pump Medications Dispensing Workflow: Non-pump medication dispensing covers the administration of MAT medication distributed in non-liquid forms like Buprenorphine, including the start-of-day process, how to change low or empty medication bottles, and the end-of-day process. 
  • Transfer Inventory between Locations: Medication Inventory (including MAT Medications) can be transferred to other locations using the Transfer to Another Location transaction type.
  • MAT Inventory: Witness Signature Workflow: You can assign a Witness to every transaction logged in MAT Inventory. These Witnesses must sign off on the transaction before the medication can be reconciled. 
  • End-of-Lot Waste Procedure for Pump Medications: When switching between Methadone bottles from the same lot, left-over medication can be safely transferred to a newly opened bottle from the existing lot. However, when a facility has used all methadone inventory from a specific lot number, a special End of Lot Waste procedure must be performed to prevent cross-lot contamination.  
  • Pre-Pour [Unit Inventory]: Depending on state requirements, MAT facilities may require doses to be dispensed directly from a pharmacist. Pharmacists usually go to the facility once a week to pre-pour all the doses based on the patient's expected for that week and their MAT orders.
  • MAT Inventory and Pumps: Special Scenarios
  • Manual Pumps without Konnector: Let's review how to manage pump medications with a manual dispensing pump.
  • Recording Manual Dispenses [Power/Internet Outage/Event]: Kipu EMR allows users to record doses that were manually dispensed during a power outage, internet loss, or another event when the EMR or pumps were not functional.

MAT Queues and Kiosk

The Queue feature allows staff to check patients in and out, track waiting times in each queue, complete documents, medicate patients, change orders, and complete other actions to expedite their workflows. It can also help facilities increase efficiency and identify areas that need improvements. 

MAT facilities can take advantage of the EMR's self-service Kiosk, allowing patients to check themselves into the facility. By seamlessly integrating with Queues, Flags, and the Patient Ledger, patients can review messages added to their account, pay outstanding balances, and be routed to the appropriate queue all without speaking to a front desk representative, increasing efficiency and decreasing manual touchpoints.

MAT Reports

The following reports are available to help you report on your MAT activities. 

  • Reconciliation: Review all transactions related to a specific medication type. Used for many facilities to review daily inventory at the start and end of the day, this report is also valuable for completing an inventory review when requested by compliance agencies.
  • MAT Inventory Transactions: Review recent transactions on MAT medications. This report includes extensive filter options, allowing you to quickly can obtain the appropriate data based on the facility protocols.
  • MAT Log: View all MAT dosages across patients, allowing facilities to view reports from specific timeframes and export them as needed to review all the MAT dosages. 
  • MAT Orders: The MAT Orders report lists all MAT orders across all patients for the selected timeframe. This report can be exported for additional insight if needed. 
  • MAT Flags: View all flags assigned to patient charts and take actions such as resolving, acknowledging, and canceling flags all in one view.
  • MAT Queues: View average queue times by location and queue type, with details on individual patient visits including check-in and check-out times, processing times, waiting times, and total duration. This report can help facility administrators to improve facility operations and decrease patient waiting times. 
  • MAT Phases: Compare patient attendance data against phase requirements based on the facility's internal protocols. This report provides an overview of the patient’s phases including historical requirements metrics.  
  • MAT Clinical: This robust report allows users to choose from a broad range of data fields to build customized reports. Combine MAT-specific data fields with patient, contact, insurance, and care team data fields, creating diverse reports for many different needs. 
  • Patient Ledger: The Patient Ledger Report lists all charges, payments, and adjustments posted for patients, allowing facilities to review outstanding balances from specific timeframes and export them as needed.

MAT Settings

MAT Settings allow Super Admins to configure the main MAT elements in their EMR instance once the MAT functionality has been enabled by a Kipu staff member.

MAT Settings

  • Medications: Create Non-pump Medications, Pump Medications, and Strength Combinations from this tab. 
  • MAT Settings: Configure duration for start and end day procedures, dosing signature requirements, quantity refill preferences, and manual dosing. 
  • Inventory Settings: The Inventory Settings section of the MAT setting tab allows users to customize the available MAT Reconciliation report types and medication remaining threshold.
  • Location Settings: Manage location-specific settings for each of your MAT Locations including MAT Order settings, Unit Inventory, the Lighthouse Central Registry Integration, the Opioid Maintenance Therapy Report, and Medication Label Instructions.
  • Pump Konnectors: Learn how to configure the automatic pump for dispensing liquid methadone within the EMR.
  • Scheduled Closure Dates: Schedule days when the facility will be closed. Patients expected to return to the facility during those closure dates will have takeout doses scheduled within their MAT Order automatically, allowing them to be dispensed at the window on a date prior to the closure.

EMR Settings

Feature Settings

  • Phase Settings: Let's review how to set up and customize your facility phase rules required to advance to the next phase of treatment.  
  • Flags Settings: Learn how to configure patient flags for MAT facilities including stop dose, no-show, and random drug screen flags.

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