Renewing an Aborted Prescription

From a medication safety perspective, it may be preferable to require the pharmacist to 'start over' and not re-activate or "copy over" a previous prescription It may take more time, however there may be small differences in the prescriptions that may not be picked up due to confirmation bias if details of the previous prescription are simply copied over. There may also be a risk if the "copy over" functionality is not only used for the exact same prescription but also is used when only one element of a previous prescription is changed (e.g. a change in dose only). It could result in forgetting to change this one element of the previous prescription (for e.g. if the pharmacist was distracted) resulting in a medication error.

I don't think this is really a use case for actually renewing the old prescription. What the pharmacist would like and what I think makes sense is to have the ability to copy the details from an old prescription. Unless the physician actually renewed the prescription, representing this copy as a renewal in the DIS is saying more than is intended, in my opinion.

By copying the prescription instead, the user gets the benefit of not having to rekey in all of the information, but there is no concern about showing a linking of prescriptions that didn't actually occur.

We have run into this and been asked to change it as well. One of the business rules in the DIS is that only active, suspended or completed drug prescription orders may be replaced/renewed. If the status is aborted or cancelled, the order cannot be replaced or renewed. We discussed with our physician advisor and raised the following points:
• Currently in the DIS, another user could clearly see that Dr.so and so decided to stop (abort) that prescription, and could even see any notes he may have added for additional detail.
• If a user renewed against that prescription, that information is lost when the status changes. It would not be evident to any user that Dr. So and So had decided to stop the prescription and any notes added would not visible either.
• If we do not change this, the work around for other users is to create a new prescription from scratch, leaving the aborted prescription with all of the status changes and notes clearly visible on the profile.
Our physician advisor felt that the history and being able to see if another prescribed had aborted that prescription and any reasons why was important and should always be visible to users as it is clinically relevant information. The workaround was seen as reasonable.
Feel free to send me an email if you want to discuss further.

Our client has asked if we could allow an aborted prescription to be renewed. There are cases where a physician tells the pharmacist to discontinue a prescription and at a later date re-prescribes the same drug. Instead of rekeying in the prescription information the pharmacy would like to be able to renew the original prescription that was in aborted status. If that is possible they would like the original prescription to remain in aborted status instead of changing to obsolete. From what I can see in the Implementation Guide, Aborted is a terminal state but I was unable to find anything specific saying that an aborted prescription could not be renewed ( although it is implied). Has anyone encountered this before? Is it against the standard to allow a renewal of an aborted prescription?

Thanks,