Processing Pharmacy Orders Reference Guide

After a resident has been mapped between the pharmacy and ALIS, the next step is to process each resident's orders. When processing an order in ALIS, you verify the order details sent from the pharmacy and manually add the information that will display in Pass Meds and on MAR documents.

About Processing Orders

After a resident has been successfully mapped between the pharmacy and ALIS, the next step is to process their incoming medication orders. Processing an order verifies the details the pharmacy sent and lets you add information that displays in Pass Meds and on Medication Administration Record (MAR) documents.

ALIS fills in many order details from the structured data pharmacies send, but most orders still need manual adjustments. You commonly set up features such as patch administration, injection sites, vitals checks, or special scheduling. Processing each order keeps the resident's MAR accurate and in sync with the pharmacy.

Processing an order involves three key steps:

1. Review the information the pharmacy sent: medication name and strength, prescriber, instructions, and route.
2. Add or update order details, such as instructions for med passers, scheduling adjustments, and safety checks like vitals or pain level tracking.
3. Click Process Order to add the medication to the resident's MAR.

When You First Connect Your Pharmacy

Once your pharmacy integration is activated and residents are mapped, each resident's active pharmacy orders appear on the Incoming Orders tab. Processing this first batch can take several hours depending on community size, so plan time for it before your eMAR go-live date.

After initial setup, the Incoming Orders tab works like an inbox. Only new, updated, or discontinued orders appear, and each one leaves the queue once you process or dismiss it. Review it regularly to keep each resident's MAR up to date.

Incoming Orders Tab

All order processing starts on the Incoming Orders tab of the Pharmacies page. You can click Process on an order directly from this tab, or click View All Orders to see and process all of one resident's orders on a single page. View All Orders is especially helpful when a resident has multiple orders waiting to be processed.

View All Orders page

The View All Orders page shows every pharmacy message for one resident, organized into four sections:

• Resident Details: Key profile information, such as Diagnoses and Allergies, to help confirm order safety while processing.
• Unprocessed Orders: Pharmacy orders that still need processing.
• Current Orders: All orders active on the resident's MAR. Use this section to spot duplicates or confirm existing medications.
• Process History: Previously processed pharmacy messages for this resident. 

Process Medication Order Page

Click Process next to an order, from either the Incoming Orders tab or the View All Orders page, to open the Process Medication Order page. 

The page is organized top to bottom in the order you typically work through it:

• Top of the page: Resident health details, the order type, schedule mapping options, and the original pharmacy message.
• Order Information: The medication, drug package, and prescriber. The pharmacy usually fills this in.
• Order Details: Details you add, such as diagnosis, Product Expiration and Use By dates, Medication Tags, Service Level, and safety checks, plus the route and instructions the pharmacy sent.
• Scheduling: Scheduling & Dosage for Routine orders, or Administration & Dosage for PRN orders.
• Med Pass Scheduling Information: Advanced settings that rarely need changes. 

When you're finished, click Process Order at the bottom of the page. Each section is described in detail below.

Top of the Page

1. Resident Health Details and Med Cart

Review basic health details about the resident. You can also update the Med Cart for this resident. See the Med Carts guide. 

2. Order Type

A blue bar at the top indicates whether the order is interpreted as Routine or PRN. Because pharmacy instructions may vary, ALIS may occasionally interpret the order type incorrectly. If necessary, you can select Convert to Routine or Convert to PRN. This keeps the pharmacy data but updates the scheduling section to match the selected order type.

3. Schedule Mapping Options

There is a toggle to create a New Schedule or Map to Existing Schedule. You can choose between:

• New Schedule (default): Creates a new order schedule for the medication. (Often, and especially as you are getting started with your pharmacy connection, you will keep this default). 
• Map to Existing Schedule: Links the pharmacy order to an existing order in ALIS to avoid duplicates. This option is commonly used when transitioning from another pharmacy integration, or if a medication was previously entered manually. For more information about mapping orders, read this Map New Pharmacy Messages to Existing Orders guide. 

4. View Rx Message

This button displays the original pharmacy message, including data such as the pharmacy technician who entered the order.

Order Information

The required fields across the Order Information and Order Details sections are Medication Name, Route, and Instructions. All other fields are optional. This section typically pre-populates with pharmacy-entered data, though the exact fields can vary based on your integration type.

Medication Name

Usually populated by the pharmacy and should not need editing.

RX NDC

Links the order to the National Drug Code directory, which can provide medication images and adverse effect information. This requires the ALIS Drug Database to be enabled. See the ALIS Drug Database Reference Guide, and contact your Account Manager for enablement assistance.

Drug Package

Populated automatically from the order's NDC number.

Equivalent to

A brand name equivalent for a generic medication. It displays in Pass Meds to help med passers recognize the medication. Whether the pharmacy fills this in depends on its software.

Prescriber (multiple fields)

The pharmacy usually supplies the prescriber, though some pharmacy connections have limitations. If the prescriber is correct, leave Update prescriber for this order set to Use Existing. To make a correction:

• Use Existing: Choose a prescriber from Community Contacts.
• Create New: Add a new prescriber contact.

Order Details

This section is optional and cannot be filled in from the pharmacy's data, but completing it is recommended for clearer medication administration. Details entered here appear in Pass Meds and on the MAR and Physician Order documents. Some features, such as Check Vitals, create required entries in Pass Meds.

Goal, Diagnosis\Indication, & Physical Description 

• Goal: The physician's stated goal for the medication. Not commonly needed, but some states require it.

• Diagnosis \ Indication: Displays on Physician Order documents. Recommended for all orders, and required by some states.

• Physical Description: A description of the medication's appearance. Rarely needed.

Patch & Injection

• Patch: For patch orders, set the toggle to Yes and type a General Patch Application Location. Pass Meds then requires the med passer to enter the patch location and shows the previous location and step. In the Scheduling & Dosage section you can also schedule which administration time applies, removes, or replaces the patch.

• Injection: For injection orders, set the toggle to Yes and type a General Injection Location. Like patches, Pass Meds requires the med passer to enter the injection site and shows the previous site.

Medication Tags

Check all tags that apply. Tags display as badges throughout ALIS, such as in Pass Meds and Manage Orders, and let you filter orders in reports. ALIS provides default tags that you can customize. See the Customizable Medication Tags for instructions. 

ALIS also auto-tags certain order types: 

• Controlled: ALIS auto-tags controlled substances from the Drug Database, and the tag appears grayed out on those orders. See How are medications automatically tagged as "Controlled"?
• Psychotropic Drug: Auto-tagging for psychotropics requires rules to be configured on the Drug Tagging tab of Medications Settings.  See How to set up Psychotropic Auto-Tagging Rules. 

Service Level

Defines how the medication is administered:

• Administer Routine: Appropriate for most orders under most building licenses, except in Florida.
• Assistance: The alternative to Administer Routine for Florida licenses.
• Self-Administered: For residents who administer their own medication. Choose whether the order shows on the MAR and in Med Pass. Common practice is to check Show in MAR and uncheck Show in Med Pass.
• Third Party: Same options as Self-Administered. Usually the order should show on the MAR but not in Med Pass, since third-party providers maintain their own MAR.
• Nurse Only: Available only when Administer is selected. See Nurse-Only Orders.

The default is Administer Routine. You can change your building's default in Medications Settings, or contact your Account Manager for assistance.

Check Vitals

Requires med passers to record selected vitals before recording administration in Pass Meds. Set the toggle to Yes, select the vital type(s), and choose a Scale Type (No Range, Minimum, or Maximum). See Recording Vitals. 

Check Pain Level 

Requires a pain level entry before recording administration in Pass Meds. With the toggle set to Yes, med passers can choose from faces rated 0 to 10 or use the PAINAD scale, which calculates pain level from non-verbal expressions. 

To allow only the PAINAD scale, set the PAINAD Scale Only toggle that appears to Yes. Only the PAINAD calculation is then available in Pass Meds and Administer PRNs.

Drug Count

Tracks medication quantity, typically for controlled substances. Set the toggle to Yes to enter the order's current quantity, or choose Link to Existing to share the quantity with another order. See Enabling medications for the Drug Count.  

Product Expiration Date and Use By Date

These optional dates tell staff when the specific medication container for this order should no longer be used. Select the (i) icon next to each field for a quick reminder of the difference. 

• Product Expiration Date: The manufacturer's expiration date on the factory-sealed, unopened product.
• Use By Date: The date the pharmacy assigns after it repackages, reconstitutes, or compounds the product (sometimes called the "beyond-use date"). It is usually earlier than the manufacturer's date. 

Most orders use one date or the other. Enter the date from the medication packaging. In Pass Meds, each date turns yellow when it is one day away and red once it has passed, so staff can pull or reorder the container before it's used. See What are the Product Expiration and Use By dates on medication orders? 

Route

How the medication is administered, such as oral or topical. The pharmacy usually populates this correctly. If not, select the correct route from the dropdown.

Instructions

Populated from the pharmacy's entry in its system. Avoid adding to this text.

If your community enables Administration Notes in Medications Settings, you get a separate field for your own instructions. Both sets of instructions show in Pass Meds. If the order has a complex schedule and/or vitals check, for example, use this field to provide additional instructions.

Routine Orders: Scheduling & Dosage Section

Routine orders include a Scheduling & Dosage section. The pharmacy usually fills in many of the required fields correctly, however it is common that you will need to update the schedule manually. 

Drug Unit of Measurement

Prepopulated from the pharmacy's data. Update it from the dropdown if needed. The most common option is TABS (tablets). Changing this field also changes the unit in the Dose field. 

Packaging

Choose Based on Dose (default) or As 1 Packed Unit. This controls how partial pills in a bubble package are tracked in the ALIS Drug Count. 

Min. Interval Between Admins (Routine)

Not needed for Routine orders, since their schedule already sets the interval. This setting is important for PRNs.

Track Acetaminophen

Tracks how much acetaminophen a resident receives in 24 hours. For applicable orders, set the toggle to Yes and enter the MG per unit. Pass Meds alerts the med passer when the resident is approaching or would exceed the 3,000 mg limit. 

Start Date

When the medication schedule begins. For intervals such as Every N Days, Every Other Day, Every Other Week, and N Days On / N Days Off, ALIS uses the Start Date as the reference point for future administrations.

Most pharmacy integrations fill in the correct date. Users with a PioneerRx pharmacy integration need to enter it manually. See Process Pharmacy Orders with PioneerRx.  

End Date

The date the order is removed from Pass Meds and discontinued automatically. Leave it blank for most orders. It can apply to orders such as antibiotics or tapering doses.

Interval

Which days the medication is scheduled, anchored by the Start Date. You can change it later from the Manage Orders page.

Dosage Type

• Fixed: Used for almost all orders.
• Range: Lets the resident choose a dose within a range you set. Rarely used in assisted living.
• Sliding Scale: Most often used to give a set number of insulin units based on blood glucose. See Sliding scale vitals check on medication orders.

Dose and Time 

How much medication is given at each scheduled time. The unit comes from the Drug Unit of Measurement field. Check Dose is different per time if the order is given at multiple times in different amounts.

Time

When the order appears in Pass Meds. First select a time range (Morning, Noon, Evening, or Hour of Sleep), then choose a specific administration time. Click + Add Another Time to add more times.

The times available in each range are set in Medications Settings, usually during onboarding and prior to eMAR go-live.

+ Add Another Schedule

Creates a separate schedule for the same order with its own instructions, start date, or end date. Use it for complex orders such as alternating or tapering doses. See How to enter a tapering dose medication and How to enter an alternating dose medication.   

Routine Orders: Med Pass Scheduling Information  

This section controls when the order starts appearing in Pass Meds. It typically does not need to be edited.

• Med Pass Schedule: Leave this set to Yes (default) so the order is scheduled in Pass Meds. 
• Start Date and Start Time: Pre-populate with today's date and the current time. Verify they align with the order's Start Date and first administration time.

Add to Current Med Pass

If the order is scheduled for a med pass shift that is currently in progress, an Add to Current Med Pass window opens when you click Process Order. Answer both questions, then click Ok:

1. Has this medication been passed to the resident already? Select No if the dose still needs to be given. Then, determine:
2. Would you like to add this medication to the current med pass shift?
   • Yes: The order appears on the current shift in Pass Meds with a status of Outstanding. 
   • No: The order does not appear on the current shift and starts in Pass Meds on its next scheduled administration time. 

PRN Orders: Administration & Dosage

PRN orders use an Administration & Dosage section instead of scheduled times. These fields are optional but highly recommended for safer administration and thorough documentation.

Min. Interval Between Admins (PRN)

The minimum safe time between doses, in 30-minute increments up to 72 hours. Pass Meds shows a WAIT tag when it's too soon to give the order.

Max. Admins. in 24 Hours

The maximum number of times the order can be recorded as passed in ALIS in 24 hours. Use it together with Min. Interval Between Admins, for example when an order can be given every 2 hours but no more than four times a day.

Check and Record Outcome

Requires staff to document the medication's outcome after the time you select. One hour suits most orders, though some medications act faster or slower. If the time passes without an outcome, the PRN outcome is marked overdue. See Record PRNs and PRN Outcomes.

Routine & PRNs: Process the Order

Once all required fields are complete, review the order details and click Process Order. ALIS highlights any missing required fields in red. Once processed, the medication appears on the resident's MAR and Pass Meds.

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