Medications

In the Details pane, the Source will be Public Health Information Management System (1). There will also be a SIG field (2) displaying the treatment information, which will appear in both the Card and Details Pane.

The SIG is treatment information sent by PHIMS; it is not sent by DPIN for dispensed medications as it is a billing system.

The Facility field displays the community pharmacy that dispensed the medication. PHIMS medications are not dispensed by community pharmacies. Manitoba Health publicly funds a drug program that makes Sexually Transmitted Infections (STI) medications available through health care providers free of charge. Medications are ordered by providers and distributed directly to patients to treat STIs, which bypasses community pharmacies/facility. The health care provider who administered or provided the medication to the patient is listed in the Prescriber field.

Health care providers who diagnose reportable STBBIs are required to report patient, treatment and contact details to Public Health, including STI treatment provided based on clinical suspicion, using the MHSU-6781 – Provider Report Form for Sexually Transmitted and Blood-Borne Infections (STBBI) and/or STI Treatment. STI treatment reported to Public Health is recorded in the Public Health Information Management System (PHIMS), and transferred daily to eChart. STI treatments provided directly by Public Health to patients are also recorded in PHIMS and transferred daily to eChart.

Medication information in eChart is received from the Drug Program Information Network (DPIN), administered by Manitoba Health , Seniors and Active Living (MHSAL). eChart Manitoba has been aggregating data since April, 2010, and keeps medication information on a long-term, lifetime basis.

eChart displays medications in the form of “cards”.  The card view shows the drug name, ingredient(s) strength(s), form, duration with units, and dispensed quantity. Clicking on the medication card will open the card details view to display additional information sent by DPIN: prescriber, facility and source.  Further information on this topic is in the Medications micro video.

To see more medication information in a single combined view, please refer to the Medications QRG.

DPIN is a billing payment system and drug database which contains medications dispensed in retail-community pharmacies. (It excludes hospital pharmacies, nursing stations, ward stock, and outpatient visits at programs like CancerCare Manitoba).

Medications dispensed from retail pharmacies in Manitoba appear in DPIN and therefore in eChart.

Identical medication information is available in the DPIN-Viewer and in eChart Manitoba – with two exceptions:

• eChart Manitoba has been aggregating data since April, 2010, and keeps medication on a long-term, lifetime basis; whereas DPIN shows the most recent six months of medication information at any given time.
• Pharmacy telephone numbers are not currently in eChart.

Medications do not appear in eChart:

• If a patient is prescribed medications that are filled through a hospital pharmacy. If the hospital has an EMR, the EMR may show other prescribed medications that have been dispensed in hospital.
• If a patient is prescribed medications that are dispensed by a pharmacy/pharmacist outside of Manitoba.
• If a patient is prescribed medications that are not insured by Manitoba Health, and are paid for by the patient or a different insurer.
• If a patient is prescribed medications that are uninsured by Manitoba Health, such as sample medications, the medications may not appear in eChart.

eChart is updated approximately every ten minutes from DPIN. If there are any delays in transmission or recent information has not yet been entered into DPIN (e.g. the medication has not yet been dispensed at a retail pharmacy), this will impact the delivery time from DPIN to eChart.

Community pharmacy data that is not displayed in DPIN or in eChart includes:

• Units of measure for the prepared form of the drug (e.g. millilitres, milligrams, metered dose per puff)
• Non-medicinal ingredients in the medium, solution or preparation form of the drug
• Provider instructions / provider details
  • No details about frequency and quantity per time of day within each 24 hour period
  • No special instructions such as ‘with or without food’ or warnings for special populations (e.g. pediatric, pregnant, or geriatric patients), etc.
• Medications ordered but not dispensed
• Pharmacy phone number

Note: If you require more information, please contact the ordering provider and/or pharmacy identified in eChart.

Dosage information is available in eChart, but it is incomplete. Especially in some forms, like suspensions or other pharmaceutical compounds, the amount dispensed can only be estimated, not confirmed (see example below).

To gather complete dosage information, the original provider and/or source pharmacy must be contacted (whether the user is using DPIN or eChart); see the Prescriber and Facility fields for contact names.

Dosage details available in eChart:

• Duration – days ordered
• Dispense – quantity dispensed

Note: Some limited dosage information may be inferred from the Days “Duration” and the Quantity “Dispensed” fields. For example, the total quantity of tablets per day (e.g. 1 tablet per day) may be inferred using the Days/Duration field (e.g. 50 days) and the Quantity/Dispensed field (e.g. 50). However, the details about frequency and quantity per time of day within each 24 hour period are not available, so the dosage details still need to be validated with the ordering provider and/or dispensing pharmacy.

eChart:

• Shows only medications dispensed by retail pharmacies (i.e. DPIN medications only)

Your EMR:

• Shows only medications ordered in your own facility’s EMR (or regional if a regional EMR)

Your paper chart:

• Shows medications ordered in your own facility on traditional paper order forms
• May also include (depending on your site’s printing policy):
  • Print-outs of medications ordered in your own facility’s EMR (or regional if a regional EMR)
  • Print-outs of eChart Medication view
  • Print-outs of DPIN Medication view (same content as eChart Medication view)
• NOTE: Patients do not always fill medication prescriptions, therefore what is entered in the EMR/paper chart may not be seen in eChart.