Medication order

The Medication order view presents the clinician’s chosen recommended dose as structured, individual components. It also acts as a decision point, ensuring that any outstanding selections such as choosing a value within a range, selecting the route of administration, or confirming the formulation are finalised.

The structured format is designed to support two paths for completing the prescription. Where order writeback is available (see Adding the order to the EP System below), the recommendation can be transferred directly into the EP System's pre-signature order form by clicking the Add order button. Where order writeback is not available, the structured properties — including a concise medication order sentence — can be copied to the clipboard to assist the clinician in completing a prescribing form manually.

Structured properties

These structured properties are displayed in a tabular format, with the property name shown in the first column and the corresponding value in the second. The table below outlines the potential properties that may be displayed.

Property name	Purpose
Dose type	Indicates the type of dose, e.g. Loading dose
Route / Method	Provides the route and method of administration, e.g. Intravenous infusion and may also include the site and adverb, e.g. Slow IV injection or. Topical application to the lesion
Formulation	Provides the suggested medicinal formulation, e.g. tablets
Dose quantity	Provides dose quantity and rate information, which may be specified as a single value or a range. When a range is given, you will need to select a specific value from within that range.
Frequency	Specifies how often a dose should be given. Frequency may be expressed as a single value (e.g. 3 times daily) or as a range (e.g. 2–4 times daily). When a range is provided, you must select a specific value within that range.
PRN	Pro re nata which has a meaning of "as required". PRN indicates whether a dose must be prescribed or only as it is required. PRN will only be shown in the table when it is "Yes".
Duration	Duration contains information about the duration of therapy for a course of medication. Duration can be ranged or unranged. When the duration is ranged you will need to select a value from the range. Note that duration is not intended to refer to the duration of administration such as the duration of an infusion.
Duration information	This free-text field is used to record information about treatment duration. It may be used to provide additional context alongside the structured duration (e.g. “extend duration if new lesions appear during treatment”), or to replace the structured duration entirely when the duration is more nuanced and cannot be captured in a simple structured format (e.g. “until oral administration is possible”).
Administration information	Provides additional information about the administration of the medication, e.g. "infuse as rapidly as possibly via intraperitoneal port".
Level of supervision information	Provides information about which clinicians can administer a drug or in which settings a drug can be prescribed, e.g. "Under expert supervision".
Dosing information	Provides additional dosing information to support optimal prescribing decisions. For example, guidance such as "Choose a dose on the higher end of the range for severe infections." helps ensure appropriate treatment selection. Please note that any dosing-related information is provided to assist you in making informed decisions but is not included in the suggested dose story at the top of the table, as this information must not appear on the prescribing form. Instead, this information is presented with distinct visual styling and is displayed at the bottom of the table.
Max Dose/Time	This section contains information about the cumulative maximum dose per unit of time, such as: "Cumulative maximum per day: 2 mg." Please note that this information is not taken into consideration by the system when generating dose recommendations. It is provided for your reference, and you may need to adjust a prescription based on this information. See General advice for more information.

Additional information about some of the structured properties

Route / Method selection

There may be situations where selecting a route and method of administration is required. Until a route has been chosen, information on form, dose quantity, or frequency cannot be displayed. After selecting the route, additional choices, such as form and frequency, may also be necessary.

Once a route is selected, the other available routes will no longer appear in the dosing summary at the top of the table.

See below for an example of a scenario where route selection is required:

Dose quantity

Unranged dose quantities

Rounding

Whenever applicable, rounding suggestions will be provided. The calculated dose will always be clearly displayed and selected by default. If rounding suggestions are available, you may either choose the suggested rounded value or retain the original calculated dose. For each rounding suggestion, the percentage deviation from the calculated value will also be shown.

Currently, rounding suggestions are only offered for doses derived from relative calculations, where a more practical rounded number falls within a 5% tolerance range.

Please see below for an example of rounding suggestions:

Ranged dose quantities

When a ranged dose is recommended, the full dose range will be displayed. You must select a value within this range. An input box is provided for you to enter any value from within the range, and quick-select buttons let you choose either end of the range with a single click.

In addition to the min and max quick select buttons there may be rounded options available as well which can be rounded up to a maximum of 5%. The percentage that the number has been rounded is clearly displayed.

The input box will not accept values outside the recommended range.

If you need to prescribe a dose outside this range, you can adjust the quantity directly in the prescribing form.

See below for an example of ranged dose selection with rounding suggestions as options:

Form selection

In some cases, selecting a form may be required, but this will only apply once a route has been chosen, if a route selection is necessary.

Once a specific form is selected, any other available forms will no longer be displayed in the dosing summary at the top of the table.

Below is an example of a scenario where route selection is required:

Frequency selection

Regular frequency selection

In some cases, you may choose a frequency from a recommended range.

Most of the time, when frequency is displayed as a range, the dose per administration does not change, regardless of which frequency within that range you select.

Example: “1 g, 2–3 times daily” → The dose per administration stays 1 g, whether you choose twice daily or three times daily.

This is what a ranged frequency selection looks like:

Frequency selection when the total daily dose is divided

In other situations, the formulary provides a total daily dose to be given in divided doses. In these cases, the chosen frequency determines both:

1. how often the drug is given, and
2. the amount per administration.

Example: “By oral administration, 1 g daily in 2–3 divided doses”

• Selecting twice daily → Touchdose will suggest 500 mg per dose twice daily
• Selecting three times daily → Touchdose will suggest 335 mg per dose three times daily

Here, the frequency selection changes the dose amount.

• Before selecting a frequency, the dose instruction will appear as “in divided doses”:

  

• After selecting a frequency, Touchdose displays the actual calculated dose per administration and produces a smart alert explaining the change:

  

Frequency Types

For regular, non-divided dose frequencies, the frequency type (standard or interval) is predefined by the content supplier in every scenario. However, when frequency is inferred from divided doses, the method of administration determines the frequency type.

• For injectable routes of administration, the frequency type is Interval (e.g., every 6 hours).
• For all other routes, the frequency type is Standard (e.g., 4 times daily).

Method	Frequency type
Infusion	Interval
Injection	Interval
Instillation	Interval
Administer	Standard
Inhalation	Standard
Apply	Standard
Rinse or gargle	Standard

*Continuous infusions, titrated injections and implantations have not been included, as Dosium does not support divided doses for these methods.

Touchdose applies all of the above logic automatically, but it is explained here to help you understand how it works.

Duration & Duration Information

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Duration pertains to the length of therapy for a course of medication and not the specific amount of time over which a medication should be administered. For clarity:

• Duration does indicate the length of a course, for instance, "One tablet, once daily for 2 weeks."
• Duration does not denote the time a medication should be administered, as this information is specified in the administration information, for example, "Dose to be administered over 2 minutes."

Misinterpreting the meaning of duration can result in medication errors, underlining the importance of understanding its intended context.

Duration

A structured representation of the treatment length which can be automatically added to the order form, for example: “For 5 days”.

Duration Information

A free-text description providing additional context about duration, used in two main ways:

• As an alternative to Duration: when the duration cannot be expressed in a structured way (e.g. “Until oral administration is possible”).
• Alongside Duration: to give further guidance (e.g. Duration: “For 5–10 days”; Duration information: “Use 10 days for immunocompromised patients”).

Handling Ranges

• If the duration is expressed as a range, you must select a value within that range.

• Small ranges: distinct buttons will appear for each option (e.g. 5 days, 6 days).

  

• Large ranges: the range will be displayed, and you must enter your chosen value in an input box.

  • You cannot enter a value outside the specified range.

  

Administration information

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Administration information is designed to encompass free-text details related to medication preparation and administration considerations. Given that this information is authored as free text, automated validation is not feasible. The reliability of this data is particularly dependent on authoring consistency.

Clinicians must consistently consider the information provided in the Administration information field. Failing to do so may lead to medication errors, underscoring the critical need for careful consideration of this textual information.

Dosing information

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Touchdose lacks the capability to modify any dose recommendations based on free text dosing information contained in this property as it is presented in free-text format. This information is presented to clinicians for their consideration, and they may need to adjust the dose recommendation based on this information when required. Given that this data is authored as free text, automated validation is not practicable, and Touchdose will convey any text found within the dosing information field in integrated formularies. The reliability of this data is therefore especially contingent on authoring consistency.

Failure to take into account the information in Dosing information could result in medication errors, underscoring the importance of carefully considering this free-text information.

Suggested dose story

The suggested dose story is a textual sentence that combines all the structured properties in the table below. See the figure below to see where the Suggested dose story can be found:

The Suggested dose story is dynamic. It will update automatically as you make selections (e.g. route or frequency).

Dosing information is shown at the bottom of the table but is not included in the suggested dose story.

Formulary dose hover feature

In the Suggested Dose story, the dose and frequency is underlined, allowing users to hover over them to display a pop-up. This pop-up provides additional details from the underlying formulary, including:

• Dose
• Frequency
• Divided doses
• Dose limits
• Patient group information

These details explain how the patient-specific dose was determined.

Handling of Relative vs. Exact Doses:

If the underlying dose is not relative (i.e., not based on weight or other patient factors), the formulary dose will be the exact same as the patient-specific dose.

If the underlying dose is relative, the pop-up will display:

• The relative formulary dose
• Any minimum or maximum dose limits specified in the formulary when present

Example of the formulary dose hover feature:

This feature allows users to:

• Check any calculations that may have been performed.
• Assess whether the patient’s dose is near the boundaries of the recommended dosing range.

Smart alerts

Smart alerts, represented by orange circles with an exclamation mark in the middle and orange underlining of the dose and frequency.

Touchdose generates patient and case-specific smart alerts to offer clinicians additional insights into the specific logic applied in determining dose suggestions. Smart alerts are triggered under the following circumstances:

1. When doses are calculated based on formulary recommendations to prescribe a total amount of medication in divided doses, such as "Suggested dose based on a formulary recommendation to prescribe 10-20 mg/kg in 2 divided doses. Doses are always divided equally. If unequal divisions are clinically preferable, adjustments may be required."
2. When dose maxima/minima considerations have been applied, as in "A maximum dose 120 mg has been applied."
3. When an alternative body weight scalar is used to calculate a dose due to the patient being obese, and the formulary recommends its use in such cases, for instance, "Patient is obese. Formulary instruction to use AdjBW in obese patients. AdjBW (67.38 kg) has been used for dose calculation."

Multiple smart alerts may be present or a combination of these components when relevant. For example, using the first two scenarios mentioned above, the smart alert would be "Suggested dose based on a formulary recommendation to prescribe 10-20 mg/kg in 2 divided doses. Doses are always divided equally. If unequal divisions are clinically preferable, adjustments may be required. A maximum delivery rate of 120 mg/hour has been applied."

An example of a smart alert can be seen below:

Dose insights

Touchdose sometimes presents additional dose insights for clinician's consideration, such as Potency, Pharmacokinetics or Dose equivalence information. These considerations are positioned above the dose recommendations, beneath the heading that reads "Please consider." For more information, see the Dose insights section.

Tags

Tags can be used to add additional information to medications and indications. Every tag returned for this screen is displayed. Tags that apply to the medication are shown next to the medication — for example flagging a controlled drug or a prescribing restriction — and tags that apply to the selected indication are shown alongside it, for example indicating the recommended line of therapy or relevant guidance.

See a screenshot below for how tags appear in the system for Abatacept as an example:

If a tag includes additional detail, clicking on it will display that information. In some cases, this view may also include a link to further information; if so, a button will be shown that allows you to open the link in a new tab.

In other scenarios, a tag may contain only a link and no additional detail. In this case, clicking the tag will immediately open the external URL, and an icon will indicate that it will take you outside the system.

Finally, if a tag has no additional detail and no associated link, it will be displayed as a non-clickable label.

Adding the order to the EP System

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Touchdose does not authorise, sign, or commit any medication order. The Add order button places the recommendation into the host EP System's pre-signature draft only. The clinician must independently review every field of the order and authorise it within the EP System before it reaches the patient record.

Where Touchdose has been launched in a context that supports order writeback (typically an in-order launch — see Limitations relating to order writeback), an Add order button is shown on this screen.

The Add order button only becomes active once all decisions within Touchdose have been completed (for example, choosing a value within a range, selecting the route of administration, or confirming the formulation). Clicking the Add order button transfers the structured properties of the recommendation into the EP System's pre-signature order form. Touchdose then closes and the EP System's order form is opened.

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The clinician must then review the order in the EP System, complete any field that Touchdose was unable to populate, and act on any clinical decision support presented by the EP System before signing. Touchdose typically populates key prescribing fields including medication, indication, brand, dose quantity, dose unit, frequency, duration, duration unit, route of administration, formulation, special administration instructions, and PRN status — but not every order will contain values for all of these, and some values may not be transferable to the EP System and will be left blank.

If order writeback is not available — for example, in a standalone deployment, in a patient-context launch, or for a medication or integration that does not support writeback — the Add order button is not active. In these cases the dose recommendation must be transcribed into the prescribing system manually; see Copying fields below.

There are also cases where writeback is intentionally blocked for a specific order even though all decisions have been completed. This happens when the order cannot be safely or correctly transferred into the EP System's order form — for example a continuous infusion, where the dose is expressed as a rate that the order form cannot represent. When writeback is blocked in this way, the Add order button remains disabled, in the same way it does when a required decision is still outstanding. You should complete the order using the standard EP System order form, exactly as you would when viewing dose recommendations outside the ordering workflow. Whether writeback is blocked for a particular order is determined by your organisation's configuration.

Copying fields

To streamline the completion of a prescribing form, clinicians can copy the dose story by clicking on it. A copy icon is displayed next to the dose story to indicate this functionality.

Additionally, clinicians can manually copy any of the dose story’s properties using the standard copy method (e.g., highlighting and right-clicking or using keyboard shortcuts).

Renal caution banner

If the caution renal flag is present, as outlined in Derived Patient Parameters, an additional banner will appear on this screen. This banner clearly indicates that the patient may have renal dysfunction, which Touchdose has not considered in its dose recommendations. As a result, manual dose adjustments may be required.

Other information and navigational elements

Patient header

At the top of the list of indications, there is a Patient header that contains all the patient information known by the system.

Navigational elements

See the bullet points below for where to find the following features and information:

• A menu button that contains the following sub items when clicked:

  • The instructions for use document / manual

  • A training video that explains how to use Touchdose

  • Information about the device and formulary

  • Feedback form that allows you to send any feedback you would like

  The menu button is found in the top right corner of the patient header to the right of the Dosium logo.

  

• Navigation to previous pages

  • Above the selected medication name.
  • In an in-order launch, the medication is fixed for the duration of the prescribing flow; the breadcrumbs do not allow navigation back to a medication selection step.
  • See the figure below for where the page navigation buttons can be found: