Documentation

What Works: Effective Practices for Office-based CareMedication Management
Medication Renewal Documentation

Recommendation: Prescription renewals are documented in the medical record.


 Effective Practice
Adhesive backed medication renewal forms
Benefit: Facilitates placement in the medical record
In practice at: Family Medicine Shrewsbury (UMass)


 Effective Practice
Prescription refill cells are entered into a log book by LPN. The physician reviews and renews in the EMR then it is faxed to the pharmacy. Changed medications automatically populate the medication list in EMR.
Benefits:
  • Automated update of medication list.
  • Allows provider and clinical staff to review.
In practice at: PPOC Community Pediatrics


 Effective Practice
Medication renewal sheet is centrally located in the medical record and lists medications that can be renewed by staff (standing orders).
Benefits:
  • Central location.
  • Orders already on sheet.
  • Paper-based.
In practice at: Westwood Pediatrics (Children’s), APG-Chelsea (BIDMC)


 Effective Practice
Yellow carbons for prescriptions and renewals are included in the record (usually batched)
Benefits:
  • Paper-based
  • Allows provider and clinical staff to review
In practice at: Chestnut Hill-Solomon (BIDMC)


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