Order Entry and Management
You can enter and edit Medication Orders (orders) at care units and in outpatient clinics. Using these orders the system generates Medication Events (events) for the relevant purpose.
The purpose is crucial when deciding whether
the drug will be administered to the patient
the drug will be dispensed to the patient
the drug is printed on a prescription for the patient
System administration can define in the drug master data for which of the following purposes a drug can be ordered:
Administration
Dispensing
Print Prescription
See Drug Header Data
Example
System administration can define, for example, that a drug can only be ordered for administration and print prescription.
Note
It is therefore not possible to change the purpose of an order to dispensing or print prescription, if the ordered drug is flagged for inpatient orders (administration) only in the drug master data.
You can override the presettings in the drug master by setting the Special Request
indicator in the drug search when selecting a drug.
You can only change the purpose using, for example, the Change to Administration
function. For active orders, the systems creates a new order (subsequent order) in this case.
If you use several drug levels, the system also takes into account whether a drug for a specific purpose (for example, administration) can only be used for the drug search or can actually be ordered.
See Drug Level
You can only create an order for an orderable drug (indicator in drug master data), which can consist of any number of ingredients.
You can create an order which has no events, for example, as a historical order (earlier order that was not yet entered in this system) or to keep the patient’s medication profile up-to-date regarding interactions with other drugs.
Note
You can enter a free text if, for example, the specific drug is not known at the time the order is saved, (e.g. the "green tablet" that the patient has been taking for years, but cannot currently remember the name of).
You do not need to select a drug from the drug catalog for this. You simple enter a description of the drug in the order description to specify the drug.
However, you should note that you cannot generate events for free text orders and you also cannot activate them. You can only execute these functions once you have entered the drug which should actually be used in the order.
You can document ad-hoc and emergency administration. In this case, the system creates a single event and creates an order with immediate validity for it. Depending on the internal status of the order, you can also enter an additional event for an existing order. For more information, see Creating an Emergency Event for Administration.
Order for Administration
Unlike when ordering the dispensing of a drug, or the printing of a prescription, the individual dose of the event and the cycle for the administration are important when ordering the administration of the drug. The system generates the individual events using the cycle times.
Order for Dispensing or Prescription Print
The issuing of packages is the most important factor for ordering the dispensing and the printing of a prescription. The system totals the individual events for an overall event and calculates the required amount (package/container size) for the dispensing or prescription print.
Furthermore, the system also generates any necessary repeat events for the order. The system generates repeat events so that containers are completely used up. In the case of the last repeat event, the container may not be completely used up.
Example
The ordering employee chooses the duration of the order, the individual dose and the cycle with which he wishes to prescribe the drug. The system uses this information and the container size of the drug, as well as the issuing quantity per event to calculate if and when the patient must come back in order to get a new prescription.
The ordering employee can also let the system calculate the order duration, if he only enters the individual dose and the cycle.
Note
The system generates events only within the event generation horizon. You can enter the event horizon for the drug or define it using the system parameter N1MEEVTH
.
Furthermore, the system can propose the number of repeat events and alternative quantities to the ordering employee. The Propose Issue Quantity
function is available for this.
Example
The ordering employee chooses the duration of the order, the individual dose and the cycle with which he wishes to prescribe the drug. The system displays a proposal list which contains alternative issue quantities and the number of repeat events.
See Proposal for Issue Quantity for Dispensing/Printing Prescriptions
You can customer-specifically change the selection of proposed drugs using the SEARCH_OTHER_PKGSIZE
method of Business Add-In ISHMED_ME_DRUG_SUBST
. See Customer-Specific Enhancements for Medication.
Various Screen Areas in Order
Depending on the Drug Category the system provides various screen areas for entering the necessary data in the order. The screen area depends on the type of customer-specifically defined drug categories and the use of customer-specific screen areas in the Business Add-In N1ME_DYNAM_SUBSCR
.
See Customer-Specific Enhancements for Medication
Standard drugs
Standard changeable compounds
Standard non-changeable compounds
Standard changeable infusions
Standard non-changeable infusions (fixed)
Standard changeable nutritional solutions
Standard non-changeable nutritional solutions (fixed)
Changeable drug kits
Non-changeable drug kits (fixed)
Status Concept of Order
The status concept of the order contains the statuses used internally in the system, to which you can assign customer-specific statuses (external status). The system always displays the external status of the order, such as Pending Check
to the user.
You can assign multiple external status to the internal status saved
. Examples of external statuses are:
Saved (sequence number 1)
Pending Check (sequence number 2)
Checked (sequence number 3)
Within this multiple status the sequence number is decisive for the updating of the status. The Change Status
function presets the status with the next successive sequence number. See Change Status of Order.
Business Add-Ins are available for customer-specific enhancements both before and after the status change. See Customer-Specific Enhancements for Medication.
Alternative Drugs in the Order
The ordering employee can also have the system propose alternative drugs.
Example
The ordering employee chooses the duration of the order, the individual dose and the cycle with which he wishes to prescribe the drug. The system displays a proposal list (alternative drug proposals), which contains proposals concerning the number of repeat events depending on the different container sizes in which the drug is available. See Propose Alternatives.
You can customer-specifically change the selection of proposed drugs using the SEARCH_ALTERNATIVE
method of Business Add-In ISHMED_ME_DRUG_SUBST
. See Customer-Specific Enhancements for Medication.
Integration
The functions for entering and managing medication orders are available in varying degrees of functionality in dynpro and smart UI:
Functions for entering and managing orders are available in the following view types of the clinical work station in dynpro:
You can also create a drug order from the SAP Easy Access
menu under 
Clinical System
Medication
Medication Order
and in the patient organizer.
Note
You can also create an order from the documentation work station.
See Base Item Types in the Documentation Work Station
Regardless of whether you call an order from the documentation work station or from one of the view types listed above, the system always uses the same order dialog.
Medication Graph of i.s.h.med charting (Charting).
The system displays the medication graph of the chart with an overview of orders and events in the order dialog and in the documentation work station in dynpro.
Display Functions
You can influence the display of the medication graph:
Shorten the displayed texts
Restrict the displayed orders to visible validity period
Sort by predecessor
Manual sorting and color highlighting
Note
You can show and hide the chart in the order dialog by choosing the icon with the quick info text Hide/Show Chart
or press F6.
To do this in the documentation work station, choose Info Area
with the quick info text Show/Hide Info Area
or press F9.
For more information about the chart display functions, see Chart Interface Functions. For information about configuring a manual sorting and color highlighting of orders in the medication graph, see Manual Sorting of Orders for Chart Display.
Processing Functions
You can use the Order
context menu of the medication graph to process one or more orders from the chart. The hotspot on individual order bars lets you transfer these into the order dialog for processing. For more information, see Chart Processing Functions for Medication.
Medication Graph in Smart Chart
Smart Chart displays a graphical overview of orders and administration events in smart UI. You can call processing functions for orders in dynpro and smart UI.
Display Functions
For each order, Smart Chart displays the following information concerning the description of an order:
Drug and dosage form
Dosage and strength
Administration route
The system highlights infusions and orders for PRN medication using special indicators. The medication graph displays order sequences in graphical form to permit the tracking of changes to the order.
The following options are provided to improve the clarity of and personalize the medication graph display:
Grouping of medication orders, for example according to the purpose
Manual sorting and color highlighting
Optimization of the height of the display by hiding ended orders
For more information on the display functions of the medication graph in Smart Chart, see Display Functions for Medication Graphs.
Processing Functions
The function bar of the medication graph und the options for interacting with the medication graph provide the following functions:
Create one or more orders
You can create one or more orders and further process them in the order dialog in dynpro. The functions of the order dialog listed under Features are available to you for this.
When you exit the order dialog, you return to
Smart Chart
.View and change an order
You can view and change a single order in the order detail dialog in dynpro. You can create and process subsequent orders. The functions of the order detail dialog are available to you for this. For more information about this, see Process an Individual Order in the Order Detail Dialog.
When you exit the order detail dialog, you return to
Smart Chart
.Edit Day's Events of Order
The
Edit Day's Events
dialog box in smart UI enables you to navigate on a day-specific basis and view the administration events of the selected day. You can edit non documented events in the dialog.You can also use the dialog to suspend, resume and end orders. You are also able to confirm orders in the dialog.
For more information, see Edit Day's Events of Order.
Confirm one or more orders
For more information on the editing functions of the medication graph in Smart Chart
, see Editing Functions for Medication Graphs.
Orders UIBB
The Orders
UIBB in smart UI displays an overview of the medication orders. The UIBB provides the following order processing functions:
Create one or more orders
You can create one or more orders and further process them in the order dialog in dynpro. The functions of the order dialog listed under Features are available to you for this.
When you exit the order dialog, you return to the
Orders
UIBB.View and change an order
You can view and change a single order in the order detail dialog in dynpro. You can create and process subsequent orders. The functions of the order detail dialog are available to you for this. For more information about this, see Process an Individual Order in the Order Detail Dialog.
When you exit the order detail dialog, you return to the
Orders
UIBB.Edit Day's Events of Order
The
Edit Day's Events
dialog box in smart UI enables you to navigate on a day-specific basis and view the administration events of the selected day. You can edit non documented events in the dialog.You can also use the dialog to suspend, resume and end orders. You are also able to confirm orders in the dialog.
For more information, see Edit Day's Events of Order.
For more information about the Orders
UIBB , see Orders.
Prerequisites
In order to be able to enter and manage medication orders, system administration must create the basic data and settings for clinical order. See Customizing Functions for Medication.
Activities
To process the medication of a patient displayed in the Patient Profile
in Smart UI in the order dialog, choose the Edit Medication
hotspot in the Applications
UIBB or in the Application Hitlist
UIBB. See Applications in Patient Profile.
Note
In the order dialog in i.s.h.med charting (Charting), the system displays the orders of the selection period configured for the chart layout. This selection period can be different from the period filter used in the Patient Profile
.