Last review date 03/02/2023

Often a medication which needs to be recorded on the patient record will be prescribed by a hospital or another organisation, for example, a DMARD or shared care drugs. It is essential for clinicians to be aware of all medications the patient may be taking in order to prescribe safely.  They need to be able to appropriately consider interactions, and side effects or the patient could be immunocompromised. When prescribing drugs of addictive potential, it is also essential to be aware of medications supplied by other services.  


On SystmOne there are two possible methods to record this information.  The medication can be recorded as a standard 'Repeat' Template or the 'Other Medication' functionality can be utilised.  There are positive and negative aspects to each approach which are outlined below.


Summary

Option 1: Record as a 'Repeat'


Pros

  • More visible and cannot be hidden by mistake on the 'Repeat Templates' screen
  • Will be merged into referrals and letters
  • Will be identified in Ardens 'Service and Local contract' reports
  • Will be included in the Summary Care Record
  • Will show in the list of medications in SystmOnline 
  • Will merge into all SystmOne documents
  • Will ensure all patient status alerts are active and any drug monitoring alerts are triggered correctly

Cons

  • Will not be identified in Ardens 'Contract' reports eg Flu Cohorts (because they haven't been 'issued')
  • Must remember to configure the repeat correctly so that it does not get issued or initiated by the patient


Option 2: Record as 'Record Other Medication'


Pros

  • Will be identified in Ardens 'Contract' reports eg Flu Cohorts 
  • Will be included in the Summary Care Record
  • Will merge into home visit printouts

Cons

  • Is not always easily visible on the 'Repeat Templates' screen (If you chose to 'Hide This' section when you click to view it again it does not always expand properly without dragging the blue bar up the screen)
  • May not merge in referrals and letters
  • Will not show in the list of medications in SystmOnline
  • Not easy to specifically identify 'other medications' in a clinical report, therefore patient status alerts and drug monitoring alerts will not function as expected
  • Clinicians are often not aware of how to record
  • Will need to be regularly re-added for 'Contract' reports eg Flu Cohorts 
  • When adding doesn't show interactions with other medications


In Detail

Option 1: Record as a 'Repeat'


To do this:

Record the medication on the normal repeat medications screen 

  • Deselect the tick box 'Patient can initiate issues'
  • Deselect the tick box 'Repeat template can be reauthorised'. 
  • In the 'Dose box', 'Script notes' and 'Admin notes' write ‘ISSUED BY HOSPITAL – Please do NOT issue from GP Practice’. (This text could be added to your text presets for future use)
  • Set the total quantity to 1
  • Set the review date to the current date



This is how it looks in the record




Option 2: Record as 'Record Other Medication'


To do this:


Right click on 'Medication' in the clinical tree and select 'Record Other Medication'





Complete the relevant details in the 'Record Other Medication' window and click OK




The medication is now recorded in the patient's record and added to the Medication view and to a separate 'Other Medication' section at the foot of the Repeat Templates view.



On the repeats view you can see at the bottom 'Other Medication' and a link to 'Hide This'



If you have clicked on 'Hide This' you can see from the screenshot below that the medication can easily be overlooked.  To restore the view click on 'Click here to view X 'other' medication'



There are several development requests that have already been submitted to TPP for Other Medications.


f4420000 Create an 'Other medication' merge field so other medication can be merged into letter templates

82320000 Make "Other Medication" section more visible when going into repeat templates

61d10000 Allow Other Medication to be recorded on SCR separately and remain on the SCR for > 12 months

a0d10000 I would like to be able to report on Other Medication

50020000 HOSPITAL DRUGS added to S1 do not highlight interactions with other medication on patients' records

56420000 Reporting on Hospital medication