How to Prevent and Resolve Duplicate Orders

Duplicate orders on a resident’s eMAR can lead to medication errors and confusion for your clinical team. This guide covers how to identify potential duplicates before they are processed and how to clean up your MAR if duplicates already exist.

'Identify Potential Duplicates' Setting

This is a specialty setting found in your Medications Settings. It acts as a "logic check" for your Pharmacy Inbox to reduce the risk of double-entry. When enabled, ALIS automatically scans the resident’s active MAR for any orders containing matching data—such as a specific Order ID or Rx #—and flags them as potential duplicates.

This is particularly helpful if you manually created an order on the Manage Orders page before the pharmacy message arrived, or if you are undergoing a pharmacy transition and need to replace old orders with new ones.

How to Enable:

1. Navigate to Settings > Medications > Medications tab.

2. Scroll to the Specialty Settings section.

3. Move the toggle to Enabled for the Identify Potential Duplicates setting.

For enablement assistance, contact your Account Manager or our ALIS Customer Success Team. 

How do Duplicates occur? 

The most common reason duplicate orders occur is that the Identify Potential Duplicates setting is disabled, allowing overlapping orders to slip through. This typically happens in two scenarios:

• Processing as "New": An incoming pharmacy message is processed as a new schedule rather than being mapped to the existing order on the MAR.

• Manual Entry Overlap: Your team manually adds an order to a resident's Manage Orders page, and then the corresponding order from the Pharmacy Inbox is processed later.

  Note: If the 'Identify Potential Duplicates' setting is enabled, ALIS will successfully flag this overlap as long as the manual order and the pharmacy order share the same Order ID or Rx #.

Review Potential Duplicates (Specialty Setting Enabled)

When ALIS detects an incoming pharmacy message with details similar to an existing order, it will automatically prompt you to review the overlap. Follow the steps below to compare the order details and decide whether to map the order or create a new schedule.

1. Navigate to Pharmacy Inbox > Incoming Orders and click Process.

2. On the next page, you will see a Review Potential Duplicates prompt. The "Incoming Order" (from the pharmacy) will be on the top, and the "Potential Duplicate" (already on the MAR) will be below. 

3. Compare Order Details between the Incoming Order and Potential Duplicate. Review Order ID, RX #, NDC, Order Type (Routine or PRN), and Instructions. 

If order details are the SAME:

If the order contains the SAME details as an active order on the MAR, take steps to MAP the order and prevent the duplicate:

1. First, call your pharmacy. Review with them the reason they sent the order and ensure it was intentionally pushed to your inbox. If it was intentional, there may be something to merge or map to an existing order.
2. In the Resolve Duplicate pane:

   1. Click Yes to the question "Is the incoming order a duplicate?"

   2. Under "What would you like to do?", select Map to Existing Schedule.

   3. Choose the correct existing order name from the dropdown menu. This is the order you plan to merge incoming information with.

   4. Click Next: Routine Order/PRN Order.

3. On the Process Order page, a blue banner will indicate the order you plan to map it to. This allows you to maintain existing order data from the original order prevent it from creating a duplicate. 

4. Review the Rx Data (the new info from the pharmacy) in the center of the page. 

   • Important: If the previous order had manual details (Medication Tags, Vitals entry, or Min. Intervals), you must re-add them here. They do not carry over automatically.

5. Click Process Order.

Once processed, the merged order will remain on the MAR with all of this information, including history of the previous medication. 

If order details are DIFFERENT:

If the order contains different details as an active order on the MAR, you can continue processing it as a NEW order  

1. In the Resolve Duplicate pane:
   1. Click No to the question "Is the incoming order a duplicate?"
   2. Under "What would you like to do?", select Create New Schedule. 
      • If the order is incorrect or was sent by mistake: You also have the option to Dismiss the message. This will not impact the MAR, however the audit trail will go to your Pharmacy Inbox > Message History tab for your records.   
2. Click Next: Routine Order/PRN Order. 
3. On the Process Order page, go through the necessary steps to process the order fully. 
4. Click Process Order. 

Manually Resolve Duplicate (Without Specialty Setting Enabled) 

It is always important to review the Order Details of an Incoming Pharmacy message to know if you need to create a new schedule or map it to an existing order. The below steps outline how to map a pharmacy message to an existing order manually, without the specialty setting enabled. 

1. On the Process Order page below the blue page header, move the toggle from New Schedule to Map to Existing Schedule. 
2. In the dropdown menu, select the existing order name. 
3. In the righthand panel, toggle to Existing Order and click the Use Data button so that any information already added to that existing order can be saved along with the order taking its place. 
4. Verify Side-by-Side: 

   1. Center Screen: Shows the new incoming pharmacy message.

   2. Right Panel: Shows the existing order being replaced. Review the center screen carefully to ensure the Pass Meds schedule and order details are accurate before finalizing.

5. Once you have confirmed all information is correct, scroll to the bottom right and click Process Order.

The resident's MAR will reflect the updated version of the order, it will be directly linked to your pharmacy, and you will have successfully prevented the creation of duplicate orders. 

Refer to this How to Map New Pharmacy Messages to Existing Orders guide for more information.

How to resolve an existing duplicate on the MAR

If an order has already been processed and you now see two active orders on the resident's eMAR, you have a few options to clean up the record:

• Discontinue (DC) the Manual Order: If you have a manually created version and a pharmacy-linked version side-by-side, DC the manually created order. You always want to keep the pharmacy-linked version active.

• Discontinue (DC) the Duplicate: If both versions are identical, simply DC the duplicate version so only one remains active for medication passes.

• Contact ALIS Customer Success: If you need an order completely wiped from the record instead of just discontinued, contact the ALIS Customer Success Team to have the duplicate safely removed or deleted.

Related Articles: 

• How to Map New Pharmacy Messages to Existing Orders
• How to manually add a new order (Routine, PRN, Treatment, Informational)
• How to Discontinue Medications

For more assistance with Resolving Duplicates,

Contact our ALIS Customer Success Team:

888.404.ALIS (2547) or support@go-alis.com