Managing patient medications effectively is vital for quality healthcare documentation and patient safety. This comprehensive guide outlines the processes for document, prescribe, adjust, refill, stop medication. By following these instructions, healthcare providers can streamline medication management, ensure compliance, and maintain thorough patient records. From handling electronic refill requests to adjusting existing prescriptions, this guide covers all essential commands and fields, making it a valuable resource for maximizing Canvas's capabilities and improving patient care workflows.

User Guides

Medication Statement | Documenting Active Medications

The Medication Statement command is used to document active medications a patient is taking that were not prescribed by the provider. It ensures the patient’s medication record is complete.

• Add the Medication Statement command into an empty line of the note

  • Medication Statement Heading: Enter the name of the medication the patient is taking.

    • Medications are sourced from First Databank (FDB). If unavailable, medications can be added as free text. Free-text entries appear in gray on the patient summary.

      

  • SIG: Specify the frequency and route of administration

  • Interaction checks are performed against all previously recorded medications and allergies. If the selected medication has an interaction, the interaction severity and warning will display.

    

• Once the command is committed, the medication will display under Medications list in the patient summary. Medications added via free text will appear in gray on the patient summary.

Prescribe | Prescribing a Medication

The Prescribe command allows healthcare providers to issue new prescriptions for both controlled and non-controlled substances.

• Add the Prescribe command into an empty line of the note and complete the fields. Red text fields are required.

• Prescribe Heading: Name of medication

• Indications: Reason for prescribing

• SIG: Special characters and line breaks are not supported

• Days Supply: Number of days prescription should cover

• Quantity to Dispense: Specify the quantity X form (tablet, capsule, box, etc)

  

• Refills: Number of refills authorized

  • Controlled substance restrictions based on their schedule badge

    • Schedule II controlled substance prescriptions cannot be refilled and expire after 6 months.

      • Review will be available if refills are set above 0

    • Schedule III or IV prescriptions may not be filled or refilled more than 6 months after the written date OR refilled more than 5 times, whichever comes first.

    • Schedule V controlled substances may be refilled as authorized. Laws may vary by state.

• Substitutions Allowed: Indicate if substitutions are permissible

• Pharmacy: Where the prescription should be sent. This will auto-populate to patient's preferred pharmacy if it is set in the patient's profile

• Prescriber: Provider ordering the medication

• Supervising Provider: Physician the prescribing provider works under

  • If the supervising provider is set in the staff profile, it will default in the prescribe command.

  • If a supervising provider is not set in the staff profile or needs to be changed, the supervising provider can be selected from the dropdown

  

• Complete the command by clicking Review and selecting the necessary action

  • Sign & Send: Prescription will be sent to the selected pharmacy

    • This will be the default if a pharmacy is added to the command

  • Sign: Will commit the command but will not send the order to the pharmacy

    • This will be the default if a pharmacy is not listed in the command

    • Available in the dropdown when Sign & Send is the default

  • Print: Print a copy of the prescription

    If Sign or Print are used to commit the command, the prescription can still be sent from the triple dot menu. Once the command is sent, it cannot be resent — a new command will need to be created.

    

  • Make Changes: Correct any errors in the prescription before sending

    

Drug and Allergy Interaction Checks

When prescribing or documenting a medication, Canvas performs drug to drug and drug to allergy checks and displays within the command. Interaction warnings can also be controlled in admin

By default Canvas shows all Drug/Drug Interaction Warnings as well as all Allergy Warnings. However, this setting can be adjusted at the organizational level in settings.

EPCS + DrFirst | Prescribing a Controlled Substance

Controlled substances are prescribed in Canvas through the DrFirst integration

DrFirst Signing Screen

• After completing the prescription in Canvas, click Send. The prescription status will change to Pending.

• The DrFirst Signing Screen opens automatically. Review:

  • Patient Information: Name, gender, birth date, and address.

  • Prescriber Information: Name, DEA number, NPI, and address.

  

• Complete the two-factor authentication:

  • Enter the Signing Passphrase.

  • Provide the One-Time Password (OTP) generated by the prescriber’s authentication device.

• Verify prescription details and select the prescription by checking the box in the first column.

• Click Sign and Send at the bottom right to finalize.

  Click this button rather than using the enter key. Pressing ENTER after adding the OTP token may cause the window to exit, leaving the prescription unsent.

  

  If several scheduled medications are being submitted in the same note, a new validation window will show for each medication.

Important: When you click Sign & Send, the prescription status immediately changes to Pending and the DrFirst signing window opens. If you exit the DrFirst window without completing the passphrase and OTP signing process, the prescription will remain in Pending status but cannot be transmitted or resent. You must create a new command to prescribe the medication.

Ordering DMEs

DMEs Using a Letter

The Letter feature is ideal for ordering durable medical equipment (DMEs), providing flexibility and comprehensive documentation.

Steps:

• Open the patient’s chart and create a new Letter.

• Include detailed information:

  • Equipment name (e.g., wheelchair).

  • Quantity (e.g., one unit).

  • Specific instructions or additional requirements.

• Include patient and insurance details as needed.

• Print or fax the letter to the supplier for processing.

Key Benefits:

• Comprehensive Documentation: Includes all necessary details for compliance.

• Provider Signature: Ensures regulatory requirements are met.

• Customization: Allows for complex or non-standard orders.

DMEs Using the Prescribe Command

For simple orders like syringes or lancets, use the Prescribe Command for quick electronic submission.

Refill | Refilling a Medication

This command provides the ability to easily issue a prescription refill for any medication on the current Medication List. This process is possible both manually through a chart note and electronically with requests from the pharmacy

Manual Medication Refill

• Add the Refill command to the note and select the medication being refilled from the dropdown.

  

• Alternatively, hover over the medication in the patient’s Medications list and click Refill. If no note is open, a Chart Review note will be created.

  

• The Refill command retrieves all the details from the previous order of the medication. Make any necessary adjustments if required.

• Complete the command by clicking Review and selecting the necessary action

  • Sign & Send: Prescription will be sent to the selected pharmacy

    • This will be the default if a pharmacy is added to the command

  • Sign: Will commit the command but will not send the order to the pharmacy

    • This will be the default if a pharmacy is not listed in the command

    • Available in the dropdown when Sign & Send is the default

  • Print: Print a copy of the prescription

    If Sign or Print are used to commit the command, the prescription can still be sent from the triple dot menu. Once the command is sent, it cannot be resent — a new command will need to be created.

    

  • Make Changes: Correct any errors in the prescription before sending

Important: When you click Sign & Send for controlled substances, the prescription status immediately changes to Pending and opens the DrFirst signing window. If you exit DrFirst without completing the signing process, the prescription remains Pending but cannot be resent – you must create a new Refill command.

Electronic Medication Refill

Pharmacies have the ability to electronically request a refill for a patient's medication.

Approve or Deny Electronic Refill

• Access the Refill Requests panel from the Schedule View.

  

• Click the desired refill request card to open the patient chart.

• Approve or deny the request using APPROVE or DENY commands. If no note is open, a Chart Review note will be created.

  

  When approving an electronic refill, the field total number of dispensing approved refers to the total number of fills, including the current fill and any refills. This value cannot be set to zero. For example:

  • A single fill without refills should have a value of 1.

  • A prescription with one approved fill and 3 refills should have a value of 4

Adjust Prescription | Adjusting a Current Medication

The Adjust Prescription command allows the user to adjust existing medications

• Add the Adjust Prescription command by adding the command to a note or from the patient summary by hovering over the medication and clicking Adjust. If no note is open, a Chart Review note will be created.

  

• Adjustments can also be made from the patient summary by hovering over the name of the medication and clicking Adjust. If no note is open, a Chart Review note will be created.

  

• Update necessary fields:

  • SIG: Will automatically fill with SIG on previously sent prescription. Adjustments can be made, if needed

  • Click here to change medication or RX: This will expand to the command to update additional fields. Previously prescribed information will populate, but they can be updated as needed. The medication can also be changed in this view as well.

• Complete the command by clicking Review and selecting the necessary action

  • Sign & Send: Prescription will be sent to the selected pharmacy

    • This will be the default if a pharmacy is added to the command

  • Sign: Will commit the command but will not send the order to the pharmacy

    • This will be the default if a pharmacy is not listed in the command

    • Available in the dropdown when Sign & Send is the default

  • Print: Print a copy of the prescription

    If Sign or Print are used to commit the command, the prescription can still be sent from the triple dot menu. Once the command is sent, it cannot be resent — a new command will need to be created.

    

  • Make Changes: Correct any errors in the prescription before sending

Important: When you click Sign & Send for controlled substances, the prescription status immediately changes to Pending and opens the DrFirst signing window. If you exit DrFirst without completing the signing process, the prescription remains Pending but cannot be resent – you must create a new Adjust Prescription command.

Stop Medication | Discontinuing a Medication

Documenting the completion or cessation of historical medications is an important part of high quality charting.

• Add the Stop Medication command to a note and select the medication or hover over the medication in the patient summary Medications list and click Stop.

• Provide a Rationale or reason for stopping medication

• Click RECORD to finalize and the medication will be removed from the patient summary

Compound Medications

Creating a new compound medication in Canvas Medical involves defining its composition, dosage, and usage parameters in the settings. This process ensures that compound medications are accurately represented and managed for both clinical and pharmacy workflows. This guide walks you through the steps to create and configure compound medications in the system.

Adding a Compound Medication

• Navigate to Settings and select Practice: Compound Medications.

• On the setup page, click ADD COMPOUND MEDICATION + to create a new compound.

• Fill in the required fields to define the compound medication:

  • Formulation: Specifies the ingredients, concentration, and form. This formulation is what will display in the command and be sent to the pharmacy.

    • Ketoprofen 15%, Baclofen 5%, Orphenadrine 5%

    • Magic Mouthwash (1 part viscous lidocaine 2%, 1 part Maalox, 1 part diphenhydramine 12.5mg per 5mL elixir)

  • Potency Unit Code: Defines the measurement unit (mg, mcg) to ensure precise dosing.

    Units without a specific measurement cannot be selected. Ex: vial is not a supported unit because it does not contain a specific measurement. Instead, a measurable unit like "mL" should be selected to reflect expected volume or dosage accurately.

  • Controlled Substances: Select the appropriate schedule for controlled substances, classified from Schedule I (high potential for abuse) to Schedule V (lowest potential for abuse).

  • Controlled Substance NDC: When using a controlled substance in a compound med, the NDC of the medication with the highest schedule should be used.

    

Prescribing a Compound Medication

Compound medications are prescribed the same as standard medications through the Prescribe command. However since this is a compound medication, there will not be any interaction checks due to the custom nature of the ingredients. There will be a prompt under the medication stating Interaction checks cannot be performed for free-text compound medications.

Refilling a Compound Medication

Refills for compound medications are completed the same as standard refills. Compound medication refills will also include the Interaction checks cannot be performed for free-text compound medications beneath the selected medication.

Updating a Compound Medication

Adjustments to a compound medication are also managed in the Practice: Compound Medications settings. To update a medication, mark the existing compound as inactive and create a new entry with the necessary changes.

Prescription Statuses

Once a medication is sent a badge of the prescription status will display next to the command's triple dot menu.

EPrescribe

EPCS | Controlled Substances

Prescription Errors

If a prescription errors, the items listed below are helpful for basic troubleshooting. Hover over the Error badge next to the triple dot on the command for further details.

• Confirm the patient has a full address in their profile to facilitate proper prescription delivery -

  • Patients must have at least one full address including city, state and country. The Type must be set for postal or both. The Use must be set as home.

• 500 error:

  • Confirm the pharmacy is still in business. Google the pharmacy to confirm it is still in business.

  • If pharmacy is closed, a new prescribe command will need to be entered with an alternate pharmacy.

• 900 error: The pharmacy did not accept the medication due to one of the following:

  • Temporary downtime at the pharmacy

  • The pharmacy is not dispensing the medication prescribed

  • The patient's insurance is not accepted by the pharmacy

• Name does not match prescriber information: This error will be seen in DrFirst. It means the provider's name in their staff profile does not match the name listed on their medical license. Their name will need to be updated in the staff profile and a new prescription will need to be made.

• Error prescribing controlled substances: Two common causes of controlled substance prescription errors:

  • Sex at Birth not specified: Confirm Sex at Birth is specified as Male or Female in the patient's profile; entries of Unknown or Other will trigger an error upon submission.

  • Missing complete address: Ensure the patient has a complete address including street, city, state, and zip code with Type set to postal or both and Use set as home.

• Authentication failed. Access is denied: This will display on the DrFirst Screen.

  • Majority of the time, it means there is an issue with the provider's passphrase. The passphrase should not include special characters.

  • If the passphrase is forgotten, it will need to be reset within DrFirst.

  • For troubleshooting steps, refer to DrFirst's troubleshooting guide

• Staff for specified staff_key is missing an address: The prescribing provider has a supervising physician with an incomplete staff profile. The supervising physician will need to have their profile updated before the provider can prescribe the medication.

• Refills will error if they are being refilled from a free text medication statement. This can be determined by hovering over the medication in the patient summary and seeing the prompt below

  

If the reason for error cannot be determined, please reach out to Canvas Support via a Pylon ticket form

References

Due to the ever evolving nature of our product, recorded videos may be slightly out of date.

Medication Statement

Prescribe | Non-Controlled

Prescribe EPCS | Controlled Substances

Refill

Adjust Prescription

Stop Medication