Cloud Practice

The Digital Health Drug Repository – commonly named DHDR – provides access to patients’ medication dispense information covered under the ODB program (including OHIP+), drugs that are considered narcotics or controlled substances, as well as COVID-19 vaccination information directly from your EMR. It also provides pharmacy services information such as medication reviews.

To access DHDR, your clinic must be registered with OntarioMD and have configured their EMR EHR details.

Accessing DHDR

DHDR is launched in context from the patient’s chart in the Juno interface. This means you must first navigate to the patient chart before you launch the platform.

Locate and click on the ‘EHR’ button located towards the top right of the chart to launch DHDR.

An overlay will appear with a few options. Ensure ‘DHDR’ is selected. Select the appropriate authority using the ‘Accessing on behalf of’ drop down towards the bottom if applicable (see note). When ready, click on the ‘Connect to EHR’ button to move on to the next step.

Note: Most clinics will have a single authority. The drop down will not appear if you only have one authority configured in your EMR. Multiple options will be displayed if you have registered relationships with multiple authorities at this specific clinic with Juno EMR.

Upon clicking on the ‘Connect to EHR’ button, a new window will open. The ONE ID login page will appear on the screen. Enter your login ONE ID login identifier and password, then click on the ‘Login’ button to continue.

Connecting to ONE ID requires two-factor authentication. Proceed with the full authentication process to fully connect to EHR. The DHDR information will be visible within Juno itself once you are successfully logged in.

Navigating in the DHDR Window

Once you are logged in, you will be brought to the patient’s DHDR view. It will look like this:

Several sections are identified in orange above. Refer to the guide below to get familiar with the various parts of the DHDR window.

A) Warning Messages

Warning messages will appear at the top of the screen. They can be dismissed after being read by clicking on the ‘X’ on the right-hand side of the warning message. Dismissed messages will come back after a time if they are still applicable.

B) Drug Dispense / Pharmacy Services Toggle

This toggle allows you to navigate between two different views: the drug dispense view and the pharmacy services view. The toggled view can be identified by its blue background and white font. In the screenshot above, for example, the ‘Drug Dispense’ is selected and that is what the screen displays.

Drug Dispense

The Drug Dispense page shows the dispense of medications from specific pharmacies. Details such as the date, the medication (both brand and generic), class and dosage will be visible on the screen.

A summary of each dispense is visible in the table located further down the page (see example below). Clicking on any medication will provide additional information regarding the dispensed medication.

A medication dispense summary.

 A medication dispense details (expanded view).

Pharmacy Services

The Pharmacy Services page shows information pertaining to pharmacy services provided to the patient. The service date, type and description are listed on the page, along with the pharmacy/pharmacist which provided the service.

C) Comparison View

The Comparison View shows both the dispensed drug, or the pharmacy services, and the medications prescribed within your Juno EMR platform. The dispensed drugs / pharmacy services will show first, followed by a ‘Prescribed’ section.

To know whether comparison view is enabled or not, look at the toggle. If the toggle is grey with a white square on the left, then comparison mode is disabled. If the toggle is blue with a right square on the right, comparison mode is enabled.

D) Group By Generic Name

When enabled, the group by generic name functionality groups all entries by the medications’ generic name and strength. This ensures you can easily track dispenses for a specific medication overtime.

The most recent dispense of each group will be shown on the screen. You will find the number of dispense on the right of the header bar. Clicking on the bar will expend the display and show all dispenses for this medication.

To know whether group by is enabled or not, look at the toggle. If the toggle is grey with a white square on the left, then group by mode is disabled. If the toggle is blue with a right square on the right, group by mode is enabled.

E) Print

The Print functionality allows you to easily print the list of entries you are currently looking at.

F) Filters

Not seeing older prescriptions? Looking to narrow down the list you are seeing further? Adjust the search filters by clicking on the ‘Show Filters’ button.

Select your desired filters, then click on the ‘Apply Filter’ button to filter the results. Use the ‘Reset Filters’ button to return to the default filters.

Blocked Access

Some patients may have blocked access to their Drug and Pharmacy Service information. In these cases, you will receive the following error message:

You can process with accessing the DHDR record for the patient if they provide permission. This will temporarily lift the block. In order to do so, you must be using Chrome. The override process will not work on Firefox ESR. The override process is described below.

The patient must provide permission for you to access their information. If they refuse, click the ‘Refuse’ button to return to the previous view.

If they accept, click on the ‘Continue’ button. This will initiate the consent process.

Select ‘Meds’ under the ‘Which records to you need?’, then select who consented to lift the block. Click on the ‘Print Form’ button and print a copy of the consent form. The patient must sign the form, and you must keep the signed copy on record afterwards.

Check the box confirming you have a printed and signed consent form, then click the ‘Unblock Records’.

The block will be temporarily lifted, and you will have access to the DHDR information for the duration of the lift.

Notes

You will remain logged in to EHR for a time. You will not need to login again each time you access DHDR so long as you remain logged in to Juno EMR. You will be automatically logged out of EHR when you log out of Juno.

If you want to log out of EHR, but keep your Juno EMR session active, navigate to a patient chart, then click on the ‘EHR’ button. Click on the ‘Disconnect’ link which is now visible under the ‘Connect to EHR’ button. The ‘Disconnect’ link is only visible when you are logged in to the platform.