British Columbia Prescription Adaptation Program
British Columbia Prescription Adaptation Program
Contents Description of Services ........................................................................................ 1 Preparing Kroll System for Prescription Adaptation ............................................ 1 Step 1: Update your system to the Kroll Adaptation compliant version ................................... 1 Performing Updates in Kroll ................................................................................................... 2 Step 2: Doctor Card Maintenance .............................................................................................. 2 Prescription Adaptation Procedure ........................................................................................ 3 Entering the SIG ...................................................................................................................... 3
Prescription Adaptation Report .......................................................................... 5 Comments Report ............................................................................................. 10
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British Columbia Prescription Adaptation Program
British Columbia Prescription Adaptation Program Recent legislature has come into effect that gives pharmacists prescriptive authority, in some situations, to renew and adapt prescriptions. The Pharmacist Prescription Adaptation Report in Kroll has been created to accommodate the documentation requirements for this program. This user guide explains how the Prescription Adaptation Program works, how to prepare your Kroll system for prescription adaptation, and how to run the Prescription Adaptation and Comment reports.
Description of Services Pharmacists can now perform the following in specific situations:
Renew a prescription that does not have any authorized refills remaining;
Change the details of a new prescription to better suit the needs of a patient;
Substitute one drug for another, within the same class of drugs, to better suit the needs of a patient (this is called a "therapeutic substitution").
Preparing Kroll System for Prescription Adaptation In order to prepare your Kroll system for performing Prescription Adaptation, you need to perform a few maintenance tasks as follows:
Step 1: Update your system to the Kroll Adaptation compliant version
The latest Kroll version for BC is Version 10 2014-Aug-27.kcu. Ensure your system is running this version of Kroll or higher.
If you are already on Kroll version 10, this will be a small maintenance update.
NOTE: If you are on any of the prior Kroll versions, the update must be performed after hours from the main station when no one else is logged on. 1
British Columbia Prescription Adaptation Program
If you are unsure about the current Kroll version that you have, please call the Kroll Helpdesk in advance of the update procedure so that they will connect to your system and inform you about the current version that you are using.
Ensure you have a good backup.
Performing Updates in Kroll 1. From the Alt-X Start screen, go to File > List Program Updates. The Update Information window will appear.
2. Click on Check Kroll to access all the updates posted on the Kroll server. 3. Place a checkmark next to the update and click Download.
4. Once the update is downloaded into the Current Updates tab, highlight the update and click Run Update.
Step 2: Doctor Card Maintenance For each dispensing Pharmacist in your system, you need to ensure that the salutation is configured correctly. This will change how the Pharmacist appears in the report sent to Doctors.
1. From the Alt-X Start screen, click F7 – Doctor. 2. Bring up each Pharmacist and check/modify the Salutation fields. 3. Ensure that the Salutation field is blank by pressing spacebar (defaults to Dr.).
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British Columbia Prescription Adaptation Program
4. Make sure that all the phone and address information is correct as it prints on the form.
NOTE: You may notice when printing the adaptation form, the salutation is changed to the format: PH pharmacist name.
Prescription Adaptation Procedure In order to adopt a prescription, copy it from an existing prescription using the pharmacist as the doctor and a new prescription number, or fill it as a new prescription. When making changes to a prescription that has not been previously filled, the Rx would be entered as new, with the adaptation mode on the first fill, using the pharmacist as the doctor.
Entering the SIG When you perform the adaptation, you will need to enter the word ‘adapted’ in the first part of the sig to identify it on the Rx label. To do this, you can manually enter the word adapted before sig or sig codes, or you can add a sig code for adapted to the system. 3
British Columbia Prescription Adaptation Program
Adding a Sig Code Follow the below steps to add a Sig Code: 1. From the Alt-X Start screen, go to Edit > Sig Codes. The Sig Code List Form appears.
2. Click Ins to create a new Sig Code. The Edit Sig Code form appears. Enter the code you would like to use and the expansion you want it to display.
NOTE: For users in British Columbia, any Adapted prescription must be submitted with one of the following intervention codes:
NI = Dosage Change
NJ = Formulation Change
NK = Directions for Use Modified
NL = Renewal of Prescription
NM = Therapeutic Substitution 4
British Columbia Prescription Adaptation Program
NOTE: Two additional intervention codes below have been added for emergency supply and emergency contraception; these prescriptions are not subject to adaptation fees.
NN = Emergency Supply of Medication
NO = Emergency Contraceptive
Adding an Intervention code 1. From the F12 – Fill Rx screen, select View > Plan Information. The Rx Plan Information screen will appear. 2. Click F2 and select ‘NI – Dosage Change’ from the Intervention Code 1 menu.
Prescription Adaptation Report Select Reports > Pharmacist Prescription Adaptation from the F12 screen.
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British Columbia Prescription Adaptation Program
The report will appear with the Original Rx Information tab displayed first. You will be required to manually enter the original prescribing doctor of this specific prescription in order to fax the adaptation form to them. The drug and sig will be prepopulated in this form according to the information in the Fill screen.
NOTE: The adapted prescription information will be automatically populated into the report from the Fill screen.
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British Columbia Prescription Adaptation Program
The Comments tab of the report is the area of the report where the pharmacist is to provide an explanation to the doctor as to why the prescription adaptation was required, as well as instructions to the patient and a follow up plan.
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British Columbia Prescription Adaptation Program
The Options tab allows you to select certain information to print on the report. The Pharmacist field will be prepopulated based on the Pharmacist that is selected as the doctor in the prescription.
Once all the required information is selected, you can choose to print or preview the report and then it must be faxed off to the doctor.
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British Columbia Prescription Adaptation Program
Sample Pharmacist Prescription Adaptation Report:
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British Columbia Prescription Adaptation Program
Comments Report The Comments Report is a useful tool for determining what prescriptions have been adapted by the pharmacist in a specified time period. 1. From the Alt-X Start screen, go to Reports > Other > Comments Report. The Comments Report form appears.
NOTE: When running the Comments Report, make ensure that you select only Rx Adaptation from the Topic dropdown menu; otherwise you will get comments from all the Rxs.
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British Columbia Prescription Adaptation Program
Sample Rx Comments Report:
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