Glossary

1	EMR	Electronic Medical Record
2	MRP	Most Responsible Physician
3	OMD	Ontario Medical Documentation

1. Encounter Prescriptions

1.1 Summary

1.1.1 Business Need

Defined users:

MRP doctors, residents, nurses, team assistants and other medical staff with the credentials and rights to access OSCAR web-site. General user is given administrative rights.
Super User/Administrator with full rights:

Add/Edit/Delete
Reactivate account
Access to admin part of the OSCAR

Main purpose of Encounter Prescriptions is:

To include all OMD mandatory data elements for Medications
To record a medication prescribed in the past
To record a medication prescribed by an external provider
To discontinue medication from the treatment plan
To filter and sort medications
To create custom drug
To include drug-to-drug/ allergy interaction information
To view date of drugref database
To show dosage information over time
To create a list of favorite prescriptions
To select items to display on the eChart Rx box

Encounter Prescriptions requirements (Confluence link: https://oscaremr.atlassian.net/wiki/pages/viewpage.action?spaceKey=QA&title=OLD+OMD-based+testing+checklist&src=email) need to be aligned with Ontario MD EMR Specification document set that describes the high level and detail requirements central to the general EMR application. Encounter Prescriptions Use cases are created to meet the EMR Requirements of Appendix A – EMR Specification v4.0 (2.2.1.2.4 – Medications) for Oscar application and to validate the application Encounter Medications functionality.

1.1.2. Description

Encounter Prescriptions use cases are designed to add prescribed medication in patient's Drug profile and include all OMD mandatory Medications data elements. A medication prescribed in the past or by an external provider should be recorded. Provider should be able to sort medications and view current/ past, active/ inactive, all drugs in the patient drug list . Drugref form should include drug-to-drug or drug-to allergy interactions information including severity of interaction and allowing to override the information. Dosage information over time for a given medication can be viewed and printed. Favorite list of medications, custom drugs can be created and option whether or not include drugs on the eChart Rx box should be available.

Note: Encounter Prescription specification “Drugref must be updated at least every 2 mo” is out of scope in this document.

1.1.3. Pre-action requirements/state:

OSCAR McMaster Test Version 12.1, system, and DB are up, running and working as expected.

1.1.4. Post-action state:

OSCAR McMaster Test Version 12.1 is running and behaving as expected.
OSCAR McMaster Test Version 12.1 has all functionality prior to the change (outside of removing functionality intentionally)

1.2 Flow of Events

This section describes the main flow of the Use Case and system responses.

Include all OMD mandatory data elements for medications

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication	Complete the medication form	Medication form is completed	General User
6	Verify all OMD mandatory fields for medications	Verify that all OMD mandatory data elements for medications are included in the form. (Refer to EMR Specification v4.0 Appendix A - 2.2.1.2.4 – Medications)	All OMD mandatory data elements for medications are included in the form	General User

1.2.1 Alternate Flows of Events

This section describes the alternative flow of events based on variations in the main Use Case scenario that still result in a Successful End Condition at completion of the Use Case.

Alternate Flow 1

Include a refill quantity/ duration with ability to be updated

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication	Complete the medication form	Medication form is completed	General User
6	Verify that Instructions data is parsed	Verify that Instructions data is parsed and populated	Instructions data is parsed and populated	General User
7	Verify that Quantity/Duration data can be modified	Change Quantity/ Repeats data	Quantity/ Repeats data is modifiable	General User

Alternate Flow 2

Record medication prescribed in the past

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication	Complete the medication form	Medication form is completed	General User
6	Record medication prescribed in the past	Verify that Start Date can be recorded in the past	Start Date is recorded in the past	General User

Alternate Flow 3

Record medication prescribed by external provider

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication	Complete the medication form	Medication form is completed	General User
6	Record external provider prescription	Verify that medication prescribed by external provider is recorded	Medication prescribed by external provider is recorded	General User

Alternate Flow 4

Discontinue a medication from the treatment plan

Num.	Step	Description	System Response	User
	Pre-condition	Medication is added to the patient's Drug profile
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Discontinue a medication from the treatment plan	Verify that a medication can be discontinued from the treatment plan without changing the status of the prescription	A medication is discontinued from the treatment plan without changing the status of the prescription	General User

Alternate Flow 5

Display current vs past / active vs inactive medications

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Display current/ past medications	Verify that current/ past medications are listed	Current/ Past medications are listed	General User
6	Display active/ inactive medications	Verify that active/ inactive medications are listed	Active/ inactive medications are listed	General User

Alternate Flow 6

Create a custom drug

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Custom drug	Click on Custom Drug button and complete custom medication form	Custom drug is added	General User

Alternate Flow 7

Include drug-to-drug/ allergy interaction information

Num.	Step	Description	System Response	User
	Pre-condition:	Medication is added to the patient's Drug profile Patient has allergies added to the Allergy Profile
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab by name	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication to verify drug-to-drug/allergy interaction	Search for a medication that has drug-to-drug/ allergy interaction via drugref including severity of interaction and allowing override	Drug-to-drug/allargy interaction warning message displays and and allowed to be overrided	General User
6	Add Medication	Complete the medication form	Medication is added	General User

Alternate Flow 8

Include drug-to-drug/ drug-to-allergy interaction information

Num.	Step	Description	System Response	User
	Pre-condition:	Medication is added to the patient's Drug profile Patient has allergies added to the Allergy Profile
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Add Medication to verify drug-to-drug/drug-to-allergy interaction	Search for a medication that has drug-to-drug/drug-to- allergy interaction via drugref including severity of interaction and allowing override	Drug-to-drug/allargy interaction warning message displays and and allowed to be overridden	General User

Alternate Flow 9

Drudgref interaction preferences

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate Rx module	Select Rx hyperlink to open Drugref from the current record	Drugref module is opened for the selected patient	General User
5	Drugref info interaction message	Verify Drugref info interaction message displays for drug/condition interactions, drug/lab interactions, recommended dosing, or therapeutic alternatives	Drugref info interaction message displays for drug/condition interactions, drug/lab interactions, recommended dosing, or therapeutic alternatives	General User

Alternate Flow 10

View date of drugref database

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab by name	General User
4	Activate eChart module	Select E hyperlink to open eChart from the current record	eChart module is opened for the selected patient	General User
5	Access Medications page	Select Medications heading on the left hand menu	Medications page opens in a new window	General User
6	View date of drugref database	Access “Drugref Info” link at top of Rx page	Drugref popup appears	General User

Alternate Flow 11

Interaction preferences

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Set up Drugref interaction preferences for Patient Provider Clinic	Change Rx Interaction Warning Level	Rx Interaction Warning Level is selected	General User
5	Verify Drugref interaction preferences	Verify that Drugref interaction preferences should be respected with Patient prefs overriding Provider prefs which overrides Clinic prefs	Drugref interaction preferences should be respected	General User

Alternate Flow 12

View and print dosage information

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate eChart module	Select E hyperlink to open eChart from the current record	eChart module is opened for the selected patient	General User
5	Access Medications page	Select Medications heading on the left hand menu	Medications page opens in a new window	General User
6	View dosage information over time for a given medication	Verify that dosage information over time for a given medication is available to view	Dosage information is available to view	General User
7	Print Timeline drug profile	Verify that Timeline drug profile is printable	Timeline drug profile is available to print	General User

Alternate Flow 13

Sort prescriptions (including manual sorting)

Num.	Step	Description	System Response	User
	Pre-condition:	Medication is added to the patient's Drug profile
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate eChart module	Select E hyperlink to open eChart from the current record	eChart module is opened for the selected patient	General User
5	Access Medications page	Select Medications heading on the left hand menu	Medications page opens in a new window	General User
6	Sort prescriptions manually	Verify that medications can be sorted manually	Medications are sorted manually	General User
7	Sort prescriptions by dates	Verify that prescriptions can be sorted by dates	Medications are sorted by date	General User
8	Sort prescriptions alphabetically	Verify that prescriptions can be sorted alphabetically	Medications are sorted alphabetically	General User

Alternate Flow 14

Create a list of favourite prescriptions

Num.	Step	Description	System Response	User
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate eChart module	Select E hyperlink to open eChart from the current record	eChart module is opened for the selected patient	General User
5	Access Medications page	Select Medications heading on the left hand menu	Medications page opens in a new window	General User
6	Add medications to Favourites	Verify that medications can be added to Favourites	Medication is added to Favorites	General User

Alternate Flow 15

Select items to display/ hide on the eChart Rx

Num.	Step	Description	System Response	User
	Pre-condition:	Medications are added to the patient's Drug profile
1	Connect to the OSCAR main page	Launch URL: http://192.168.1.202:8080/Oscar12_1/index.jsp	OSCAR main page with the login is opened	General User
2	Log In	Enter user's valid credentials (User Name / Password/2nd Level Pass code if applicable)	By entering right credentials user is getting system verification acceptance	General User
3	Search by patient name	Access Patient Search Results page from Search Tab	Patient search results page is accessible from Search Tab	General User
4	Activate eChart module	Select E hyperlink to open eChart from the current record	eChart module is opened for the selected patient	General User
5	Access Medications page	Select Medications heading on the left hand menu	Medications page opens in a new window	General User
6	Select items to display/ hide on eChart CPP	Verify that items can be selected to display/ hide from eChart CPP	Items can be selected to display/ hide from eChart CPP	General User

1.2.2 Exception Flows of Events (Negative)

N/A

OSCAR EMR

Use Cases Encounter Prescriptions