E-referrals and e-prescriptions

Referrals and prescriptions are issued from the e-examination itself — in the "Referrals" and "Prescriptions" sections below "Therapy". This page describes how to fill them in, issue them and void them.

How the examination itself works: E-examination.

Before you start

• The examination must be open in NHIS, closed, or in correction. A draft (without an NRN) cannot have referrals or prescriptions — the section reads "Referrals are issued after the examination is opened in HIS." A voided examination cannot have them either.
• Issuing goes through signing with a qualified electronic signature, so work through the desktop application.
• The referral takes the diagnoses from the examination when it is issued. Fill in the "Primary diagnosis" first.

E-referral

1. In the examination, in the "Referrals" section, press "Create".
2. Choose the "Referral type" and the "Financing source".
3. Fill in the fields of the type (see the table).
4. Optionally write a "Note".
5. Press "Issue in HIS" and sign with your qualified electronic signature. On success you see "The referral was issued in HIS."

"Referral type"	What you fill in
"Medical diagnostic activities"	At least one "Medical diagnostic activity" — add the next one with "Add activity"
"Consultation with a specialist"	"Specialty"
"Highly specialized activity"	"Specialty" and "Activity code"
"Hospitalization"	"Admission type", "Directed by" and "Clinical pathway"

"NHIF referral type" is shown only when it is required — for medical diagnostic activities, a consultation and a highly specialized activity financed by the NHIF.

If you want to finish later, press "Save" — the referral stays a draft and you see "The draft was saved."

The type of a saved referral cannot be changed. To use a different type, create a new referral.

E-prescription

1. In the examination, in the "Prescriptions" section, press "Create".
2. In "Dispensation", choose "Single dispensation" or "Multiple dispensation". For multiple, fill in "Allowed repeats" as well.
3. Every medication has its own card ("Medication 1", "Medication 2" and so on). In it, fill in:
   • "Medication" and "Pharmaceutical form";
   • "Quantity" and "Unit" — "Packages" or "Pharmaceutical form";
   • optionally "Note for the pharmacist" and "Substitution allowed".
4. Fill in the dosage (see below). Add the next medication with "Add medication".
5. Optionally fill in "Dietary supplements" — vitamins, probiotics and other supplements that are not in the medication list.
6. Press "Issue in HIS" and sign with your qualified electronic signature. On success you see "The prescription was issued in HIS."

As with the referral, "Save" keeps the prescription as a draft.

Dosage

Every medication has at least one dosage. Add another one with "Add dosage".

• "Dose" and "Dose form" — how much is taken at once;
• "Times" and "Every" with a unit (hours, days, weeks, months) — how often;
• "Duration" with a unit — for how long;
• "When to take" — you can choose several, morning and evening for example. "Times" matches the number of times of day you chose, unless you change it by hand. Once you choose a time, "Minutes offset" appears as well;
• "Route" and "Instructions";
• "As needed" — when the medication is taken as needed.

Below the dosage is "Text in HIS" — the text that is sent to NHIS with the prescription. While the dosage is incomplete, it reads "Appears once the dosage is complete."

Patient address

Under "Patient address" the referral and the prescription show the address from the examination. When the examination lacks a part of the address the document requires, the note "The examination has no address for this document — it is saved in the examination too." appears there, with the fields for what is missing — "Province", "Settlement (EKATTE)" or "City". "Save" and "Issue in HIS" save the address in the examination too.

What you see in the examination

Every document is a row in its section:

Label	What you can do
"Draft"	"Edit" — continue filling it in; delete
"Issued in HIS"	The NRN with a copy button; "Void"
"Voided"	—

An issued document cannot be changed. To fix a mistake, void it and issue a new one.

note

When a document is issued after an NHIF examination is closed, the examination does not list the document yet, and the section shows "Issued after closing: send a correction so that the examination lists it for the NHIF report." Correct the examination and send the correction — see Correcting a closed examination.

Voiding a referral or a prescription

1. Press "Void" on the document row.
2. The window shows what you are voiding and its NRN. Fill in "Reason for cancellation".
3. Press "Cancel referral in HIS" or "Cancel prescription in HIS".

Before you void the examination, void the referrals and prescriptions issued for it.

Related topics

• E-examination
• NHIS (HIS BG)