Pharmacy Assistant Training Manual, Module 5: Prescription Data Entry

Copyright © 2019 by Pharmasave Drugs (National) Ltd.

Revised July 2019

All rights reserved. No part of the Pharmacy Assistant Training Program shall be reproduced,
stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying
or otherwise, without the written permission of Pharmasave.

For reprint permission and more information about the Pharmacy Assistant Training Program,
contact patraining@[Link].
Prescription Data Entry
Table of contents
Prescription data entry .................................................................................................................. 6
Learning objectives ....................................................................................................................... 6
Getting started .............................................................................................................................. 7
Pharmacy management system ................................................................................................... 7
Logging onto the Kroll pharmacy system ...................................................................................... 7
Kroll help ....................................................................................................................................... 8
Basic Kroll keystrokes ................................................................................................................... 9
Menu bar................................................................................................................................ 9
Alt key .................................................................................................................................... 9
Control key............................................................................................................................. 9
Entry field ............................................................................................................................. 10
Function keys ....................................................................................................................... 10
Tab key ................................................................................................................................ 10
Enter key.............................................................................................................................. 10
Arrow keys ........................................................................................................................... 10
Drop-off ................................................................................................................................ 10
Start screen................................................................................................................................. 11
Entering patient information into Kroll ......................................................................................... 15
Search/add patient – F3.............................................................................................................. 15
Entering new patients ................................................................................................................. 17
Patient information ...................................................................................................................... 17
Fields on the patient card ............................................................................................................ 17
Government and third-party prescriptions plans ......................................................................... 20
Patient allergy information .......................................................................................................... 21
Additional patient information ...................................................................................................... 24
Patient sidebar functions ............................................................................................................. 26
Search drug – F5 ........................................................................................................................ 27
Mixture-drug – F5........................................................................................................................ 28
Search doctor – F7 ..................................................................................................................... 29

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Entering prescriptions into Kroll .................................................................................................. 29
Fields on the prescription filling screen ....................................................................................... 30
Entering prescription directions (sig) ................................................................................... 31
Entering SIG codes .............................................................................................................. 31
Entering a new SIG .............................................................................................................. 32
Entering other prescription information ................................................................................ 32
Pricing .................................................................................................................................. 34
Dispensing allowed period ................................................................................................... 35
Administration period ........................................................................................................... 35
Comments ........................................................................................................................... 35
Indications............................................................................................................................ 35
Warnings.............................................................................................................................. 36
Managing on-line prescription adjudication ................................................................................. 37
Adjudicating claims .............................................................................................................. 37
Refilling prescriptions .................................................................................................................. 38
Obtaining doctor authorization ............................................................................................. 42
Managing system warnings ........................................................................................................ 44
Process warnings ................................................................................................................ 44
Clinical warnings .................................................................................................................. 46
Useful features and tools ............................................................................................................ 49
Detailing prescriptions from profile ...................................................................................... 49
Cancelling a prescription ..................................................................................................... 50
Reprinting a prescription ...................................................................................................... 51
Putting a prescription on hold (Unfill) ................................................................................... 52
Owing Label ......................................................................................................................... 52
Inactivating a prescription .................................................................................................... 53
Glossary of terms ........................................................................................................................ 55
Memory work .............................................................................................................................. 57
Verbs ................................................................................................................................... 59
Quantity ............................................................................................................................... 60
Routes ................................................................................................................................. 61
Interval ................................................................................................................................. 62
Condition (Qualifiers) ........................................................................................................... 63

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 Medical Conditions .............................................................................................................. 65
Short Cut Codes .................................................................................................................. 67
Auxiliary Directions .............................................................................................................. 69
Bits and Pieces .................................................................................................................... 69
Dispensary assignments ............................................................................................................. 74
Computer Skills 101 ............................................................................................................. 74
Main Street Kroll .................................................................................................................. 74
Prescription Entry ................................................................................................................ 74
Managing System Warnings ................................................................................................ 74
Practice exercises ....................................................................................................................... 75
Exercise one ........................................................................................................................ 75
Exercise two ........................................................................................................................ 82
Exercise three ...................................................................................................................... 83
Exercise four ........................................................................................................................ 88
The fundamentals ....................................................................................................................... 89
Computers 101 .................................................................................................................... 89
Main street Kroll ................................................................................................................... 89
Entering prescriptions into Kroll ........................................................................................... 89
Managing On-line prescription adjudication ......................................................................... 89
Refilling Prescriptions (Play it again Sam) ........................................................................... 89
Managing System Warnings ................................................................................................ 89
Useful Features and Tools ................................................................................................... 90
Checklist for the mentor .............................................................................................................. 91
Coaching.............................................................................................................................. 91
Review ................................................................................................................................. 91
Check................................................................................................................................... 91
Administer mastery assessment .......................................................................................... 91

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Prescription data entry
Learning objectives
1. Become familiar with the TELUS Kroll Pharmacy Management System and its functions
2. Learn how to create patient cards and enter prescriptions into the Kroll Pharmacy
System
3. Find out how to manage drug allergies, drug usage, and drug interactions during
prescription entry
4. Learn to manage on-line prescription adjudication

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Getting started
People learn to master new technology in different ways. Some people prefer careful study and
consideration prior to using the computer and other people prefer to use the technology and
learn as they go. Providing that the key features of patient entry, prescription filling and refilling,
Drug Usage Review, and adjudication are all mastered, the approach taken does not matter.
You can choose any of the following learning methods:

1. Follow along in this manual to gain a basic understanding of the Kroll Pharmacy
Management system and its functions
2. Load a copy of Kroll’s User Manual off the Pharmasave Portal and use that to master the
system. From the Portal, go to Rx Ops/Kroll Software. You will find a link to the Kroll
website, plus links to different training videos.
3. With the guidance of your mentor, work on the Kroll system in your store and master the
basic functionality.

Whichever approach you choose, the goal is to master the ability to enter and refill prescriptions
independently on the Kroll system.

Pharmacy management system

There are several different pharmacy prescription management software programs available. At
Pharmasave, our preferred software program is the TELUS Health Kroll™ Pharmacy
Management System. This windows-based program operates on the current version(s) of
Microsoft Windows® operating systems. Kroll is intuitive and is able to effectively manage both
basic and advanced pharmacy processes.

You can use the Kroll Pharmacy System without a mouse by learning and using various key
functions and key combinations. With Kroll, the computer keyboard is your connection to the
computer’s functions and to the programs and information stored inside it.

TIP! It is more efficient to use the keyboard than it is to switch back and forth
between the mouse and the keyboard. Investing the time to learn the key
board shortcuts will increase your efficiency as a pharmacy assistant.

Logging onto the Kroll pharmacy system

A username and password to access the Kroll Pharmacy Management System will be provided
to you by your mentor.

To logon to the Kroll Pharmacy system, do the following:

• Locate the Kroll shortcut icon on your computer desktop.

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 • Use the mouse to highlight the icon and then click on the icon to load the Kroll
Windows® Program.

Once the program has loaded you will be asked to log on with your username and password.
These will be provided to you by your mentor.

Kroll help
If you cannot find the help you need in the Kroll Help menus, you can either solicit help from
another member of the pharmacy team or phone the Kroll Help Desk.

Alberta office

Address: 10020 - 100 Street NW Floor 9,

Edmonton, Alberta Canada T5J 0N5

Ontario office

Address: 25 York Street, 21st floor,

Toronto, Ontario M5J 2V5

Nova Scotia office

Address: 1959 Upper Water St Suite 410,

Halifax, Nova Scotia Canada B3J 3N2

Support: 1-866-285-4457

Sales: 1-855-505-7655

Fax: 1-833-383-0001

Email: Krollsupport@[Link]

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Basic Kroll keystrokes
Although the Kroll Pharmacy Management system can be used with a mouse, it has been
carefully designed to be keyboard friendly. Using the various menu and hot key shortcuts can
be much more efficient than switching back and forth between the mouse and the keyboard.

Menu bar
The Kroll menu bar gives you access to all the different functions in Kroll. The words in the
menu bar include a drop-down list of subheadings for each function. You can use the mouse to
access the menu bar options or by using the Alt key in combination with the underlined letter on
each menu option.

Alt key
The Alt key is used to access the menu bar across the top of the screen in conjunction with the
underlined letter, e.g., Alt + F to access the “File” drop-down menu. All of the “Alt” functions can
be performed by clicking on the menu options as well.

Control key
The Ctrl key is used in conjunction with an underlined letter on the screen to advance to that
field on the screen (with the exception of the top menu, mentioned above), e.g., Ctrl +N to enter
the last narcotic number.

The Esc key always takes you back a step. Pressing Alt + X always takes you back to the Start
Screen when in other screens.

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Entry field
The entry field on the Kroll start screen is a powerful search tool. The field is a blue colored box
located in the upper left-hand portion of the main menu. Numbers or text can be entered to
initiate a search or function in the Kroll system. Data entered in this field is usually followed by
selecting one of the Kroll function keys or simply pressing the enter key to search. Example:
Patient/Doctor Name or a prescription number.

Function keys
These keys are found at the top of the keyboard (F1, F2, F12). They allow you to access Patient
(F3), Drug (F5) and Doctor (F7) information as well as perform many prescription filling
functions.

Tab key
This key is found on the left side of the keyboard. The Tab key is used to move from field to
field on the screen. To move backwards, press Shift and Tab together.

Enter key
Also known as the “Return” key, it is found on the right side of the alpha keyboard as well as on
the right of the numeric keypad. The Enter key is used to save information once changes or
new information is typed.

Arrow keys
The arrow keys are used to move up and down in a scan to select a certain line. On some
screens, the arrow keys are used in conjunction with the Ctrl key to move through different
windows of information.

Drop-off
This feature is designed to improve workflow in the pharmacy by allowing an assistant to scan
and enter a prescription into the system, to allow another pharmacy user to start working on it.
The function key F11 will take you directly to the feature. The function allows the user to build a
work order for a patient and quickly enter the new prescription or refills and queue the work to
be filled later.

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Start screen

All functions begin from this screen. The menu across the top of the screen (File, Edit, Reports,
etc.) can be accessed by clicking on the word with the mouse or pressing Alt in conjunction with
the underlined letter.

Any function key buttons (F3 – Patient, F5 – Drug, etc.) can be accessed by clicking on the
button with the mouse or by pressing the Function key on the top of the keyboard.

From the start screen you can use the universal search field to search for patients, drugs,
doctors, and prescriptions. For example, search for a patient by entering a few letters of the last
name and/or comma (,) the first name or by phone number and then press F3 or search for a
drug by entering the DIN and then press F5.

The dashboard icons (Callbacks, Follow-ups, Notes, etc.) provide access to tools that support
pharmacy operations. The numbers in red circles indicate the number of entries listed under the
specific icon.

The dashboard allows you to monitor the progress of a prescription as it is being filled along
with a snapshot of your current workload.

Rx’s To Do includes IVR prescriptions, eCare Refills, scanned prescriptions waiting to be

entered, and prescriptions put into the Trouble Queue.

Rx’s in Progress displays any prescriptions that are currently being filled along with any
prescriptions that are in the Trouble Queue or pending adjudication.

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Rx Counts are also displayed on this screen. Here you can view how many New, Repeat,
Cancelled, and Total prescriptions were filled for the day. The count resets at 12:00am daily.

Clicking the Details button beneath it will display additional information such as dollar value
breakdown and third-party adjudication totals. You can also choose to enter a previous date and
select the Recalculate button:

The Callbacks icon displays communications initiated from the system to prescribers and
allows users to manage those communications for all prescribers, for all patients in one area. An
entry can be automatically created in this list any time a Fax Doctor Report is either printed or
previewed, or if the Add to Doctor Callbacks function is selected from the patient medical profile:

The Follow-ups icon displays entries that serve as reminders to follow up with patients
regarding a specific matter; the actual follow up can be performed via phone call or face-to-face
interaction:

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Under the Notes icon, notes can be manually entered and include comments and due dates.
You can use this tab to create notes, comments, or reminders for pharmacy staff of tasks that
need to be completed:

Inbound Docs will display images that have been scanned into the system via the document
scanner and if configured, those received via fax. You can filter to display items that are
Pending, Completed, or Deleted:

The Outbound Fax icon is used to send items such as Prescription Authorization Requests and
Rx Transfer Reports. Kroll FaxRx must be configured to fax directly from the Kroll system:

The Mail icon accesses the internal email system built within Kroll. A red number beside the
mail icon indicates the number of unread messages available for the user that is currently
logged into the system. Clicking the icon will open the mail system. From here, messages can
be replied to, forwarded to other users in the system, or deleted:

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The Appointment Calendar is a tool that helps pharmacies manage and organize appointments
within the Kroll application. Appointments can be made for a wide variety of services such as
Flu Shots, Immunizations, Medication Reviews, and can also be used to coordinate staff
activities such as shifts, break times, and vacation.

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Entering patient information into Kroll
With the program started and the introduction to the Kroll Main screen complete, everything is
ready to begin using the program. The next sections of this module are designed to be used as
a guide as you begin to explore the Kroll pharmacy system. The sections are organized by Kroll
function area to make learning easier. To maximize your learning, it may be easiest if you work
your way through the next sections using the module as a guide with a Kroll terminal available
for you to practice as you progress.

The information that is gathered from patients during the initial interview at the dispensary
counter must be entered into the Kroll computer system. The following three types of basic
information will need to be entered into Kroll:

1. Demographic information about the name, address, and contact information for the
patient is set out by provincial statute
2. Basic patient clinical information such as the birth date, allergy status, and any known
medical conditions
3. Pricing and insurance coverage information must also be set up for the patient and is
often the most complex part of the process

Search/add patient – F3
1. From the main menu, press F3 or click on the F3-patient button to access the patient
card. A search screen will appear.
2. To search for a patient, type the first few letters of the last and first names separated by
a comma, or the phone number, or a “#” followed by the billing number (PHN), or a “.”
followed by the old code (if applicable from a converted system) and press ENTER or
click on Search.
3. Type * to recall all patients. A list of patients matching the search criteria will be listed:

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4. Using the arrow, select the desired patient and press ENTER, or double click on the line,
or type the line number beside the name and the patient information will appear.

TIP! The more information typed in initially, the shorter the resulting scan will
be. If the patient is not found on the displayed patient lists, the user can utilize
the Advanced search function and proceed to add a new patient.
To perform an advanced search, do the following:
1. Check the Advanced option box on the Patient List Screen using the
mouse or press Ctrl + A to check the box.
2. The Advanced search criteria screen will display.
3. Type in more detailed information to search, including Address, Birth
date or Price Group.
4. If the patient is still not found, you will need to enter a new patient card

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Entering new patients
To enter a new patient, do the following:

1. From the patient list screen, press Insert on the keyboard or click on the Ins button to
bring up a blank patient screen to enter a new patient.
2. If the new patient has family members in the system, select the family member on the
patient list screen then press Ctrl + Y or click on the Copy Pat button to copy the
information from an existing patient.
3. Enter the required fields in the form with information gathered from the patient.

Patient information

Fields on the patient card

There are two types of fields on the patient card as well as other records in the system. In some
fields, there is one piece of information entered. In other fields, there is a “List Box”. In these
fields, more than one piece of information can be entered and kept as a list, for example, phone
numbers. These List Boxes are differentiated on the screen with a name in bold and one
underlined letter. There is a number in brackets as well as the ability to Edit, Insert or Delete the
information in the List Box.

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To access any of these fields, Tab to the field or press Ctrl in conjunction with the underlined
letter to move directly to that field (Ctrl + H in the previous example) or click on the field.

Any field with a key to the right has a drop-down menu. Begin typing and the system will try
to match the letter(s) to select the option or click the arrow and select the appropriate option.

Last Name/First Name/Salutation /Address1/2/City, Prov, Postal, Country, Email – Enter

the appropriate information as necessary.

Quick code – If the patient was converted from a previous system, the old patient code will
appear. Any code can be typed here.

Family doctor (optional) – Press F2 on the keyboard or click on F2 to search for and select a
default doctor. When an Rx is filled for this patient, this doctor will be automatically displayed on
the screen (but can be overwritten).

Phone numbers – Multiple phone numbers may be entered.

To add a phone number:

1. Press the Insert key on the keyboard or click on Ins or simply begin typing while in this
field
2. Type the phone number, including area code if applicable, and the system will
automatically format the number
3. Select the designation e.g., Home, Office, Cell, etc.

To delete a phone number:

1. Highlight the appropriate line and press Delete on the keyboard or click on Del.
2. A window will appear to confirm the deletion.

To edit a phone number:

1. Highlight the appropriate line and press F2 on the keyboard or click on F2 or double click
on the desired line and make any necessary changes.
2. Press ENTER or click on Save.

Birthdate – Enter the birth date as DDMMYYYY. The year can be entered as a 2- or 4-digit
number. The screen will display the patient’s age.

Gender – Type M, F or Undifferentiated or click on the arrow to the right to select the gender.

Language will default to English. Click on the arrow to the right to select a different language.

Height/Weight – The patient’s height and weight can be entered in these fields. For
consistency, use the same units of measure for all patients, e.g., ft. or cm but not both and kg or
lbs. but not both.

Provincial Plan – Enter the patient’s provincial health number (i.e., ODB, HSN, PHN, ULI) here.

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Load Patient Image – A patient image can be loaded using a document scanner. Feed the
photo into the scanner and click Load to initiate scanning.

Comments – Patients can have an unlimited number of comments. Each comment is assigned
a Topic and is sorted that way.

To add a comment:

1. Press the Insert key on the keyboard or click on Ins or simply begin typing while in this
field. The following screen will appear:

2. Select the topic from the list provided by clicking on the arrow on the right, or you can
overwrite it with a topic of your choice. Each comment has three options.
3. Select an option using the Tab key or use the space bar to check or click on the
checkbox options
a. Show on Rx – will display this comment on the Rx Filling Screen
b. Print on hardcopy – will print this comment on the hardcopy
c. Alert – when selected, will display the comment any time you access the patient
card or a prescription is filled for this patient
4. Once the information is complete, press ENTER or click Save to continue

To delete a comment:

1. Highlight the appropriate line and press Delete on the keyboard or click on Del.
2. A small window will confirm the deletion.

To edit a comment:

1. Highlight the appropriate line and press F2 on the keyboard or click F2 or double click on
the desired line and make any necessary changes.
2. Press Enter or click on Save

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Government and third-party prescriptions plans
Patient government and/or third-party information is saved in the plan window. This information
will have to be entered for all new patients and also for existing patients when there are
changes to their prescription drug coverage. A patient can have any number of third-party plans.
It is very important to enter this information accurately preferably directly from the patient’s drug
benefit card.

To add a plan:

1. Press the Insert key on the keyboard or click on Ins or simply begin typing while in this
field.
2. The following screen will appear:

Plan is the third-party plan. It can be selected from the list provided by clicking on the arrow on
the right or begin typing the plan name.

Always Use in Rx – This flag is turned on by default. The checkmark can be removed if the
plan is not to be used for every prescription.

Inactive – Place a checkmark here if the plan is no longer accepting claims for this patient.

Order – If there is only one plan, it will be Primary. If there is more than one, the pharmacist can
specify the order in which to send the claims.

Carrier ID, Group ID, Client ID – Enter these numbers from the patient’s card information.
(NOTE: If a specific plan does not require any of these fields, the field will be grey and the
pharmacist will not be able to type any information.)

Pat Code/Tag is only used by certain plans (e.g., Green Shield).

Relationship – Type the number or click on the arrow to the right to view all options and select
the appropriate relationship.

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Deduct Type refers to the type of deductible (percentage, dollar amount, etc.).

Deduct Value is usually left blank. The response from the third party will include the deductible
amount. For a manual plan, the amount can be entered.

Expiry Date – Enter as DDMMYYYY, if required.

Last Name/First Name/Birthday/Gender can be entered if these are registered differently with
the plan than what appears on the patient card.

• Once all applicable information is entered, press Enter or Ctrl + S or click save to
continue

To delete a plan:

1. Highlight the appropriate line and press Delete on the keyboard or click on Del.
2. The system will prompt to confirm this change.

To edit any plan information:

1. Highlight the appropriate line and press F2 on the keyboard or click F2 or double click on
the desired line.
2. Make any necessary changes and press Enter or Ctrl + S or click to save

Patient allergy information

CAUTION: Patient allergy information must be added into the system.

This allergy information is added in a consistent manner for all patients as this
allows the system to do automatic checks of prescription medications to ensure
the patient is not allergic to any of the ingredients. Each of the known allergies
for a patient must be added here.

To add an allergy:

1. Press the Insert key on the keyboard or click on Ins.

2. The following screen will appear:

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 3. Type the beginning letter(s) of the allergy and then press Enter or click on Search.
4. The list of matching allergies will appear on the screen:

5. Use the arrow to scroll up or down or use your mouse to highlight

6. Once you have chosen the allergy, press Enter or click on Select
7. Once an allergy is selected, a screen will appear allowing the pharmacist to type a
comment about this allergy, as well as the source. Type the comment and press Enter or
click OK to save this information.
8. Press Esc or click on Cancel to exit this screen without typing a comment:

To delete an allergy:

1. Highlight the appropriate line and press Delete on the keyboard or click on Del.
2. The system will prompt to confirm this change

TIP! If the patient does not have any allergies, enter NKA in the allergy field so
that the information is transferred to the rest of the team and the patient is not
repeatedly asked about allergy status in the future.

CAUTION: Allergies should only be deleted when needed to correct an entry

error. If an allergy needs to be deleted from an existing profile the pharmacist
on duty should be consulted about the removal.

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To edit an allergy:

1. Highlight the appropriate line and press F2 on the keyboard or click F2 or double click on
the desired line
2. Make any necessary changes and press Enter or click on OK

Conditions – Any number of the patient’s conditions can be added here.

To add a condition:

1. Press the Insert key on the keyboard, or click on Ins.

2. The following screen will appear:

3. Type the beginning letter(s) of the condition and then press Enter or click on Search.
4. The list of matching conditions will appear on the screen:

5. Use the arrow to scroll up or down or use your mouse to highlight. Once you have
chosen the condition, press Enter or click on Select.
6. Once a condition is selected, a screen will appear allowing the pharmacist to type a
comment about this condition, as well as the source. Type the comment and press
ENTER or click OK to save this information. Press ESC or click on Cancel to exit this
screen without typing a comment:

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Additional patient information
There are tabs of extra information at the bottom right area of the patient card: General, Family,
Nursing Home, Copays, Communications and Other. To move from tab to tab, press Ctrl in
conjunction with the underlined letter, for example, General is Ctrl + E or click on the name at
the top of the tab or press Ctrl +  or  to move back and forth between tabs.

In this window, general information and specific patient preferences can be saved:

Active is selected by default. Remove the checkmark if this patient has not filled prescriptions at
this pharmacy for an extended period of time and you do not want them to appear in a “regular”
patient search. Inactive patients are also excluded from reports unless otherwise specified.

Alt. Last Name allows users to save an alternative last name against patient records. This can
then be used as patient search criteria.

Patient Type – In addition to an animal, you can use this to record if the ‘patient’ is a pharmacy,
physician’s office, nursing home or wholesaler used to record the selling or transfer of stock,
physician office use, ward stock or narcotic returns.

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Deceased On – A date can be entered here in the format DDMMYYYY as necessary. When
populated, the Active flag will automatically become unchecked.

Delivery Type/Route – Select an available option if these have been configured for your store.

Price Group – Patients can be placed in a price group for specific pricing requirements. Click
on the arrow to the right to select from the available price groups e.g. PS Staff, Vet, etc. Use
the arrow to select the desired group and press Entre or double click. (Note: The system does
not come preloaded with any groups; these are added as needed).

Drug Line 1/2 – Choose from None, Brand, Generic, Description, Equivalent To, or Description
2 (taken from the drug record) to select what prints on the vial label for this patient if required to
be different from the default.

Double Count – If an option to double count is selected, a message will display on the
packaging screen (if configured) to prompt the user to double count the medications for this
patient.

No Kroll Care – Use the space bar or click on the box to note if this patient should not receive
any monographs.

No Wallet Card – Use the space bar or click on the box to note if the patient should not receive
a printed wallet card. Note that Wallet Cards can be configured to print automatically for all
prescriptions, only New prescriptions or none.

Snap Caps Requested – Use the space bar or click on the box to note if snap caps have been
requested. If yes, the “Snap Caps Documented” option will become available. Compliance
Calendar on Label – Use the space bar or click on the box to enable a calendar to print
according to the days’ supply on the Rx. This is intended for the patient to record when a dose
has been taken.

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Patient sidebar functions
The patient sidebar was designed to quickly access functions related to the patient with just one
click of the mouse. The options are made easily visible here but are also available from the
menu at the top of the screen.

Different patient profile views can be accessed by clicking on the options in the
sidebar or pressing the corresponding function keys on the keyboard. These
include All Rxs (Shift + F3), Active Rxs (Shift + F5), Active Rxs with Passtimes
(Shift + F10), Refillable Rxs (Shift + F6), a Pricing Profile view with the costs and
markups displayed (Shift + F7), Not Dispensed/OTC Rxs (Shift + F8), Rxs Filled in
Error (Shift + F9) and Suspended Rxs.

Clicking Perform Clinical Analysis will initiate a First Data Bank clinical interactions
analysis based on the medications in the patient’s profile.

Alternate Addresses can be set up for the patient if necessary.

Batches created in the system can be viewed. Charting allows users to record
health metrics such as weight, height, blood pressure, blood sugar, cholesterol,
Creatinine clearance, International Normalized Ratio factors, and white blood
cell/Neutrophil counts for Clozaril.

Consents allows users to record patient consent to programs such as Central Fill,
Rx Sync, Privacy and any other provincial programs such as FOD.

Information about patient Credit Cards can be saved and encrypted with a
password.

Documents can be scanned into the system and saved to the patient profile.

The History displays a read-only view of any changes that were made to the patient record.

Immunizations allows users to record and bill (where applicable) patient immunizations such
as Influenza and Non-Influenza vaccines.

Limited Use Items is for Ontario only and displays prescriptions billed to ODB with Section 8 or
Limited Use codes.

PharmacyLink Access is used to enroll a patient in the eCare@Pharmasave enhanced refills

to allow them to view their prescription profile online.

Professional Services allows pharmacists to electronically record Medication Reviews,

General Counseling, or Pharmacist Consultations.

Rx Counseling History allows pharmacists to electronically record and document the patient’s
Rx counseling sessions.

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Rx Notes displays any notes that were entered on the prescription during the time of fill. Users
can modify a prescription and add any additional notes.

To Do Items will display outstanding callbacks and follow ups for the patient.

Work Orders will display outstanding work orders for the patient.

CPHA Pat Code – This code is only used by certain plans, e.g., Green Shield. It is typically the
relationship code plus 1, e.g., the cardholder would be entered as 001.

Card Holder Name – A name can be entered here if different than the name on the Patient
Screen, or if patient is not the cardholder.

Relationship – Type the number or click on the drop-down list arrow to view all.

Deduct Type – This refers to the type of deductible — percentage or dollar amount.

Deduct Value – This must be left blank for on-line plans. The response from the third-party will
include the deductible. For manually billed plans, the amount can be entered.

Search drug – F5
1. Press F5 or click on the F5-Drug button to access the drug card. A search screen will
appear.
2. To search for a drug, type the beginning letters of the brand or generic name, comma (,)
strength, or DIN, or a “.” followed by the old code from the old system and press Enter or
click on Search. Type * to recall all drugs. A list of drugs matching the search criteria will
be listed:

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 3. Using the arrow, highlight the desired drug and press Enter or type the line number
beside the name and press Enter or double click on the desired drug.
4. The drug information will appear.

Mixture-drug – F5
1. Press F5 or click on the F5-Drug button to access the drug card.
2. Then to access a mixture card, press Ctrl + M and use the space bar or your mouse to
click the Mixture checkbox.
3. A search screen will appear.
4. To search for a mixture, type the beginning letters of the component(s), or description, or
a “.” followed by the old code from an old system if applicable.
5. Press Enter or click on Search. Type * to recall all mixtures.

6. A list of mixtures matching the search criteria will be listed.

7. Use the arrow to highlight the desired mixture and press Enter or type the line number
beside the name and press Enter or double click on the desired mixture.
8. The mixture information will appear.
9. If the mixture is not found, press Insert or click on the Insert button to enter a new
mixture.

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Search doctor – F7
1. Press F7 or click on the F7-Doctor button to access the doctor card.
2. A search screen will appear.
3. To search for a doctor, type the beginning letters of the last and first name separated
with a comma, or the phone number, or a “#” followed by the License number or, a “.”
followed by the old code from an old system if applicable.
4. Press Enter or click on Search. Type * to recall all doctors.
5. A list of doctors matching the search criteria will be listed:

6. Use the keyboard arrows to highlight the desired doctor and press ENTER or type the
line number beside the name and press ENTER or double click on the desired doctor.
7. The doctor information will appear.

Entering prescriptions into Kroll

Patient prescriptions are entered into your pharmacy system through the Prescription Filling
Screen F12-Fill Rx:

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Fields on the prescription filling screen
The three main components of a prescription are the patient, drug and doctor. These areas
displayed at the top of the screen are colored corresponding to the colors on the individual
screens, i.e. yellow, green, and magenta.

Patient search – Enter the patient by typing the beginning letters of the last name, comma (,)
first name.

Drug search – Enter the drug by typing the beginning letters of the name, comma (,) strength or
DIN. If the Rx is for a mixture, begin the search with “@”.

For purposes of maintaining perpetual inventory, it is important to dispense the medication

from the correct pack size. The screen will prompt to select the correct pack size. Use the Up
and Down arrow keys to move to the desired Size and press the Enter key or click on the Size,
and then OK.

CAUTION: If the system detects any allergies or drug interactions when the
drug is selected, the system will provide a warning pop up that must be
overridden. Initially you will need a pharmacist or senior pharmacy assistant to
clear these pop ups for you. For more information on this topic, see Drug
Usage Review.

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Doc search – Enter the doctor by typing the beginning letters of the last name, comma (,) first
name.

Entering prescription directions (sig)

When entering directions into the Kroll system, always ensure that the directions are written in
complete sentences in the standard format:

Verb, quantity, form, interval, condition

There are also standard conventions for different dosage forms:

• Directions for medications given by mouth begin with “Take”, “Give” or “Chew and
swallow”
• Directions for medications on skin conditions begin with “Apply”
• Directions for medications used in the ears or eyes begin with “Instil”
• Directions for medications used in the vagina or rectum begin with “Insert”
• Write out numbers except when noting time (8:00 am)

There can be more than one correct way of translating SIGs but adhering to these conventions
will generally produce labels that are clear and easy for the patient to understand.

The Kroll system uses a number of SIG codes to simplify the process of entering prescription
directions into the system. Fortunately, many of these codes are very similar to the common
pharmacy abbreviations used to write prescriptions. (For a review of common pharmacy
abbreviations, see Module 3: Tools of the Trade, page 35.)

A list of the common SIG codes used in the Kroll System is included in the Memory Work
Section of this module (see page 59) and should be reviewed and learned.

Entering SIG codes

To enter a SIG code:

1. From the Prescription Entry screen, press Tab to reach the SIG field.
2. Type the SIG code into the SIG field. The window below the SIG field, will display the
directions as they will appear on the prescription label. Or:
3. Type a combination of SIG codes and words separated by a single space. The window
below the SIG field will display the directions as they will appear on the prescription
label. Or:
4. Type the directions as you wish them to appear on the label.
5. Review the directions for clarity and make any required corrections.
6. Tab to the next field to be entered (Quantity) or use the mouse to click on another field.

If a SIG is not found, it can be entered into the system while filling the prescription. This should
only be done in consultation with the pharmacist on duty or a senior pharmacy assistant to
ensure that an alternative has not already been entered.

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Entering a new SIG
To enter a new SIG:

1. Press Alt + E, S or click on Edit and then on Edit SIG Codes.

2. A list of SIG codes will appear in the current Rx language (the default is English).
3. If the desired SIG cannot be found in the list, press Ins on the keyboard or click on Ins to
enter a new SIG code.
4. The Edit SIG Code dialogue box will appear:

5. In the Code field, type the code to be added.

6. Tab to the Expansion field and type the long form of the instructions.

NOTE: An expansion may include more than one existing code. For example, in the screen
above, SW4 expands to: Shake well and inhale 2 puffs 4 times per day. The expansion may
include other codes, e.g., QID and the system will further expand the instructions when printing.

Entering other prescription information

Disp Qty – The quantity to be dispensed for this prescription, not including repeats.

Rem Qty – If there are refills authorized on the prescription, press CTRL + R or click on the
Rem Qty button – Enter the number of repeats of the dispensed quantity or the total quantity of
units authorized. Press ENTER or click on OK to save. This number will display in the
“Authorized Quantity” field.

Days – The days’ supply of the prescription. The system will calculate this number based on the
quantity dispensed and the sig where possible.

TIP! If the standard SIG codes are used, the days supply calculation will be
automatically done for you saving time and effort.

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Prod Sel will default to 3-“Pharmacist Choice”. Click on the arrow to select alternatives, e.g.
Prescriber’s Choice, Patient’s choice, etc.

O/W – Type “O” for oral or “W” for written for a narcotic or controlled drug or click on the right
arrow and select the appropriate choice.

Labels – The screen will default to print one label. If more than one label is required, type the
number and press ENTER. The system will assume that the quantity is NOT split, e.g. If the
quantity is 100 on 2 labels, each will print 100 tablets.

To split the quantity:

1. Press F2 while in the Labels field, or click on F2.

2. A screen will appear. To split the quantity, use the space bar, or click the checkbox to
check “Split Quantity on Labels”. Once that box is checked, the system will attempt to
split the quantity evenly, in the previous example, 50 tablets per label.
3. If this is not the case, uncheck that box using the space bar or your mouse.
4. A field will open up in which to type the quantities desired on each label, for example 70
tablets on one label and 30 on the other.
5. Press Enter or click on Save to save the information.

Auth Qty – Type the total number of units (Tab, Cap, etc.) authorized on the prescription,
including the current prescription quantity. If repeats were added using the Refills (+) button,
the number will be translated here.

To fill a prescription:

1. Fill in the above fields and press Enter

2. The system will search for the correct patient, drug and doctor and populate the
information in the windows.
3. The system will display a search screen if no exact match is found.
4. Select the desired information.
5. If any changes are made at any time, press Enter again or click on Lookup to recalculate
the amounts.

NOTE: For stores keeping perpetual inventory, it is important to dispense the medication from
the correct pack size. If this option is turned on, the screen will prompt to select the correct pack
size. Use the Up and Down arrow keys to move to the desired size and press Enter or click on
the size, then on OK.

There are tabs of extra information at the bottom left and right of the Rx Filling Screen. On the
left, there are Plans, Pricing, Dates, Comments, Indications, Images and Other. On the right
side any Warnings are displayed. To move from tab to tab, press Ctrl in conjunction with the
underlined letter, e.g., Pricing is Ctrl + N or click on the name at the top of the tab or press Ctrl +
 or  to move back and forth between tabs on the left side.

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Rx Plans displays the plan(s) for this prescription listed in the order in which they will be
adjudicated.

Next Disp Qty – If this Rx is filled for a different amount than the usual fill, type the quantity of
the next fill here. When the Rx is repeated, this quantity will appear.

Min Interval – If a narcotic or controlled Rx is filled as a partial fill and there is a minimum
number of days required between the fills (different than days’ supply), enter the number here.

Max Disp Qty – If a narcotic or controlled Rx is filled as a partial fill and there is a Maximum
Dispensed Qty indicated by the Doctor, enter the number here.

Pricing

Pricing is displayed for this Rx. The top line shows the Strategy on which the pricing is based.
Acq Cost is copied from the drug card.

If any changes are required for this specific prescription, Tab to and use the space bar or click
the checkbox for Manual Price. Once the box is checked, the fields for all of the prices will open.
Tab to or click on the appropriate price to change. Make any changes and press Enter or click
on Lookup to recalculate the Rx.

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Written Date – The date the Rx was written by the doctor. The system will enter the written date
as the first fill date. This can be overwritten.

Dispensing allowed period

Start Date – The first fill date for this prescription.

Stop Date – If this option is set in Configuration, this date will be calculated by the system.

Administration period
Start – The system will automatically enter the start date based on the fill written date.

Stop – The user can enter a stop date based upon the date the patient must stop taking the
medication.

Drug Expiry – If a number is entered in the drug card, it will be calculated to this field.

Ingest – Applies to prescriptions that the pharmacist witnesses ingestion, e.g., Methadone.

Comments

Comments pertaining to this Rx can be entered here.

Indications

Indications pertaining to the Rx can be entered here and will pre-populate the associated fields
on the Medication Review forms.

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If available, script and hardcopy images can be viewed here.

Admin Sites – If administering an injection, the user can select the site of administration from
the (…) button

Max Dosage – Users can enter specific dosage information by selecting the (…) button.

Extra information on doctor authorization and narcotic reporting can be selected.

Warnings

Warnings appear on the bottom right side of the screen.

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There are three types of warnings appearing with a red, yellow or green sign:

• A red warning will not allow the Rx to be filled until it is corrected

• A yellow warning will allow the Rx to be filled, but warns of a possible problem

• A green warning is information only and will allow the Rx to be filled

To clear warnings, you will need to return to the section of the prescription filling screen that is
generating the warning and update the information entered.

Once all the red warnings have been cleared and if none of the possible problems are an issue,
the prescription can be filled.

To fill the prescription press F12 on the keyboard or click on F12 – Fill Rx using the mouse. The
prescription will be adjudicated and the label set generated.

Once all information is correct and complete, the Rx can be filled. Press F12 on the keyboard or
click on the F12 – Fill Rx button.

Managing on-line prescription adjudication

Once all the prescription information has been corrected and adjusted, the prescription can be
processed by the computer. The process of transmitting the prescription information to the
government and third-party payer computers is called Adjudication.

Adjudicating claims
• If it is a Cash or manual third-party claim, the system will print the label set right away.
• If the prescription will be billed on-line to a third party, the system will transmit the
prescription information to the third-party server to adjudicate the prescription.
• The third-party plan adjudicating the prescription may send back error messages that
need to be cleared. Examples of these include: Drug Usage Review Messages, days
supply errors, and other coverage messages. Some of these will require that the
prescription be adjusted and retransmitted while others will be for information only. The
error messages will be presented to you in a pop-up window that requires your
acceptance or reversal by entering the appropriate response at the bottom, (see Drug
Usage Review, page 5–52).
• If no error messages are returned to the pharmacy by the third-party plan, the claim
adjudication screen will appear (see figure 5–24).

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Figure 5–24: claim adjudication screen

• If the prescription has been adjudicated as submitted and the patient copay amount is
correct, then press the Enter key or click OK.
• If there is a problem with the adjudication and the cost or fee have not been covered
then the prescription may need to be cancelled and either altered or the billing may need
to be adjusted.
• If more than one plan will be billed for the prescription, the computer will send out to the
secondary plan to adjudicate the balance remaining on the prescription and another
similar adjudication screen will be displayed for review. The amount paid by the primary
plan will be displayed in the Prev Paid field on the right side of the adjudication screen
(see figure 5–24).

Refilling prescriptions
Refilling prescriptions is easier and quicker than entering new prescriptions because the
information has already been entered into the Kroll system. The process is a little complex
because not all prescriptions have refills and not all patients understand the regulations
governing refill prescriptions. For a review of the process of receiving prescription refill requests,
see Module 4: Prescription Preparation, page 10.

With today’s technology, patients now have access to request refills through the Pharmasave
mobile app or Pharmasave website. If submitted via their eCare@Pharmasave account, the
patient will be alerted that their prescription will be ready 30 min from the time they submit the
request. Some Pharmasave stores may adjust this wait time, allowing for more time to prepare
the refill. Patients submitting a refill request via the Rapid Refill option will be given a 24-hour
pick-up time. Should any of these prescriptions have remaining refills available, the pharmacy
assistant would then process the refills through the Kroll system and prepare the prescriptions

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for the pharmacist to check. These tasks should be completed in advance of the patient arriving
in the store.

In practice, patients often don’t know the prescription number and may not even know the name
of the medication they wish to have refilled. They may not use the available technology or may
not phone in advance or not have any authorized refills remaining. Fortunately, the Kroll system
supports all these scenarios.

Refilling from the start screen:

1. Type the Rx number in the universal search field near the top of the screen and press
F12 or click on the F12 – New Rx button.
2. The prescription will appear on the screen. If there are repeats remaining on the
prescription and no changes are necessary, simply press F12 or click on the F12 – Fill
Rx button.
3. The claim will adjudicate to appropriate provincial and third-party plan(s) and then print a
label.
Information about the first and last fill will appear across the top of the screen. It is
important to ensure that the prescription is not being filled too soon or too late. For
example, if the last prescription should have lasted the patient 30 days but it is only 15
days since the last fill, the pharmacist on duty may need to consult with the patient
before the prescription is filled. Warnings will also be displayed in the prescription
warning box on the bottom right of the Prescription Filling Screen (see figure 5–23).
4. Review any cost differences that appear on the right side of the price portion of the
screen. If the Rx price increased, a green up arrow will display beside the Total. If the Rx
price decreased, a red down arrow will display beside the Total (see figure 5–25).

Figure 5–25: pricing screen showing price changes on refill

5. If there are repeats remaining on the prescription and no changes are necessary, press
the F12 on the keyboard or click F12 – New Rx.
6. The prescription will adjudicate just as a new prescription

From the patient profile:

1. While in the patient card, press SHIFT + F3 or access the Profile Menu by pressing ALT
+ O then L for All Rx’s or click on the All Rxs button on the sidebar.

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 2. The patient’s profile will display on the screen:

3. Use the arrow keys to move to the desired Rx(s) and press the space bar to select them.
Selected Rx’s will appear in bold. Similarly, press the space bar again to “unselect” an
Rx.
4. Once all prescriptions have been selected, press F to refill.
5. The prescription will appear on the screen. If there are repeats remaining on the
prescription and no changes are necessary, simply press F12 or click on the F12 – Fill
Rx button.
6. The claim will adjudicate to the appropriate provincial and third party plan(s) and then
print a label.

If there are no repeats remaining, in many areas in Canada the patient must return to the
doctor’s office to get a new prescription. If a refill authorization is not available by phone or fax,
the patient needs to be informed of the requirement to contact their physician.

CAUTION: When patients have no refills remaining and must see their
physician, it is important to determine if they have enough medication to last
until this can be done. If they will run out, consult the pharmacist on duty about
the situation.
In some areas, the pharmacy can authorize a refill then notify the doctor. Ask
your Mentor to let you know what the usual procedures are for your pharmacy.

If there are no refills remaining, the following options will be presented:

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Copy to a new number:

Using the Copy to a new number option. The “Are you sure?” dialogue box will appear (see
figure 5–26).

Figure 5–26: Are you sure? dialogue box

1. Press the Y key or click Yes to continue. The system will copy all information on to a
new Rx screen and a window will appear asking for the new authorized quantity.
2. Type the number of repeats or total authorized quantity of tablets, capsules, etc., to be
authorized.
3. Press the Enter key or click OK to save
4. Make all necessary adjustments to the prescription, then press the Enter key or click OK
to save.
5. The screen should automatically display “Call Doctor is Enabled” in the Warning Box and
will print a Doctor Authorization label. (Note: This function may have been turned off in
system configuration)
6. Press F12 or click on the F12 – New Rx Button to fill. When the prescription label is
printed, the Doctor’s Information on the hard copy will be highlighted.
7. The original number will be Inactive. The patient’s profile will display the link between the
new and old number.

Request renewal:

Using the Request renewal function will open the Request Renewal window where the reason
for the renewal is entered and the renewal can be marked as urgent.

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NOTE: If the prescriptions to be authorized are prescribed by different doctors, the report will
print on separate pages for each doctor.

Clicking the Request button or pressing Enter will print a doctor’s authorization fax request.
Once the doctor has authorized the Rx, the Copy to a new number option is used and the
prescription can be processed.

Continue to view the Rx:

Using the Continue to view the Rx option will display the prescription details screen where the
user can continue to add repeats to the prescription using the steps below.

Adding Repeats to an Existing Prescription

To add repeats to an existing prescription, do the following:

1. Press Alt + X to return to the Start Screen.

2. Type the Rx number(s) to be repeated in the field at the top of the screen and press F12
or click F12–New Rx. The prescription will appear on the screen.
3. Press Ctrl + R or click Rem Qty to add repeats. A dialogue box will appear displaying the
original dispensed and remaining quantities as well as the new values.
4. Type the number of repeats or total authorized quantity of tablets, capsules, etc., to be
authorized.
5. Press the Enter key or click OK to save.
6. The screen should automatically display “Call Doctor is Enabled” in the Warning Box and
will print a Doctor Authorization label. (NOTE: This function may have been turned off in
system configuration.)
7. Press F12 or click on the F12 – New Rx Button to fill. When the prescription label is
printed, the Doctor’s Information on the hard copy will be highlighted.

Obtaining doctor authorization

In some stores, the store does not fill the prescription until the doctor has authorized the
repeat(s). There are two ways to create a Doctor Authorization request – by phone or by fax.

Phone repeats — authorization label

To create a phone repeat authorization label, do the following:

1. Press Alt + X to return to the Start Screen.

2. Type the Rx number to be repeated in the field at the top of the screen and press the
F12 key or click F12–New Rx.
3. Select “Continue to view the Rx” then, press Alt + R to

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 4. Press the Z key to print Doctor Authorization Label or from the New Rx Main Menu at the
top of the screen, click Rx, then click Print Authorization Label. A report for the doctor’s
authorization will print on blank paper with areas to write comments and any information
about this Rx.
5. Once the doctor has authorized the Rx, refill by copying to a new prescription. For
instructions, see Copy to a new number, page 41.

Fax repeats – see request renewal

To initiate a Doctor Authorization request by fax, ensure the doctors card includes a fax number
and follow the steps to Request renewal.

Refilling from the patient profile:

1. While in the patient card, press SHIFT + F3 or access the Profile Menu by pressing ALT
+ O then L for All Rx’s or click on the All Rxs button on the sidebar.
2. The patient’s profile will display on the screen:

3. Use the arrow keys to move to the desired Rx(s) and press the space bar to select them.
Selected Rx’s will appear in bold. Similarly, press the space bar again to “unselect” an
Rx.
4. Once all prescriptions have been selected, press F to refill.
5. The prescription will appear on the screen. If there are repeats remaining on the
prescription and no changes are necessary, simply press F12 or click on the F12 – Fill
Rx button.
6. The claim will adjudicate to the appropriate provincial and third party plan(s) and then
print a label.

Basic refilling

1. To refill any prescription(s), use the arrow key to move to the selected Rx(s) or click on
the selected Rx(s) and press the space bar. Each Rx selected will now display in bold.
2. To “unselect” an Rx, repeat the procedure.
3. Once all prescriptions have been selected, press the F key to fill. The prescription will
appear on the screen.
4. If there is more than one prescription to be filled, the system will automatically advance
through each Rx once the previous one is completed.
5. Once the prescription is on the screen, repeat the steps for either method of refilling.

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Autofill function

If there is more than one prescription to be filled for one patient, adjudication may be performed
in the background as the Rx’s are being processed.

1. Use the arrow key to move to the selected Rx(s) or click on the selected Rx(s) and press
the space bar. Each Rx selected will now display in bold.
2. To “unselect” an Rx, repeat the procedure.
3. Once all prescriptions have been selected, press the X key for Extra Functions, then the
F key to “Autofill Selected Rx’s”. The system will begin to process each prescription until
all have been completed.
4. Prescriptions will be adjudicated and labels printed. In some cases, at the end, a small
window will appear to alert that intervention is required (see figure 5–28).

Figure 5–28: information dialogue box

5. Press the Enter key or click OK to begin reviewing problematic Rx’s.

6. Once each prescription is addressed, the process will be complete.

When refilling a prescription from a Patient Profile with no repeats, Doctor Authorization reports
can be produced and tracked for more than one Rx by using the Extra Functions option. This is
only relevant in dispensaries where refill authorization can be obtained by the pharmacy.

Managing system warnings

The pharmacy computer system is a powerful tool for preparing prescription labels, tracking
inventory, and automating prescription pricing and billing. In addition to these technical
functions, the system also helps the pharmacists with some important clinical functions. These
functions include allergy screening, drug interaction review, and therapeutic reviews.

Process warnings
Warnings regarding pricing, billing, and available inventory quantity can safely be handled by
pharmacy assistants. For example, if a patient chooses to have a brand name medication

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dispensed for them when a cheaper generic alternative is available, the system will produce a
warning pop-up and request direction on how to proceed (see figure 5–29).

Figure 5–29 generic override warning

The pharmacy assistant can confirm with the patient the request for the more expensive brand
and proceed, choose a generic equivalent or, at the doctor or pharmacists direction, proceed
with a NoSub prescription. No Substitution (or NoSub) prescriptions are prescriptions where a
particular brand is specified usually due to an intolerance or therapeutic failure with a generic
equivalent.

The transaction warnings present in the lower right-hand corner of the filling screen contain
other information that pharmacy assistants need to be aware of during the filling process (see
figure 5–30).

Figure 5–30: transaction warnings

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Clinical warnings
Clinical warnings are flagged by patient allergies or drug interactions. The Kroll system will pop-
up a clinical report that details the type of warning, the severity, and some background
information about the allergy or interaction.

All clinical warnings must be communicated to the pharmacist on duty. Each dispensary will
have a different procedure for how the notification is achieved. In some stores, the pharmacy
assistants will have to interrupt the process of prescription entry to have the pharmacist review
and override the warning. As pharmacy assistants gain experience, many stores allow
pharmacy assistants to override the warnings and either print the warning or make a note on the
prescription hard copy for the checking pharmacist to look up later. Clinical warnings can be
printed by pressing Ctrl+R or clicking on the Print button on the clinical report.

Discuss with your mentor the procedures that are in place in your store

CAUTION: If you are at all unsure about how to manage a clinical warning,
always consult with the pharmacist on duty. It is always better to err on the side
of caution.

Allergy warnings

When a drug is selected for a patient where the patient has an allergy to the drug or one of the
ingredients in the drug entered on his or her profile, the system will generate a clinical report to
notify you that an allergy has been detected (see figure 5–31).

Figure 5–31: Allergy report

Not all allergies that the system flags will be clinically significant. Pharmacists will review the
documented allergic reaction, the patient’s medication history, and the need for the medication

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to make a decision about whether to dispense the medication. Consultation with the patient and
the doctor may also be required.

There are some common instances where the pharmacist will proceed with the prescribed
treatment. These include:

• Previous treatment with the prescribed medication

• Previous treatment with a medication in the same drug class
• Reported intolerance (rather than allergic response) to the medication

In these instances, the pharmacist may direct you to override the warning. To override the
warning press Ctrl + P or click on the Proceed.

If the pharmacist does not want to proceed with the prescription, then cancel the warning using
the cancel button on the lower left corner of the clinical report screen.

Usage review

After checking for allergies, the Kroll system checks the patient medication profile for any
dangerous combinations between the new drug and other drugs entered on the profile. These
are called Drug-Drug Interactions. As well, the system will check for dangerous combinations of
the new drug with disease states (conditions) that have been entered on the patient profile.
These are called Drug-Disease Interactions.

The Kroll system will produce a clinical report whenever an interaction is detected, for an
example see figure 5–32.

Figure 5–32: Drug interaction report

In this instance, the system had detected two different drug-drug interactions. Notice the red
and yellow boxes in the upper left-hand side of the screen where the report assigns different
severity levels.

There are many potential interactions that may in theory cause problems for patients, but which
are so rare that the doctor and pharmacist will proceed with the treatment and just monitor the

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patient for any indication of an emerging problem (Severity 2 and 3 interactions). There are;
however, some instances when two drugs should not be taken together. This is called a
contraindication. The system will flag these as Severity 1. These must be brought to the
attention of the pharmacist on duty before proceeding with the prescription.

TIP! Severity 1 interactions may be overridden if the interacting medication has

already been discontinued by the patient. It is good practice to inactivate the
original medication so that the profile is accurate. For directions on how to
inactivate prescriptions, see Inactivating a Prescription, page 53.

Some medications should not be used in patients who have particular medical conditions.
These are called Drug-disease interactions. Most commonly these occur when a side effect of a
prescribed medication is similar to the effects of a condition that the patient already has.

The Kroll system is set up to generate drug/disease interaction warnings for these instances.

Figure 5–32: Drug disease warning

Many of these interactions will be of minor severity and should not impede the filling process. It
is still important to notify the pharmacist of the interaction. Check with your mentor for the
procedures in place in your dispensary.

NOTE: In addition to the Kroll System allergy and drug usage warnings, many of the provincial
and third-party computer systems will return allergy and drug usage warnings when the
prescriptions are transmitted for adjudication. These warnings will in most cases duplicate the
Kroll System warnings. It is important to communicate any additional warnings to the
pharmacist. Duplicate warnings need only be communicated once.

Page 48 of 91
Useful features and tools
In addition to the primary functions of entering patients, filling new prescriptions, and processing
prescription refills, there are other functions in Kroll that pharmacy assistants need to be aware
of to function efficiently on the pharmacy team. These include reviewing the details of a
prescription from the patient profile, cancelling prescriptions that are not correct or not needed,
reprinting prescription labels, modifying prescriptions, putting prescriptions on file for later pick
up, and managing prescriptions where there is not enough inventory in stock to fill the full
quantity.

Detailing prescriptions from profile

The Patient Profile summarizes the last fill of the patient’s prescription(s).

1. To view a detailed list of a refill, including adjudication results, access the Patient’s
profile on the screen. For instructions, see Refilling from the patient profile, page 43.
2. Use the arrow key or click on the desired Rx to view.
3. Press the D key to see Detail History. A refill history will appear — for the one
prescription only

Figure 5–34: Rx detail screen

4. From the Rx Detail screen, specific refills may be modified, reprinted or cancelled.
5. Press the D key again to view the billing detail for the specific fill (see figure 5–35).

Figure 5–35: Rx plan detail form

6. If this is an on-line claim, press the D key again to view the Adjudication History.

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Cancelling a prescription
The prescription can be cancelled using the prescription number or from the patient profile.

From the Start Screen:

1. If you know the prescription number, press Alt + X to return to the Start Screen and type
the Rx number in the universal search field
2. Press Ctrl + C and the screen will advance to the prescription

From the Patient Profile:

1. To cancel from the patient profile, access the patient card. To access the profile, press
Shift + F3 or access the Profile Menu by pressing Alt + O then L for All Rx’s or click on
the All Rxs button on the sidebar.
2. The patient’s profile will display on the screen:

3. Use the arrow keys to move to the desired Rx(s) and press the space bar to select them.
4. Selected Rx’s will appear in bold. Similarly, press the space bar again to “unselect” an
Rx. Once all prescriptions have been selected, press C to cancel.
5. Depending on the type of prescription being cancelled, the system will prompt you with
varying messages, for example:

6. If this is not the correct Rx to cancel, press Enter or press N or click on the No button.
7. If this is the correct Rx, press TAB to move to Yes and press Enter or press Y or click on
the Yes button.
8. If you need to make a change to the prescription and would like to re-adjudicate the
claim choose Cancel and Refill.
9. If there is more than one prescription to be cancelled, the system will automatically
advance through each Rx once the previous one is completed.

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Reprinting a prescription
The prescription can be reprinted using the Rx number or from the patient profile.

From the Start Screen:

1. If you know the prescription number, press Alt + X to return to the Start Screen and type
the Rx number in the universal search field.
2. Press Ctrl + R and the screen will advance to the prescription.

From the Patient Profile:

1. To reprint from the patient profile, access the patient card. To access the profile, press
Shift + F3 or access the Profile Menu by pressing Alt + O then L for All Rx’s or click on
the All Rxs button on the sidebar.
2. The patient’s profile will display on the screen:

1. To reprint any prescription(s), use the arrow keys to move to the desired Rx(s) or click
on the desired Rx(s) and press the space bar to select them.
2. To “unselect” an Rx, repeat the procedure.
3. Once all prescriptions have been selected, press R to reprint.
4. A window will appear to confirm the reprint. Depending on your store configuration
settings it may appear as follows

5. If this is the correct Rx to reprint, use the Tab key with the space bar to select which
documents to reprint and press Enter or Ctrl + R or click on the Reprint button.

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 6. If this is not the correct number, press Tab to move to No and press Enter or press Ctrl +
N or click on the No button.
7. If there is more than one prescription to be reprinted, the system will automatically
advance through each Rx once the previous one is completed.

Putting a prescription on hold (Unfill)

To “Unfill” a prescription is to put it on hold if for various reasons a patient does not require it to
be filled at the time.

1. Enter the new prescription as usual.

2. Any time before pressing F12 to fill, press Alt + R to access the top Rx Menu.
3. From the drop-down menu, press U to Make the Rx Unfilled or click on the Make Rx
Unfilled button on the sidebar.
4. A “yellow” warning will appear in the warning box, “Rx is being Unfilled”.
5. Press F12 or click on the F12 – Unfill Rx button to complete the process.
6. The prescription will appear in the patient’s profile with a Status of “Unfilled”:

To fill this prescription, simply refill from the unfilled Rx.

Owing Label
There may be cases where a patient brings a prescription and there is not enough inventory on
hand to fill the total quantity. After the prescription has been filled, an “Owing Label” can be
created.

To Print an Owing Label:

1. Select the prescription from the patient profile and press M to modify.
2. Then press Alt + R to access the Rx Menu on the top of the screen.
3. From the following menu, press W for “Owe Quantity” or click on the Owe Quantity
button on the sidebar.
4. A small window will appear:

Page 52 of 91
 5. Type the quantity (number of tablets, capsules, mls, etc.) that will be packaged now, and
the owed quantity will be automatically calculated.
6. Then press Enter or click on OK.
7. A “green” warning will display in the warning box: “Owe the patient ##” (will display the
actual number).
8. Press F12 or click on F12 – Save Changes to generate the label

Inactivating a prescription
If a prescription is inactivated, it will not cancel billing or remove it from the profile, but it will
disable the Rx from being refilled and will also exclude it from certain reports. If a prescription is
copied to a new Rx number or transferred out to another pharmacy, the status of the Rx will
automatically change to “Inactive”. If it should be inactivated for any other reason, this can be
done manually on the Rx Filling Screen or from the patient profile.

From the Start Screen:

1. If you know the prescription number, press Alt + X to return to the Start Screen and type
the Rx number in the universal search field.
2. Press Ctrl + M and the screen will advance to the prescription.
3. Then access the top Rx Menu by pressing Alt + R.
4. From the menu, press I for “Inactivate Rx”, or click on Inactivate Rx button on the
sidebar. A small confirmation window will appear:

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 5. If the wrong Rx number was typed press Enter or N or click on No.
6. If this is the correct Rx to inactivate, press Y or click on Yes.
7. If configured, a screen will appear allowing for a comment to be entered describing the
reason for the inactivation.
8. Type the comment and press Enter or Ctrl + S or click on the Save button.
9. If there are no comments, press Esc or click on the Cancel button.

From the patient profile:

1. To inactivate one or more prescriptions from the patient profile, access the patient card.
2. To access the profile, press Shift + F3 or access the Profile Menu by pressing Alt + O
then L for All Rx’s or click on the All Rxs button on the sidebar.
3. From the profile, use the arrow keys to move to the desired Rx(s) or click on the desired
Rx(s) and press the space bar to select them.
4. To “unselect” an Rx, repeat the procedure.
5. Once all prescriptions have been selected, press “I” to inactivate. The Inactivate Rx(s)
screen will appear:

6. Press Ctrl + R to reactivate the prescription(s) or click on the Reactivate Eligible Rxs
button. Otherwise press Esc or click on the Cancel button to abort the process

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Glossary of terms
The process of transmitting the prescription information to the government
Adjudication
and third-party payer computers.

Used to access items on the menu bar when used in combination with
Alt key underlined letters. Also used in combination with other function keys to
display information or perform certain functions.

Used to move up and down to select a specific line on the screen. On

Arrow keys some monitors, the Arrow keys are used in combination with the Ctrl key
to move through different windows or screens of information.

Instances where two drugs should not be taken together. The Kroll system
Contraindication
will flag these as a Severity 1 problem.

A powerful search tool located on Kroll’s Main Menu (start screen). Used
Entry field in combination with function keys to search for information about drugs,
patients, doctors, Rx’s, etc.

Drug-Disease The Kroll system checks for any dangerous combinations of a new drug
Interactions with disease states (conditions) entered on the customer profile.

Drug-Drug The Kroll system checks for any dangerous combinations between a new
Interactions drug and other drugs entered on a patient profile.

Function Keys on the Kroll Main Menu (or start screen): F3 Patient, F5
Function keys
Drug, F7 Doctor, F12 New Rx, Alt-X.

Found along the top edge of the keyboard and are generally labelled F1
Keyboard function through F12. Using these keys can help you quickly access Patient, Drug,
keys and Doctor information, as well as help you effectively perform many
prescription-filling functions.

Logging on The process of starting a computer program.

Gives you access to all the different functions in Kroll. The words in the
menu bar are like headings and when you access one of these headings,
Menu bar a drop-down list of sub-headings appears for you to choose from. The
Menu Bar headings are: File, Edit, Reports, Cards, Utilities, Session,
Help.

No substitution These are prescriptions where a particular brand is specified (usually due
(or NoSub) to an intolerance or therapeutic failure with a generic equivalent).

Prescription Found on the left edge of Kroll’s Main Menu (start screen). Used to
function keys modify, reprint, or cancel prescriptions.

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 Found on the left edge of the keyboard and is used to move around the
Tab key items displayed on your computer monitor. Each time you press the Tab
key you will move from one field to the next.

Tabs, shaped like file folder tabs, found on various Kroll screens. Tabs
indicate that more screens of information are available. To open a tab,
Tabs
you can click on the tab with your mouse, or press the Ctrl key in
combination with the underlined letter on the tab.

From the Kroll Main Menu (start screen) a group of To Do Items are
located in the centre of the screen. This feature is like a notepad that
To do items stores important information and tasks that need to be completed. You
can create a to-do item for a number of different tasks such as refills, IVR,
follow-ups, notes, and doctor.

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Memory work
Quick Codes:

Quick Code Description

APSPQD APPLY SPARINGLY ONCE DAILY

APSPBI APPLY SPARINGLY TWICE DAILY

AAAQD APPLY TO AFFECTED AREA(S) DAILY

AAABID APPLY TO AFFECTED AREA(S) TWICE DAILY

H1NQD INHALE 1 PUFF DAILY

H1N46H INHALE 1 PUFF EVERY 4 TO 6 HOURS

H1NQID INHALE 1 PUFF FOUR TIMES DAILY

H1NTID INHALE 1 PUFF THREE TIMES DAILY

H1NBID INHALE 1 PUFF TWICE DAILY

H2NQD INHALE 2 PUFFS DAILY

H2N46H INHALE 2 PUFFS EVERY 4 TO 6 HOURS

H2NBID INHALE 2 PUFFS TWICE DAILY

I1AUQD INSTILL 1 DROP IN BOTH EARS DAILY

I1OUQD INSTILL 1 DROP IN BOTH EYES DAILY

I1OUQI INSTILL 1 DROP IN BOTH EYES FOUR TIMES DAILY

I1OUTI INSTILL 1 DROP IN BOTH EYES THREE TIMES DAILY

I1OUBI INSTILL 1 DROP IN BOTH EYES TWICE DAILY

I1ALQD INSTILL 1 DROP IN THE LEFT EAR DAILY

I1OSQD INSTILL 1 DROP IN THE LEFT EYE DAILY

I1ADQD INSTILL 1 DROP IN THE RIGHT EAR DAILY

I1ODQD INSTILL 1 DROP IN THE RIGHT EYE DAILY

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Quick Code Description

I2OUQD INSTILL 2 DROPS IN BOTH EYES DAILY

I2OSQD INSTILL 2 DROPS IN THE LEFT EYE DAILY

I2ODQD INSTILL 2 DROPS IN THE RIGHT EYE DAILY

*1C TAKE 1 CAPSULE ONCE A DAY

*2C TAKE 1 CAPSULE TWICE A DAY

*HS TAKE 1 TABLET AT BEDTIME

*AM TAKE 1 TABLET EVERY MORNING

T1TQWK TAKE 1 TABLET EVERY WEEK

*1 TAKE 1 TABLET ONCE DAILY

*2 TAKE 1 TABLET TWICE DAILY

*1P TAKE 1 TEASPOON(5ML) ONCE DAILY

TATQD TAKE 1 TO 2 TABLETS DAILY

TATTID TAKE 1 TO 2 TABLETS THREE TIMES DAILY

TATBID TAKE 1 TO 2 TABLETS TWICE DAILY

T2THS TAKE 2 TABLETS AT BEDTIME

T2TAM TAKE 2 TABLETS EVERY MORNING

T2TQID TAKE 2 TABLETS FOUR TIMES DAILY

T2TTID TAKE 2 TABLETS THREE TIMES DAILY

T2TBID TAKE 2 TABLETS TWICE DAILY

TUD TAKE AS DIRECTED

T1SSQD TAKE ONE AND A HALF TABLETS DAILY

T1SSBI TAKE ONE AND A HALF TABLETS TWICE DAILY

TSSQD TAKE ONE HALF TABLET DAILY

Page 58 of 91
 Quick Code Description

TSSBID TAKE ONE HALF TABLET TWICE DAILY

Verbs
SIG Code Verb

AP APPLY

APS APPLY SPARINGLY

G GIVE

GAR GARGLE

IH INHALE

INJ INJECT

INS INSTILL

IR INSERT

PAT APPLY PATCH

SAS SWISH AND SWALLOW

SG SHAKE WELL AND GIVE

T TAKE

CH CHEW

CR CRUSH

DIS DISSOLVE

PL PLACE

DOU DOUCHE

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Quantity
SIG Code Quantity

1-2 1 OR 2

2-3 2 OR 3

3-4 3 OR 4

GTT 1 DROP

SS ½

SS1 1/2 TO 1

SIG Code Form

CAP CAPSULE

CAPS CAPSULES

CPL CAPLET

CS CAPSULE(S)

DPFL DROPPERFUL

DPS DROPS

GTTS DROPS

ML ML(S)

PAC PACKET

PF PUFF

PFS PUFFS

PKG PACKAGE

PUF PUFF(S)

SUP SUPPOSITORY

TAB TABLET

Page 60 of 91
 TABS TABLETS

TSP TEASPOONFUL

APL APPLICATORFUL

INJT INJECTION

INH INHALATIONS

VS SUPPOSITORY INTO THE VAGINA

VA APPLICATORFUL INTO THE VAGINA

GTTIN DROPS INTO EAR CANAL

GTTN DROPS INTO THE EAR CANAL

Routes
SIG Code Route

PO BY MOUTH

IEN IN EACH NOSTRIL

EY IN THE AFFECTED EYE

OUS IN THE EYE(S)

IM INTRAMUSCULAR

IAE INTO AFFECTED EYE(S)

OAU INTO THE AFFECTED EYE

R INTO THE RECTUM

NASY NASALLY

REC RECTALLY

SUB SUBCUTANEOUSLY

VAGY VAGINALLY

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Interval
SIG Code Interval

BTID 2 OR 3 TIMES A DAY

TQID 3 OR 4 TIMES A DAY

TID 3 TIMES A DAY

HS AT BEDTIME

NOCTE AT NIGHT

DA DAILY

QD DAILY

Q1-2H EVERY 1 OR 2 HOURS

Q12H EVERY 12 HOURS

Q2H EVERY 2 HOURS

Q23H EVERY 2 TO 3 HOURS

Q24H EVERY 24 HOURS

Q3D EVERY 3 DAYS

Q3H EVERY 3 HOURS

Q34H EVERY 3 TO 4 HOURS

Q4H EVERY 4 HOURS

Q46H EVERY 4 TO 6 HOURS

Q6H EVERY 6 HOURS

Q68H EVERY 6 TO 8 HOURS

Q8H EVERY 8 HOURS

QAM EVERY MORNING

QO EVERY OTHER

QOD EVERY OTHER DAY

Page 62 of 91
 SIG Code Interval

QOAM EVERY OTHER MORNING

EOW EVERY OTHER WEEK

Q2D EVERY SECOND DAY

3D THREE TIMES A DAY

BID TWICE A DAY

BW TWICE EACH WEEK

WKLY WEEKLY

QHS NIGHTLY AT BEDTIME

12D ONCE OR TWICE A DAY

QID FOUR TIMES A DAY

Condition (Qualifiers)
SIG Code Condition

PB AFTER BREAKFAST

PC AFTER MEALS

PCHS AFTER MEALS & AT BEDTIME

ASU AFTER SUPPER

PRN AS NEEDED

PRNF AS NEEDED FOR

FP AS NEEDED FOR PAIN

TOL AS TOLERATED

AB BEFORE BREAKFAST

AC BEFORE MEALS

ACHS BEFORE MEALS & AT BEDTIME

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SIG Code Condition

PS BEFORE SUPPER

BETM BETWEEN MEALS

F1D FOR 1 DAY

F1W FOR 1 WEEK

F10D FOR 10 DAYS

F14D FOR 14 DAYS

F25M FOR 1ST 25 DAYS OF EACH MONTH

F2D FOR 2 DAYS

F2W FOR 2 WEEKS

F21D FOR 21 DAYS

F21 FOR 21 DAYS SKIP 7 THEN REPEAT

F28D FOR 28 DAYS

F28 FOR 28 DAYS, THEN REPEAT

F3D FOR 3 DAYS

F3W FOR 3 WEEKS

F30D FOR 30 DAYS

OES ON AN EMPTY STOMACH

FS ONLY AS NEEDED FOR SLEEP

UF UNTIL FINISHED

WA WHEN AWAKE

WAT WITH A GLASS OF WATER

WEF WITH EXTRA FLUIDS

WF WITH FOOD OR MILK

WM WITH MEALS

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Medical Conditions
SIG Code Conditions

ABD ABDOMINAL DISCOMFORT

ABP ABDOMINAL PAIN

ACN ACNE

AGI AGITATION

ALLER ALLERGY

ANX ANXIETY

ART ARTHRITIS

AST ASTHMA

BAP RELIEF FROM BACK PAIN

BP BLOOD PRESSURE

CAC COUGH & CONGESTION

CO COLD

CONG CONGESTION

CONS CONSTIPATION

COU COUGH

CP RELIEF FROM CHEST PAIN

CRA CRAMPS

DEP DEPRESSION

DIA DIARRHEA

DISC DISCOMFORT

DIZ DIZZINESS

DP DENTAL PROCEDURE

DR DIAPER RASH

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SIG Code Conditions

FC FOR COUGH

FW FOR WHEEZING

GLA GLAUCOMA

HA HEADACHE

HIV HIVES

HYP HYPERTENSION

INF INFECTION

INFL INFLAMATION

IT ITCH

ITC ITCHING

LBM LOOSE BOWEL MOVEMENT

LS LOOSE STOOL

MS MUSCLE SPASM(S)

MUS MUSCLE

NER NERVES

PN PAIN

PR PAIN RELIEF

SLE SLEEP

SHB SHORTNESS OF BREATH

ECZ ECZEMA

NAU NAUSEA

NAV NAUSEA & VOMITING

RA RASH

Page 66 of 91
Short Cut Codes
Quick Code Description

1.5TS TAKE 1&1/2 TEASPOONSFUL(7.5ML)

1/21T TAKE 1/2 TO 1 TABLET

1/2T TAKE 1/2 TABLET

1/2TS TAKE 1/2 TEASPOONFUL (2.5MLS)

12C TAKE 1 OR 2 CAPSULES

12GTT INSTILL 1 OR 2 DROPS INTO

12T TAKE 1 OR 2 TABLETS

1C TAKE 1 CAPSULE

1P APPLY ONE PATCH

1T TAKE 1 TABLET

1TB TAKE 1 TABLESOONFUL (15ML)

1TS TAKE 1 TEASPOONFUL (5MLS)

2GTT INSTILL 2 DROPS INTO

2TB TAKE 2 TABLESPOONFULS (30MLS)

2TS TAKE 2 TEASPOONSFUL (10MLS)

34GTT INSTILL 3 TO 4 DROPS INTO

3GTTS INSTILL 3 DROPS INTO

4GTTS INSTILL 4 DROPS INTO

AAA APPLY TO AFFECTED AREA(S)

G1.5TS GIVE 1 & 1/2 TEASPOONSFUL (7.5ML)

G1/2T GIVE 1/2 TABLET

G1/2TS GIVE 1/2 TEASPOONFUL (2.5ML)

G1T GIVE 1 TABLET

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Quick Code Description

G1TS GIVE 1 TEASPOONFUL (5.0ML)

G2/3TS GIVE 2/3 (3.3ML) TEASPOONFUL

G2T GIVE 2 TABLETS

G2TS GIVE 2 TEASPOONSFUL (10.0ML)

G3/4TS GIVE 3/4 TEASPOONFUL (3.75MLS)

HAN46H INHALE 1 TO 2 PUFFS Q46H

SL DISSOLVE 1 TABLET UNDER TONGUE

SP1 SPRAY ONCE IN TO EACH NOSTRIL

SP2 SPRAY TWICE INTO EACH NOSTRIL

T1 TAKE 1

T1T TAKE 1 TABLET

T2C TAKE 2 CAPSULES

T2T TAKE 2 TABLETS

T3C TAKE 3 CAPSULES

T3T TAKE 3 TABLETS

IN1OV INSERT 1 OVULE

INS2 INSTIL 2 DROPS

INSA INSERT 1 APPLICATORFUL

INSO INSERT ONE OVULE

INSS INSERT 1 SUPPOSITORY

RMW RINSE MOUTH WITH

Page 68 of 91
Auxiliary Directions
SIG Code Description

AAO TAKE ALL AT ONCE

DIW DISSOLVED IN WATER

ES TAKE ON AN EMPTY STOMACH

MREP MAY BE REPEATED AS NEEDED

NS DO NOT SWALLOW

POI **POISON**

REF REFRIGERATE

SIA SEE INSTRUCTIONS ATTACHED

SW SHAKE WELL

Bits and Pieces

SIG Code Description

21 21 DAYS STOP 7 AND REPEAT

1H 1 HOUR

1ST FIRST

2STAT TAKE 2 AT ONCE, THEN

AA THE AFFECTED AREA(S)

AD RIGHT EAR

AER THE AFFECTED EAR(S)

AEY THE AFFECTED EYE(S)

AFF AFFECTED

AFT IN THE AFTERNOON

AL LEFT EAR

AM IN THE MORNING

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SIG Code Description

AMHS IN THE MORNING & AT BEDTIME

ANA ANAL AREA

APPT APPOINTMENT

AR AREA

AU EACH EAR

AUS IN THE EAR

BET BETWEEN

BF BEFORE

BKF BREAKFAST

BM BOWEL MOVEMENT

CHE CHEST

D DAY

DC DISCONTINUE

DEC DECREASE BY

DS DAYS

E EACH

F FOR

F16 DAILY ON DAYS 16 TO 25

F1WT FOR ONE WEEK, THEN

FE FEET

FGTT A FEW DROPS

FO FOOT

GL IN A GLASS OF

H HOUR

Page 70 of 91
 SIG Code Description

HH 1/2 HOUR

HRS HOURS

INC INCREASING TO

ITT INTO THE

JUI JUICE

K KNEE

L LEFT

LES LESIONS

LOC LOCALLY

LUN LUNCH

M MEALS

MAX TO A MAXIMUM OF

MEN MENSTURAL

MIN MINUTES

MON MONTH

MWF MONDAY, WEDNESDAY AND FRIDAY

N NIGHT

NAS NASAL

NN NOON

NOS NOSTRIL

NOSS NOSTRILS

NT NOW, THEN

OD RIGHT EYE

OS LEFT EYE

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SIG Code Description

OU EACH EYE

P AFTER

P1T PLACE 1 TABLET

PM IN THE EVENING

Q EVERY

QPM EACH EVENING

REL RELIEF FROM

REP REPEAT

RIN1 RINSE FOR 1 MINUTE IN MOUTH

RT RIGHT

SAT SATURDAY

SCA SCALP

SEV SEVERE

SK SKIN

SP SPARINGLY

SPP SUPPER

SPR SPRAY(S)

STT AT ONCE, THEN

SUN SUNDAY

SYM SYMPTOMS

TL THIN LAYER

VAB VAGINALLY AT BEDTIME

VAG VAGINA

W WITH

Page 72 of 91
 SIG Code Description

WK WEEK

X TIMES

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Dispensary assignments
Computer Skills 101
1. Have an experienced staff member show you the location of the main pharmacy CPU
along with the component parts of the Pharmacy Computer Network.
2. If you have never used a Microsoft Windows based program, have an experienced user
demonstrate basic log on and navigation skills to you.

Main Street Kroll

1. Practice locating patients, drugs and doctors from the main screen to gain familiarity with
the Kroll Program.

Prescription Entry
1. Collect 15 to 20 prescription refills and fill them paying particular attention to the process
of adjudication.
2. Identify 15 to 20 prescriptions that need to be copied and fill them.
3. Fill 15 to 20 new prescriptions.

Managing System Warnings

1. Print an example of each type of system warning and document the procedures you
would undertake to resolve the warning.

Page 74 of 91
Practice exercises
Exercise one
Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Translate the following directions to SIG form:

Answer:

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Exercise two
Translate each of the following prescription abbreviations into a complete sentence that states
the directions clearly to the patient. Then provide the SIG code you would use to enter the
directions into the Kroll System.

Answer:

Page 82 of 91
Exercise three
This assignment is a review of reading and interpreting prescriptions. For each of the following
prescriptions, provide answers for the 10 items listed to the right of the prescription:

1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

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1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

Page 84 of 91
 1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

Pharmacy Assistant Training Manual

Module 5: Prescription Data Entry Page 85 of 91
1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

Page 86 of 91
 1. Patient’s Age:

2. Name of drug ordered (as written on the Rx):

3. Generic name of the drug ordered:

4. Strength of the drug ordered:

5. Quantity of the drug ordered (total):

6. Dosage form you would dispense (based on Rx):

7. SIG (directions):

8. Duration of therapy (days supply):

9. Number of refills:

10. Physician's name:

Pharmacy Assistant Training Manual

Module 5: Prescription Data Entry Page 87 of 91
Exercise four
Answer each of the following questions:

1. Give three examples of system warnings that pharmacy assistants can override without
informing the pharmacist on duty:

2. When will the Kroll System identify a Drug-Disease Interaction? What should be done
about this?

3. Give one reason why it is important to inactivate medication on the medication profile.

4. Why must the pharmacist on duty always be informed of drug interaction warnings?

5. Why might a prescription need to be “modified” after it’s been filled?

Page 88 of 91
The fundamentals
Computers 101
• The computers used in the pharmacy are just networks of personal PC’s.
• The Kroll Windows® System is a software program that operates in the Microsoft
Windows® environment. Most of the functionality will be familiar to users of other MS
Windows® based programs.

Main street Kroll

• The Kroll main screen is the primary launch point for the system. It can be reached from
anywhere in the program by entering Alt + X.
• The Entry Field is where searches are initiated for patients, drugs, doctors and
prescriptions by entering text and numbers and selecting the required function button.
• Patients, Drugs, and Physicians can all be searched for and entered if necessary from
the Main Kroll Screen.

Entering prescriptions into Kroll

• Select the Patient, Drug, and Doctor for the prescription
• Enter the directions using either SIG quick codes or a combination of codes and text.
• Enter the quantity, days supply and refill information
• Enter any additional information required for the prescription
• Press F12 or select the F12-Fill Rx button to fill the prescription.

Managing On-line prescription adjudication

• Adjudication is the process of transmitting prescriptions to government and third party
payers to request payment for a prescription.
• Pricing set up should automate the adjudication process but some overrides may be
needed in cases where drug costs or dispensing fees are cut back by payers.

Refilling Prescriptions (Play it again Sam)

• Prescription refills are processed most easily using the prescription number when there
are refills authorized on the prescription.
• In many communities, doctors will not issue prescription refill authorization directly to
pharmacies. The patients must make an appointment to see their doctor.
• When no refills are available, preauthorization filling of prescriptions can be done to
distribute workload in the dispensary.

Managing System Warnings

• Transaction warnings including pricing, inventory and product selection may be handled
by pharmacy assistants
• Clinical Warnings include allergies, drug interactions and drug usage review must be
communicated to the pharmacist on duty.

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Module 5: Prescription Data Entry Page 89 of 91
Useful Features and Tools
• It is important to maintain current and accurate medication profiles through prescription
reversals, modifications, and inactivation’s.

Page 90 of 91
Checklist for the mentor
Coaching
 Provide opportunities for the pharmacy assistant to explore the Kroll System and
become familiar with how to navigate through the fields
 Collect 15 to 20 prescription refills and have the pharmacy assistant fill them paying
particular attention to the process of adjudication
 Identify 15 to 20 prescriptions that need to be copied and filled to provide the opportunity
for the pharmacy assistant to become familiar with the use of the patient profile and copy
functionality
 Provide 15 to 20 new prescriptions that are relatively straight forward for the pharmacy
assistant to practice new prescription data entry

Review
 Review the most common prescriber signatures found in your practice
 Review the rules and process for pharmacist notification of allergies and drug usage
review
 Review your procedures for handling cost cutbacks and fee cutbacks on prescription
adjudication

Check
 Memory work has been completed (Kroll SIG codes)
 Practice exercises are complete
 Fundamentals have been mastered

Administer mastery assessment

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Module 5: Prescription Data Entry Page 91 of 91