Encounter completion — orders & prescribing

Order medications, labs, imaging & more

The Orders section is one search box for everything you order at the visit — prescriptions, lab panels, imaging, referrals, screeners, and forms. Pick a destination pharmacy first so prescriptions know where to go.

1. Choose the pharmacy. Open Select pharmacy… and the dropdown is grouped, not one flat distance-sorted list: Primary Pharmacy first, then Patient Pharmacies, then up to five Closest to Physician, then up to five Closest to Patient. A group with nothing in it is left out entirely, so don’t expect all four on every patient — the first two need pharmacies already saved on the chart, and Closest to Patient needs a usable home address to measure from. On a patient with neither, the dropdown opens on Closest to Physician alone. Type two or more characters and a Search Results group from the wider pharmacy directory appears above those groups. Add or edit pharmacies with Manage pharmacies.
2. Search and add. Type into Search orders and press Search & Add to open the Search Orders window. Filter by tab: all, order sets, medication, lab, imaging, referral, screeners, forms, or favorites. The order sets tab only appears when order sets are enabled for your organization — see Order sets. Each result shows its name, brand names, and type; controlled medications are flagged with their schedule (for example Schedule: CIV).
3. Watch the renal cue. Latest Cr under the order list surfaces the most recent creatinine so you can dose-adjust without leaving the screen.

Write a structured prescription

Selecting a medication opens Edit Medication, where you build the sig from structured fields. Hero EMR assembles the directions and a one-click Auto-fill proposes a starting regimen with dosing guidance.

1. Build the sig. Set Action, Route, Dose (amount + unit), Frequency, Duration, Dispense (amount + unit), and Refills. A live summary of the directions is assembled from those fields and updates as you go.
2. Fill in the as-needed details. Choosing As needed (PRN) (or ticking the as-needed box) reveals a free-text reason — “As needed for… (e.g. pain, nausea, anxiety)” — and a Max doses per day field. Both fold into the directions the pharmacy receives.
3. Check the advisory readouts.
   • If the dispense quantity looks implausible for the days’ supply, the dialog shows the implied amount per day so you catch an absurd quantity (1800 tablets, 20 capsules a day) before sending. The same dispense/day summary appears on the order row in the list. It’s advisory and never blocks you.
   • For patients under 18 with a recorded weight and a catalog-matched product, a weight-based mg/kg readout appears under the dose fields. It is advisory only — it never edits the order.
4. Let Auto-fill propose a regimen. Auto-fill populates the structured fields and surfaces a Medication Hero dosing note — e.g. “For anxiety, clonazepam initial adult dose is 0.25–0.5 mg PO daily, may increase to 1 mg daily as needed.” Adjust anything before saving.
5. Delay the fill if you need to. Do not fill until (optional) sends the prescription now but asks the pharmacy to hold the fill until the date you pick. Leave it blank to fill now.
6. Set substitution and pharmacy notes. Toggle Substitution Allowed and add a Note to Pharmacy if needed, then Save Changes to drop the order onto the list.

Read the medication safety checks

Every medication order carries a row of five Medication Hero checks. Four of them — interactions, allergies, indication/dosage, and black box — run automatically and show green when clear; click any icon for the detail. A red or amber result means review before you sign. The fifth, PDMP, is a status readout only: it stays grey until a check has actually been run, and clicking it just opens its tooltip.

Link each order to a diagnosis

Orders should be tied to the diagnosis that justifies them. The Associations grid — diagnoses down the side, orders across the top — lets you check the box where they intersect. Linking supports medical necessity and is required before a prescription can be sent.

1. Open the Associations grid. It appears under the order list once you have at least one diagnosis and one order.
2. Check the intersections. Tick the box where a diagnosis row meets an order column (for example F41.1 × Clonazepam). The footer tracker shows Linked (0/1) in amber until every order is linked, then flips to a green Linked.

Sign controlled prescriptions (EPCS)

Non-controlled prescriptions send when you press their own Sign & Send, or when you finalize the visit if you haven’t. Controlled substances (Schedule II–V) require EPCS — DEA-regulated two-factor signing — before they can be transmitted. The order’s button always reads Sign & Send; for a controlled drug that is otherwise ready to go, its tooltip adds “(2FA required)”. The button stays disabled until a pharmacy is selected and a diagnosis is linked.

1. Select a pharmacy and link the diagnosis. Both are prerequisites; the button’s tooltip tells you what’s still missing (“Cannot send: Select a pharmacy, Associate a diagnosis with this medication”).
2. Click Sign & Send. The Controlled Rx Mobile Approval dialog opens. It restates the full prescription — patient and DOB, medication with its schedule, directions, refills, and the prescriber’s name, address, and DEA number — alongside the legal signing attestation.
3. Check the PDMP. The dialog shows a PDMP not checked indicator with a Run PDMP button. This is the only place the state database is actually queried. Where a PDMP check is required for this drug’s schedule and your state, Start mobile approval stays disabled until Run PDMP comes back with a usable report — a stale or expired result blocks it too, and the reason is shown beneath the indicator.
4. Complete two-factor approval. Choose Start mobile approval to push the request to your registered phone, or Enroll passkey if you haven’t set up a second factor. Completing 2FA signs the prescription and authorizes transmission to the pharmacy.