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How to Create a New Client Order

The Client Orders page allows you to see all orders for an active client, including discontinued and completed orders. You can also create new orders for an active client from this screen.

  1. You must first have the client open, then click the Search icon.
  2. Type “Orders” into the search bar.
  3. Click to select Client Orders (Client).   

The Client Orders list page opens.

NOTE: Use any of the filters below to see a specific list of orders. 
  1. Click the New icon.
  1. This takes you to the Orders Being Modified/Discontinued window. Without selecting any orders listed in the top half of the window, click the OK button.

Note: If you select an order listed in the top half of the window and click OK, you can modify or discontinue the selected order. Refer to Modify an Order or Discontinue an Order for instructions.

Note: The medications in the Other Current Meds bottom section, allows you the active outpatient medications

  1. In the Order Entry Details section, ensure the details are correct.
    1. Note: Order Mode does not have any associated logic; it is strictly for documentation.
  2.  Type the name of the order in the search box and select the appropriate order. 
 Note:If you are unable to find a Medication order you need, click the Search Adhoc check box. The Create Adhoc Order button appears. Refer to How to Create an Ad Hoc Order for instructions.

The Order fields will become visible. Order defaults are set up by your county.

  1. Click the clock icon to see/change the set time frequencies.
  2. Enter Start Date, this refers to when order is placed, not the time of the first order. Enter an End Date as appropriate. 
  3. Click the Rationale drop-down menu to select or you can choose Other and free text the problem/diagnosis.
  4. Enter the Max Quantity Allowed in 24 Hours. This based on dose (units for pills) rather than total dose amount (mg).  There is no warning if over the limit has been administered previously.
Note: If this medication will be administered in a unit that uses the MAR, you must select the days of the week to proceed.
  1. Scroll down the Order section if you need to use the Instruction Text field or Comments field.
  2. Click Insert.
    1. The Add Additional Orders link will allow you to see or modify existing orders.
    2. The Titration Summary will only be available if your admin has set it up.
  1. Click Sign or follow the co-sign process.

Detailed Description on Other Order Fields:

Depending on setup options, different Orders will include different fields. It is always best practice to include as much specific information as is possible during the creation of Orders. Ensure that fields are completed to the best of your ability during the Order creation process.

For many search fields in Orders, you can view all currently-available options by clicking in the search field, then pressing the Backspace key.

  1. Frequency: Frequencies represent directions to the person carrying out the order. For example, Once versus twice a day.
    1. Frequencies tie to the MAR, if the order is indicated to show on the MAR. Non-PRN or frequencies more than once will tie to times to administer on the MAR   
    1. Frequencies will indicate dispense based on set up not the frequency name.
      • For example, a frequency of Q4H will not consider the start time, step 4. It will always consider time associated with the frequency. If the frequency of Q4H is set up as 1:00 am, 5:00 am, 9:00 am, 1:00 pm, 5:00 pm, 9:00 pm and order start time is 3:00 pm, the MAR will not indicate to administer until 5:00 pm. The exception to this is Now and Scheduled, see 3.b.
      • If you would like administration to begin at time or order and continue every four hours you would need to use the clock icon. 
      • To view the associated times click on the clock icon. This will open the Dispense Time pop-up window.
      • If needed, times can be updated. Click Save if they are updated.
        1. Keep in mind, changes may not correspond with med dispense rounds.

Note: There are 5 new order template frequencies available for non-lab orders in Client Orders with the starting title of “As Directed- See Instructions”

There are 4 new frequencies that have “Set X Time” as their suffix. This should be utilized when there is a complex or free text order where the time needs to be set in the MAR.  CalMHSA has made dispense time defaulted, but these can be changed by your Sys Admin. This is utilized by the clock function in Client Order Details. If “Set 1 Time” is selected then there will be only 1 time available versus if the “Set 2 Times” is selected, then there will be two times available etc.

There is a 5th one that is “As Directed as Needed (PRN) – See Instructions.”  Currently, this is set up to recur once every 24 hours from the last administration.

  1. Priority: Priorities identify the rank of the order in proportion to other orders for end users. This does not affect logic within the SmartCare system.
  1. Start: Based on schedule dropdown options the Start and End fields will change or have carry over logic.
    1. Today: Start date and time are inactive for the user.
      1. Start date and time will default to date and time the order is created after it is signed.
    1. Now and Scheduled: Start date and time are inactive for the user.
      1. This option is used for orders that will appear on the MAR (Medication Administration Record).
      2. When selected it will queue an administration at the current time before reverting to set up of the frequency.
      3. For example, TID medication is scheduled for administration at 8:00 am, 1:00 pm, and 8:00 pm. If the order is entered at 9:00 pm and Now + Scheduled is selected, the MAR will show administration for 9:00 pm and will then revert to regular TID frequency.
    1. Standing Administered Once: Start date and time are inactive for the user
        1. Start date and time will default to date and time the order is created after it is signed.
        2. This is used for orders that need to have action taken once and apply through the admission.
          1. For example, providing a walker. The walker is provided to the client and remains with the client until discharge.
    1. When equipment is received: Start and End date and time are active and can be entered by the user.
      1. should be used if order is dependent on equipment. There is no logic associated with this but used to identify this dependency
    1. Users should enter a start date and time, when system allows, and an end date if applicable.
      1. Note: If the end date is added, after the end date the order will no longer indicate to administer. However, the order is still active. To inactivate the order it has to be discontinued. 

Updated: 2/2/24