Encounter Requisitions

Introduction

An Encounter Requisition (labeled Write order on the patient chart) is how a physician requests drugs and supply items for a patient during an active encounter. It’s built around the facility’s item catalog: every drug requested is automatically screened for interactions against the other drugs on the same requisition, and once submitted, Aevora automatically creates and routes the underlying item requisitions to whichever department can fulfill each line — pharmacy for drugs, the appropriate stockroom for supplies — so nobody has to manually re-key the request into a separate form.

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Key Concepts

Encounter Requisitions vs. Item Requisitions

An encounter requisition (ORD-NNNNNNNN) is the clinical instruction — what the physician is asking for, at what dose, route, and schedule. An item requisition (REQ-…) is the logistics side — the actual request for stock to move from a department’s inventory to fulfill it. One encounter requisition can fan out into several item requisitions if its lines are stocked in different departments (e.g. a drug routed to Pharmacy and a supply item routed to Central Supply). The encounter requisition’s detail page shows every item requisition it generated, grouped with the lines each one covers.

STAT / One-time vs. Routine

Each drug line is marked as one of:

• STAT / One-time — a single administration, no schedule.
• Routine — recurring per a schedule: Daily, Weekly, Monthly, or a Custom schedule (free text). Routine lines also carry a frequency (e.g. “Twice daily (BID)”), duration, start date, and end date.

An encounter requisition’s overall priority is set to STAT if it contains any one-time line, or ROUTINE if every line is routine.

Drugs vs. Items

The catalog mixes two kinds of catalog entries:

• Drugs — get the full clinical field set (dosage, route, max intake, frequency/duration for routine lines) plus RxNorm normalization and interaction screening.
• Items (non-drug supplies) — only quantity and an optional free-text note; no clinical fields or interaction checks apply.

RxNorm Normalization

When a drug is added to the requisition, Aevora looks it up against NLM RxNorm to resolve it to a standard concept (ingredient, strength, dose form, RxCUI):

• Found — a single unambiguous match; the verified concept is shown under the line.
• Ambiguous — multiple concepts match (usually different strengths of the same drug); the physician picks the intended one from a candidate list.
• Not found — the drug isn’t in RxNorm, so interaction checking is unavailable for that line, but the requisition can still be submitted.

Drug Interaction Check

Once at least two drugs on the requisition have resolved to an RxNorm concept, Aevora checks every pair for interactions:

1. A direct RxNorm interaction lookup between the resolved RxCUIs.
2. For pairs with no direct RxNorm result but in the same drug class, a check of FDA drug label text for a documented interaction.
3. A cross-class fallback that searches each drug’s label for a mention of the other drug’s class.

Results are shown as a triangular matrix (one cell per drug pair) and a list of flagged pairs, each with a severity of Major, Moderate, or Minor. This is an informational aid — it does not block submission, even for major interactions, so the physician’s judgment remains the final check.

Auto-Routing to Departments

On submission, Aevora determines which department’s inventory currently stocks each requested item (matched by SKU or item name) and groups lines by that department into one item requisition per department:

• For drugs, a department with type PHARMACY is preferred if it has stock.
• For supply items, the department with the highest available quantity is chosen.
• If no department currently stocks an item, its line is created without a target department and appears as unassigned on the encounter requisition (still visible, but won’t auto-route until stock exists somewhere).

Each generated item requisition starts in Pending status, exactly as if a staff member had created it manually — see Item Requisitions for the approve → release → complete flow that follows.

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Use Cases

Writing a New Encounter Requisition

1. Open the patient’s chart and find the active encounter.
2. Click Write order (visible only to doctors and owners) to open the Encounter Requisition screen.
3. In the Item Catalog, filter by All / Drugs / Items and search by name or SKU, then click a row to add it to Order Items.
4. For each added line, enter the quantity, and for drugs, the order type (STAT or Routine), dosage, route, max intake, and — for routine lines — frequency, duration, and start/end dates.
5. Review the Drug Interaction Check panel at the bottom if two or more drugs are on the requisition.
6. Click Submit Requisition.

Item requisitions are created and routed automatically; the encounter requisition appears under Medication Orders on the encounter’s chart tab.

Who can write encounter requisitions

Only staff whose role is flagged as a doctor, or an OWNER-level account, can write or cancel encounter requisitions (Write order is hidden for other roles).

Reviewing an Encounter Requisition

Click any entry under Medication Orders on the encounter tab (or its order number) to open the detail page. It groups the requisition’s lines by the item requisition each was routed to, showing the destination department and that item requisition’s current status, plus any lines still unassigned.

Downloading an Encounter Requisition as PDF

Click Download PDF in the header of the detail page. This generates a printable document with the order information, every requisitioned drug/item (dosage, route, schedule, and the department it was routed to), the status of each generated item requisition, and a signature line for the attending physician — useful for a physical chart or an offline record.

Selecting an Ambiguous RxNorm Match

If a drug resolves to multiple RxNorm concepts (typically different strengths), a candidate list appears under that line — click Select next to the correct one to confirm it before submitting.

Cancelling an Encounter Requisition

1. Open the encounter requisition from Medication Orders on the encounter tab.
2. Click Cancel in the header (visible only to doctors and owners, and only while the requisition isn’t already cancelled).
3. Optionally enter a reason, then confirm.

The requisition’s status is set to Cancelled and cannot be reactivated — write a new one if the request needs to be reissued.

Cancelling also cascades to its generated item requisitions, but only the ones that haven’t been approved yet:

• Item requisitions still Pending (or a Draft) are cancelled automatically along with the encounter requisition.
• Item requisitions that are already Approved, Released, or Completed are left untouched — stock may already be committed or have physically moved, so those must be handled separately (e.g. through a manual adjustment) if they need to be unwound.

For example, if an order generated two item requisitions — one to Pharmacy and one to Central Supply — and Pharmacy already approved theirs while Central Supply’s is still pending, cancelling the order cancels only the Central Supply requisition; the approved Pharmacy one is unaffected.

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Reference

Encounter Requisition Status

Status	Meaning
Active	Requisition is in effect
Transcribed	Requisition has been transcribed/actioned downstream
Cancelled	Requisition was cancelled; no further action

Encounter Requisition Line Fields

Field	Applies to	Notes
Quantity	All	Required, must be > 0
Order Type	Drugs	STAT / One-time or Routine
Dosage	Drugs	Free text, e.g. “500mg”
Route	Drugs	Oral, IV, IM, SC, Sublingual, Topical, Inhalation, Rectal, Nasal, Ophthalmic, Otic, Buccal, Transdermal
Max Intake	Drugs	Free text, e.g. “2000mg/day”
Frequency	Routine drugs	Required for routine lines
Duration	Routine drugs	Free text, e.g. “7 days”
Start / End Date	Routine drugs	Optional
Notes	All	Free text

Permissions

Writing and cancelling encounter requisitions is restricted to staff whose role has isDoctor set, or an OWNER-level role — there is no separate granular permission toggle for this action. Viewing them on a patient chart follows the same access as the chart itself. The item requisitions generated from one are governed by the standard item requisition permissions.