5.6 First Databank and Micromedex Cleanup Steps for Customers with PHA and RXM

Transcription

1 5.6 First Databank and Micromedex Cleanup Steps for Customers with PHA and RXM This article outlines the steps for cleaning up recycled NDCs in the Pharmacy and RXM application in the 5.6 release for customers who use the Formulary Service Vendor (FSV) of First Databank or Micromedex. Steps are also provided for reviewing mismatched trade names in RXM. If you are populating your RXM Drug dictionary with FSV content, you should already have started by ensuring that your RXM Drug dictionary has been populated with the same FSV monthly or quarterly data file as your Pharmacy Drug dictionary. For example, if you have updated the PHA Drug dictionary using the monthly June FSV data file, an RXM FSV update for the June file should also be completed. Please contact your RXM Specialist if you need any assistance with the RXM FSV update process. Do not move onto the next steps until you have PHA and RXM utilizing the same FSV content. Please notify your specialist as you complete each step so the checklist added to the beginning of your task can be updated. 1. Upon receipt of appropriate change control for PHA and RXM and confirmation PHA and RXM are using the same FSV content, MEDITECH will deliver necessary PHA and RXM DTSs. These changes will also include the following PHA and RXM utilities which will be run by your PHA and RXM Programmers at MEDITECH. The utilities will be run as follows: 1a. Receive PHA utility to identify any drugs in your PHA Drug Dictionary that are currently associated with an invalid numeric generic name. If the PHA drug has a usage of RETAIL, the utility will remove the drug from the Drug dictionary. It will be replaced with a correct version of the drug with the next FSV update. If the drug has a usage of FORMULARY or NON-FORMULARY, then you will receive a list of these PHA drugs from your PHA Specialist. The list will be attached to the files portion of the task to be used later in the cleanup process. 1b. Receive PHA utility to identify any RETAIL drugs in your PHA Drug Dictionary with an NDC no longer supported by your FSV. If there are any RETAIL drugs in your PHA Drug Dictionary with NDCs no longer supported by your FSV, these NDCs will be inactivated by the utility. 1c. Receive RXM utility to identify any drugs in your RXM Drug Dictionary that are currently associated with an invalid numeric generic name. If located, RXM Programming will need to run a corrective numeric generic loop to update these RXM Drugs with valid generics in step 20. Note: Results of utilities will either be attached to the task as a file or the list copied into the task for future reference. 2a. Once the DTSs and utilities have been delivered, prior to beginning your recycled NDC and mismatched trade name clean up, use the steps provided in the task to perform allergy and interaction checking testing. 2b. Validate your PHA Drugs are utilizing NDCs supported by First Databank or Micromedex. To do this, run the PHA FSV Non Matching List for your latest run to identify those drugs without NDCs or with inactive NDCs. These drugs should be updated with a valid NDC in the PHA Drug dictionary. Please reference Knowledge Base Article for additional information regarding the PHA FSV Non Matching List.

2 3. Identify recycled NDCs in PHA and RXM using the new PHA Generic Integrity Report and RXM Generic Integrity Report. These reports will compare the raw FSV Generic Name with the PHA Generic Name to identify those NDCs that could potentially have been recycled and may be corrupted. If there is a mismatch between the FSV and PHA Generic Name, the NDC will appear on this report. These reports will only be needed for the initial cleanup and not for future FSV updates. It is likely you will receive many NDC hits on the report where the FSV and PHA Generic Name are the same but due to slight naming differences will appear as a mismatch on the report. These should be considered false positive hits and can be ignored. The report sorts the generics alphabetically by name so these can easily be identified and ignored. Those NDC hits on the report where the FSV and PHA Generic are two different drugs will need to be addressed using the cleanup steps below. 3a. To access the PHA Generic Integrity Report it must added to a custom menu in PHA (DPM.Procedure is PHA.DRUG.compare.drug.generics). You must run this report with the "Include Retail Drugs?" and "Include Drugs Not on Current Suspense File?" fields set to N. Identify those NDCs where the FSV and PHA Generics are two different drugs and save this list for the manual PHA cleanup in step 7. 3b. The RXM Generic Integrity Report can be accessed from the RXM Report Menu. You must run this report by "BOTH" Active and Inactive RXM Drug entries. The number of entries on this report will help in determining whether or not your organization will perform a manual RXM cleanup or an expunge assisted cleanup. Important Note: You must run the RXM Generic Integrity report before the PHA cleanup is started. Once a recycled NDC is edited in PHA, RXM will lose the data needed to run the appropriate checks to identify recycled NDCs. 4. Identify RXM NDCs with mismatched Trade names using the new RXM Trade Name Integrity Report. This report will identify any RXM Drugs in your RXM Drug Dictionary that have a different Trade Name than the Trade Name provided by your FSV. If there is a Trade Name mismatch, the NDC will appear on this report. This report will only be needed for the initial cleanup and not for future RXM FSV updates. It is likely you will receive many NDC hits on the report where the Trade Names are the same but due to slight naming differences will appear on the report. These should be considered false positive hits and can be ignored. Only those NDCs where the two trade names are the same drug (same generic, same active ingredients) but are associated to two different products will need to be addressed using the cleanup steps below (e.g. Benadryl Children's Allergy w/red dye vs Benadryl Children's Allergy dye free). 4a. The RXM Trade Name Integrity Report can be accessed from the RXM Report Menu. You must run this report with the "Print" field to "MISMATCHES" and the "Active" field to "ACTIVE". 5. Determine whether or not your organization would like to proceed with an RXM Drug Dictionary Expunge/Deindex. The recycled generic and mismatched trade name issue will require you to perform an integrity check on all drugs (Active and Inactive) in the RXM Drug Dictionary. Due to the potential impact of these Priority issues on RXM functionality, as well as resources, it was determined that an Expunge/Deindex routine will be standardly offered. The RXM Drug Dictionary Expunge/Deindex toolbox routine will allow customers to expunge RXM drugs that are not on a patient file, with options to not expunge RXM drugs associated to user favorites, Order Sets, Favorites Sets or Office Injections. This routine will reduce the quantity of drugs requiring integrity cleanup, as well as assist our customers

3 with ensuring their RXM Drug Dictionaries reference valid internal and external data. Things to consider when evaluating an RXM Expunge: - Expunge will NOT impact RXM Drugs (active or inactive) associated to a patient's record - Reduce the quantity of drugs requiring integrity checking and cleanup - Potential to rebuild RXM dictionaries for optimal interaction checking and eprescribing via DrFirst - May opt to keep RXM Drugs linked in other RXM Dictionaries to reduce rebuild *RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary - Expunge options do *not* include check for existing strings on RXM Drugs - If opt to expunge drugs that impact other RXM Dictionaries, list of impacted dictionaries can be provided for rebuild - Listing of drugs ineligible to be expunged can be provided for required integrity checking and clean up prior to expunge - Have option to inactivate and de-index RXM Drugs ineligible to be expunged and load completely new content, or stay LIVE with "leftover" drugs and perform RXM FSV Update to recreate full drug content - Inactivate/Deindex will result in having to "replace" when renewing prescriptions, must evaluate impact on provider workflow Please let your RXM Specialist know which RXM Cleanup Option you would like to proceed with: Option 1. I do not want to expunge any RXM Drugs in my RXM Drug Dictionary. I will use the RXM Generic and Trade Integrity reports to identify corrupted NDCs in my RXM Drug Dictionary and proceed with the manual cleanup steps outlined below. If you have chosen this option, please proceed to step 7. Option 2. My organization is LIVE with RXM and I would like the maximum number of drugs to stay in my RXM Drug Dictionary. This means that MEDITECH will not expunge any RXM drugs associated to a patient's record. MEDITECH will also not expunge any RXM Drugs associated to requested cross referenced RXM dictionaries (RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary). MEDITECH will provide me with a listing of drugs that are ineligible to be expunged (drugs that will remain in my RXM Drug Dictionary because they are associated to a patient or a cross referenced dictionary) as well as a listing of drugs that will be expunged from my RXM Drug Dictionary that impact cross referenced dictionaries. Option 3. My organization is LIVE with RXM and I would would like to expunge as many RXM Drugs as possible from my RXM Drug Dictionary. This means that MEDITECH will only keep RXM Drugs that are associated to a patient's record. MEDITECH will expunge everything else, including RXM Drugs associated to cross referenced dictionaries (RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary). MEDITECH will provide me with a listing of drugs that are ineligible to be expunged (drugs that will remain in my RXM Drug Dictionary because they are associated to a patient) as well as a listing of drugs that will be expunged from my RXM Drug Dictionary if associated to a cross referenced dictionary. MEDITECH will also provide me with an option to inactivate and de-index any RXM Drugs that are ineligible to be expunged. Option 4. My organization has RXM in TEST and we have been actively building. I would like the maximum number of drugs to stay in my RXM Drug Dictionary in TEST. This means that MEDITECH will not expunge any RXM drugs associated to a patient's record. MEDITECH will

4 also not expunge any RXM Drugs associated to requested cross referenced RXM dictionaries (RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary). MEDITECH will provide me with a listing of drugs that are ineligible to be expunged (drugs that will remain in my RXM Drug Dictionary because they are associated to a patient or a cross referenced dictionary) as well as a listing of drugs that will be expunged from my RXM Drug Dictionary that impact cross referenced dictionaries. Note: This is similar to Option 2, but due to TEST build, a full cleanup in RXM TEST is required to facilitate a future copy of content to LIVE. The status of RXM Drug string build should be considered. If drugs with strings are attached to template user favorites per best practice recommendations, setting expunge to keep favorites will be important. If drugs with strings are not in a cross referenced dictionary, RXM Drug Dictionary entries with strings build would likely be expunged. Option 5. My organization is currently stagnant with RXM but we have gone LIVE with RXM in the past. I would would like to expunge as many RXM Drugs as possible from my RXM Drug Dictionary. This means that MEDITECH will only keep RXM Drugs that are associated to a patient's record. MEDITECH will expunge everything else, including RXM Drugs associated to cross referenced dictionaries (RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary). MEDITECH will provide me with a listing of drugs that are ineligible to be expunged (drugs that will remain in my RXM Drug Dictionary because they are associated to a patient) as well as a listing of drugs that will be expunged from my RXM Drug Dictionary that impact cross referenced dictionaries. MEDITECH will also provide me with an option to inactivate and de-index any RXM Drugs that are ineligible to be expunged. Note: MEDITECH recommends organizations stagnant with RXM do not reload FSV content into RXM after an expunge/deindex until ready to perform regular FSV updates and maintenance. Option 6. My organization is currently stagnant with RXM and never brought functionality LIVE and I would would like to expunge as many RXM Drugs as possible from my RXM Drug Dictionary. This means that MEDITECH will only keep RXM Drugs that are associated to a patient's record, in the event that functionality was utilized but no one was aware. MEDITECH will expunge everything else, including RXM Drugs associated to cross referenced dictionaries (RXM User Defaults, RXM Favorite Sets, RXM Order Sets, RXM Procedure Dictionary). MEDITECH will provide me with a listing of drugs that are ineligible to be expunged (drugs that will remain in my RXM Drug Dictionary because they are associated to a patient) as well as a listing of drugs that will be expunged from my RXM Drug Dictionary that impact cross reference dictionaries. MEDITECH will also provide me with an option to inactivate and de-index any RXM Drugs that are ineligible to be expunged. Note: MEDITECH recommends organizations stagnant with RXM do not reload FSV content into RXM after an expunge/deindex until ready to perform regular FSV updates and maintenance. 6. If you have chosen from expunge options 2-6, your RXM Specialist will work with you on confirming your RXM Drug Dictionary Expunge/Deindex toolbox parameters. Once your parameters are confirmed, your RXM Specialist will run the IDENTIFY process for the Expunge/Deindex Drug routine in your RXM Toolbox parameters. Based on the expunge criteria you have chosen in step 5, this RXM Toolbox routine will identify the drugs that that will/will not be expunged from your RXM Drug Dictionary.

5 6a. Your RXM Specialist will ask you to respond to the following Y/N "IDENTIFY" parameters to determine how many RXM drugs will/will not be expunged based on your responses: Do you wish to EXPUNGE RXM drugs filed as......as user favorites? (Y/N)...in RXM Order Sets? (Y/N)...in RXM Favorite Order Sets? (Y/N)...as Office Injection Medications in the RXM Procedure dictionary? (Y/N) If Yes to above, do you wish to INACTIVATE Office Proced that have drugs removed by the EXPUNGE? (Y/N) Include listing of drugs ineligible to be expunged? (Y/N) 6b. RXM Specialist will then dial into your RXM Toolbox and run the IDENTIFY routine based on your responses in 6a. 6c. RXM Specialist will instruct you to review the report. You can access this report directly from your RXM Reports Menu by accessing the Expunge/Deindex Drugs Report. At the 'Print On' prompt you can choose to PREVIEW or DOWNLOAD. If you choose to DOWNLOAD, you will need to hit your F9 key to choose where you would like to save the file. When you are prompted to enter a file name, you must put in a file extension after the title (.RTF, or.xls). We recommend that you suppress page banners and form feeds. Please review this report and determine if you would still like to proceed with an RXM Drug Dictionary Expunge. If you would like to review a report based off of different IDENTIFY parameter responses, please provide these new responses to your RXM Specialist so that he/she can reset these for you. 6d. Repeat steps 6a-6c if you want to re-run the report based on a different set of expunge parameters. Otherwise, proceed to step 6e. 6e. Let your RXM Specialist know if you want to proceed with an RXM Drug Dictionary Expunge (this will need to be performed in TEST first). The expunge/deindex will be incorporated into the process as you proceed with your manual cleanup. Important Note: The RXM Generic and Trade Integrity reports must be run before proceeding with PHA cleanup in step 7. Once a recycled NDC is edited in PHA, RXM will lose the data needed to run the appropriate checks to identify recycled NDCs. 7. To cleanup the PHA Drug Dictionary: Using the PHA Generic Integrity report from step 3a locate the recycled NDCs in the PHA Drug Dictionary. If the drug is a Formulary or Non-Formulary medication, you must replace the existing primary NDC with a NEW NDC number. This NEW NDC should represent a drug which is substantially equivalent to the data formerly associated with the original NDC number. For example: PHA Drug Mnemonic: DOXA2TAB NDC used to be: Generic Name: Doxazosin Mesylate

6 This NDC was then recycled by the manufacturer and NDC is now: Generic Name: Venlafaxine Hcl In this example, access the drug mnemonic DOXA2TAB in the PHA Drug dictionary and replace the primary NDC with a NEW NDC that represents Doxazosin Mesylate. 8. To clean up the RXM Drug Dictionary: Note: If expunging RXM, the only RXM Drugs to check for manual cleanup are those that appear after the final "Identify" run on the Expunge/Deindex Drugs report. Any drug that is ineligible to be expunged must be cross checked with the integrity reports as noted below. 8a. Using the RXM Generic Integrity report, locate the recycled NDCs in the RXM Drug Dictionary (e.g. CARDURA2 MG, NDC ) and replace the NDC that represents a drug which is substantially equivalent to the data formerly associated with the original NDC number (Doxazosin Mesylate). The NDC must be pulled from your suspense file to ensure that the drug continues to be maintained by the RXM FSV Update process. If you are unfamiliar with this process please reference linked KB article If you are unable to replace the NDC, strip the PHA Drug Mnemonic and NDC from page 1 of the RXM Drug Dictionary and inactivate the recycled RXM Drug entry. 8b. Using the RXM Trade Integrity report, locate the mismatched Trade name NDCs in the RXM Drug Dictionary and replace the NDC that represents a drug which is substantially equivalent to the data formerly associated with the original NDC number. If you are unable to replace the NDC, strip the PHA Drug Mnemonic and NDC from page 1 of the RXM Drug Dictionary and inactivate the mismatched RXM Drug entry. 9. If your organization is at a release LOWER than noted below based on platform and formulary service vendor, or has not performed a PHA FSV update since going up with the noted release, perform step 9a. If above the noted release with a PHA FSV update having been completed, please proceed to step 10. Releases requiring Step 9a if LOWER than: MAGIC FDB: 5.62 PP19, 5.63 PP19, 5.64 PP4, 5.65 PP0 MAGIC MDX: 5.62 PP19, 5.63 PP20, 5.64 PP5, 5.65 PP0 CS FDB: 5.64 PP19, 5.65 PP2 CS MDX: 5.64 PP21, 5.65 PP5 9a. Re-Load and file your existing First Databank or Micromedex files into PHA. For example, if you receive FSV files on a monthly basis this would be the June file set. This will establish a baseline "Date of Add" (DOA) on existing PHA NDC's which will be used to identify recycled NDCs. If you have not previously done so, you should run the PHA FSV Non Matching List to see if there are any drugs with invalid NDCs as these drugs will not have a DOA. These drugs should be updated with a valid NDC in the PHA Drug dictionary. If required to re-load FSV content into PHA, an RXM update to the same run must also be performed.

7 10. Prepare for FSV Updates and Expunge: - Plan RXM rebuild *Review RXM Drug Dictionary Best Practices: Prescription and Ambulatory Order Management Drug Dictionary Build Recommendations *Prepare to load FDB POEM strings or manually add drug strings on new RXM Drugs *If expunging favorite drugs in RXM User Defaults, prepare list of common orderables/existing favorites *Evaluate order sets, favorite order sets, and office procedures impacted by expunge - Determine potential downtime process if inactivating and deindexing "leftover" drugs *Check access and prepare users for free text med entry - Evaluate/Update PHA FSV Parameters for optimal RXM use: *Monographs, Dose Ranges, Drug Types, Medication Forms, Drug Classes, "Get From" for Drug Type and Drug Class *Set RXM Parameter to control baseline dose strings (CS sites may require CS RXM 4365) - Review PHA FSV Update process recommendations with specialist: *Load, Fix, Delete, Re-Load, File 11. Once you receive your next FSV file set, load the FSV files into PHA. For example, if you receive FSV files on a monthly basis, this would be the July file set. DO NOT file at this time. Important Note: If your facility is Version 2 Allergies and/or utilizing RX Norms, please remember to update your allergy and Rx Norms content before loading the FSV files (Knowledge Base Article 38336). Also, each quarterly/monthly CD from First Databank or Micromedex contains unique recycled data, which is not repeated on subsequent CDs. Therefore, it is very important from this point forward to load each update CD from First Databank or Micromedex, and not to skip any. 12a. Conduct the appropriate steps between your PHA FSV load and filing process. (e.g. print the Price Comparison report, FSV Non Matching list, and Errors list). 12b. Print the new PHA List Recycled NDC Numbers report located off of your PHA Formulary Service Menu. Pull in your run from step 11 and respond "N" to "Include Retail Drugs?" when running the report. The report will identify drugs with NDCs that have been recycled within the last month or quarter depending on your FSV contract. The report will include the recycled NDC, the OLD MNEMONIC, and the NEW MNEMONIC. The OLD MNEMONIC is the mnemonic of the PHA Drug dictionary entry that was formerly associated with the NDC and stripped of the NDC number during the filing process. The NEW MNEMONIC is the mnemonic of the new PHA Retail Drug dictionary entry created during the filing process and now associated with the NDC. If the report identifies any formulary drugs with recycled NDCs, locate and fix the OLD MNEMONIC drug in the PHA Drug dictionary by adding a new NDC. The new NDC should represent a drug which is substantially equivalent to the data formulary associated with the original NDC number. Fixing these drugs, deleting the run, re-loading the same FSV content, and THEN filing in PHA will ensure any PHA Formulary drug with a recycled NDC are not impacted by filing the run. Important Note: The PHA List Recycled NDC Numbers report should be run with each FSV

8 update performed from this point moving forward. 13. If you make any edits to the PHA Drug dictionary as a result of the PHA FSV Non Matching List, PHA List Recycled NDC Numbers, or any other FSV report, in step 12, you must delete the run from step 11, verify a new PHA run, and reload the FSV files for PHA. If you do not make any edits to the PHA Drug Dictionary, please proceed to step 14a. 14a. File the final, "fixed" FSV run into PHA. If there are any Recycled NDCs present on any drugs in the PHA Drug dictionary upon initiating the filing process the system will automatically perform the following. This includes all drugs in your PHA Drug Dictionary (Formulary, Non-Formulary, and Retail drugs). PHA will delete the recycled NDC off of the existing PHA Drug dictionary if it is the primary NDC (alternate NDCs list on page four of the Drug dictionary will not be auto-deleted, manual review will be necessary). PHA will then create a brand new PHA Retail Drug for the same NDC with the new drug data. 14b. You will be able to again print the PHA List Recycled NDC Numbers report which will list any drugs that were stripped of their NDCs, in case the entry was not corrected before re-loading and filing the fixed FSV run. 15. Conduct the steps normally taken after the PHA FSV file completes (e.g. run the Errors list). 16. If applicable, reference the list of drugs with invalid numeric generics under the files portion of the task from step 1a. For each drug on the list, replace the invalid numeric generic in the PHA Drug dictionary with the proper generic. 17. If expunging your RXM Drug Dictionary, proceed with the following steps: 17a. MEDITECH will back up your RXM Dictionary content. 17b. RXM Specialist will obtain change control to run the RXM Drug Dictionary Expunge routine in your RXM Toolbox to expunge your RXM Drug Dictionary based on the Expunge parameters you outlined in step 6a. Once the expunge has completed, your RXM Specialist will ask you to review your RXM Drug Dictionary post expunge. 17c. Re-run your RXM Generic and Trade Integrity report post RXM Drug Dictionary Expunge via your RXM Reports Menu. Remember to run the RXM Generic Integrity report on BOTH Active and Inactive entries. Important Note: The RXM Generic and Trade Integrity reports must be re-run after the expunge to ensure any drugs added to patients between the initial Identify and final Expunge are listed for integrity checking. 18. Go to RXM and perform an RXM FSV update as you normally would. Replace your existing RXM run with the PHA run from step 14 to the "Current Formulary Service File" field located on page 1 of your RXM Customer Defined Parameters. Re-file your RXM Customer Defined Parameters to trigger the update:

9 -You will be prompted with, "Formulary Service file has changed and information will be updated. Continue?" Answer "Yes" to this question. -You will then immediately be prompted with the message "Auto-load New Drugs from formulary?" MEDITECH's recommendation is to answer "Yes" to this question. If you answer "No," no new RXM drugs will be created in your RXM Drug Dictionary. -You will then immediately be prompted with the message "All New Drugs will be loaded, are you sure?" Answer "Yes" to this question. During the FSV Update, the RXM system will now automatically check to see if the NDCs in your RXM Drug Dictionary are in the new PHA recycled NDC index. a. If an RXM drug's NDC is in the new recycled NDC index, the RXM system will search the FSV suspense file for another NDC with the same FSV generic product code and FSV Trade Name and replace the NDC on the RXM Drug entry. If an NDC is edited during this process, this NDC will show up on your RXM Formulary Service Report as an "NDC Number Change." b. If the RXM system is unable to locate a replacement NDC, RXM will inactivate the RXM drug and list this drug on the RXM Formulary Service Update report as "inactivated". This RXM Drug will also be flagged on the report as "NDC recycled". Please note, if you try to reactivate this drug in the RXM Drug Dictionary, the user will be prompted with a warning "NDC has been recycled, reactivation is not recommended. Continue?" 19. Conduct the steps normally taken after the RXM FSV Update completes and run the Formulary Service Update Report located off of your RXM Reports Menu. a. If applicable, you may compare the NDC's listed on the PHA List Recycled NDC Numbers to the "inactivated" NDC's located on your RXM Formulary Service Update Report and check to see if any of NDC's under the "inactivated" header also have the "NDC recycled" flag. b. If any NDC's on this report meet the criteria from step 14, try to reactivate this recycled RXM Drug in the RXM Drug Dictionary by setting its "Active" flag from Y to N. Confirm that you receive "NDC has been recycled, reactivation is not recommended. Continue?". c. Search the FSV Update report by "NEW DRUGS CREATED." If applicable, confirm that you do not have any new RXM Drug Mnemonics on the report that have a mnemonic with the text "(None)". If you find any new RXM drugs with the text of "(None)", contact your RXM Specialist. 20. If your RXM Programmer identified any invalid numeric generics in step 1c, please inform your RXM Specialist that the RXM FSV update is complete. Your RXM Specialist will then work with you on obtaining change control for RXM Programming to run a numeric generic cleanup loop to replace the numeric generic with a valid generic. You have now completed the generic integrity cleanup and first review of the recycled NDCs. 21. If expunged RXM, begin rebuilding for LIVE use: - Load FDB POEM strings or manually add drug strings on new RXM Drugs - Favorite drugs in RXM User Defaults, prepare list of common orderables/existing favorites - Order sets, favorite order sets, and office procedures as needed Important Note: Steps will need to be completed with every FSV update from now

10 and moving forward. It is vital to not skip an FSV update CD and to update RXM each time PHA is updated.