DrFirst will release the following updates on August 17, 2021. These updates will affect all BestNotes DrFirst users.

Quantity unit validation

This release of DrFirst guides you to comply with changes to the list of dispense quantity units that have been mandated by NCPDP (National Council for Prescription Drug Programs). The list of quantity unit codes that may be sent in NCPDP SCRIPT electronic prescribing messages has been reduced from 85 to 28. Starting September 1, 2021, the Surescripts network will enforce this mandate and begin rejecting any prescription that is sent with retired quantity unit. The units that are being retired are generally not discrete or measurable. Examples include, bottle, box, tube, vial, and inhaler.

This change only affects dispense quantity unit. Dose unit and other "sig" fields are not changed.

DrFirst will not correct retired quantity units in existing medication, prescription, or favorite records. When you modify one of these records, the quantity unit must however be changed to a unit that has not been retired.

Prescribe from a medication or favorite

When you start a new prescription from an existing medication record or from a saved favorite, and the dispense quantity uses a required unit, you will be prompted to change the quantity and unit (see Figure 1-1). You may select from a list of package sizes that are available for the drug and then adjust the quantity amount as needed (see Figure 1-2). You may alternatively enter a different quantity and select from the list of quantity units instead of from the list of packages (see Figure 1-3).

Figure 1-1. Prompt to change the quantity and unit.

Figure 1-2. List of package sizes.

Figure 1-3. Enter a different quantity.

Adjust a pending prescription

If a prescription was saved and left as pending before this DrFirst update, then you will see a warning that the quantity unit will be transmitted to the pharmacy as "unspecified" unless you edit the prescription to select a different unit (see Figure 1-4). The prescription may still be send and delivered to the pharmacy, but the dispensing may be made in an incorrect amount unless the unit is changed to a supported value.

Figure 1-4. Pending prescription warning.

Adjust a pharmacy renewal request

There is a chance that a pharmacy may send a prescription renewal request prior to September 1, 2021 that includes a retired quantity unit. When this happens, you will be warned that the unit has been deprecated. If you approve the request without changing the quantity unit, the response will be sent to the pharmacy with quantity unit "unspecified." To avoid this happening, you should select the "Modify selected" option to change the quantity on the "Prescribe education" panel.

Figure 1-5. Pharmacy renewal request update option.

Adjust a pharmacy change request

There is a chance that a pharmacy may send a prescription change request prior to September 1, 2021 that includes a retired quantity unit in one or more of the requested medications. No warning is shown to you in this case and will result in one of the two following scenarios:

1. If you approve the request for a non-controlled medication without changing the quantity unit, the response will be sent to the pharmacy with quantity unit "unspecified."
2. If you approve the request for a controlled substance without changing the quantity unit, the response will be sent to the pharmacy with the requested unit if the approval is made before September 1, 2021. If the approval is made on September 1, 2021 or after, then the response to the pharmacy will fail, resulting in the prescription being flagged as undeliverable.

To avoid either of these cases, you should select the "Modify selected" option and change the quantity unit on the "Prescribe Medication" panel.

Select a package from drug search

When you start a new prescription from a drug search, the available packages for the drug are shown next to the drug strength (see Figure 1-6). You may click one of the packages to pre-populate the quantity amount and unit on the "Prescribe Medication" panel. This is an existing feature, mentioned here as a reminder.

Figure 1-6. Prescription available packages.

Preventative action recommendations

The features shown above will help you modify prescriptions to replace quantity units that are not valid going forward. You can reduce the number of changes that must be made during the prescribing flow by taking these actions:

• Update the "Favorites" to change quantity units that are no longer valid.
• Use the "Modify suggested" action when approving pharmacy renewal or change requests that include a retired quantity unit.
• Respond to all pending controlled substance pharmacy renewal or change requests before September 1, 2021.

Retired and retained DrFirst quantity unit words

Retired quantity unit words

Retained quantity unit words