Therapeutic Interchange Management: Frequently Asked Questions Copied

Therapeutic Interchange Management (TIC) in iKnowMed Generation 2 helps practices align therapy selection with payer and practice preferences during new regimen ordering, so teams can avoid preventable rework later in the workflow.

Is use of Therapeutic Interchange required?

No. Therapeutic Interchange is optional. If no settings are configured for TIC, no changes are applied to patient regimen orders. Practices that do not plan to use it should avoid granting the Manage > Therapeutic Interchange permission to users.

Can a practice control whether and when Therapeutic Interchange is used?

Yes. Practices maintain full control over Therapeutic Interchange through:

• User permissions
• Configuration of practice and payer preference settings
• Effective dates that support staged or phased adoption

If it is not configured, it will not impact ordering workflows.

Will the system force a specific drug selection?

A: No. Therapeutic Interchange provides selection guidance, not mandatory substitution. Clinicians can override a TIC‑selected medication, choose an alternative, and document a reason for the override. Clinical decision‑making remains with the provider.

What if a Therapeutic Interchange selection does not seem clinically appropriate?

Clinicians may override the Therapeutic Interchange selection by selecting a different medication and unchecking the TIC‑selected option.

When a TIC selection is overridden, the clinician is prompted to enter a reason while allowing care to proceed.

Will Therapeutic Interchange add work for clinicians?

TIC is intended to reduce manual substitution and downstream rework during regimen ordering. In cases where an exception is needed, clinician override and reason capture are integrated into the workflow so that additional steps are minimal.

Will Therapeutic Interchange change medications for patients already on treatment?

No. It applies only to new regimen orders. Active patient regimens are not impacted.

When does Therapeutic Interchange apply within a regimen?

It is applied only when a new regimen order is created, and the medication in the regimen template is marked as Optional.

TIC does not apply to medications marked as Required. Required medications must remain exactly as defined in the regimen template and are not eligible for Therapeutic Interchange.

Does Therapeutic Interchange apply to clinical research regimens?

Yes, provided the same criteria are met. If a medication in a research regimen template is marked as Optional and included in a TIC group with applicable settings, TIC will apply to new research regimen orders. If the medication is marked as Required, TIC will not apply.

 What happens if a Therapeutic Interchange‑configured medication is not already included in the regimen template?

If a medication specified by TIC is not present in the regimen template, the system will add that medication to the patient’s regimen order. The dose, instructions, and schedule will need to be entered for the added order.

Who manages Therapeutic Interchange groups in iKnowMed?

TIC groups are created and maintained by Ontada’s Clinical Information Services team and are published to iKnowMed.

How often are Therapeutic Interchange groups updated?

TIC group updates are published on a quarterly basis and may also be updated as needed to reflect changes or corrections.

What if my practice needs a Therapeutic Interchange group that is not available?

Practices can submit a ServiceNow ticket to request an update or addition to TIC content. Please include the relevant details and rationale for the requested change.

This sounds like significant maintenance—who is responsible for updates?

Ontada maintains the underlying Therapeutic Interchange groups. Practices are responsible for configuring:

• Practice or payer preferences
• Effective dates
• User permissions

This approach allows practices to manage adoption without maintaining the clinical content itself.

What if payer rules change or appear incorrect?

The Therapeutic Interchange workflow is designed to surface issues early in the ordering process. If a discrepancy occurs:

• Clinicians can override the selection with reason capture
• Relevant TIC content can be reviewed and updated as appropriate

This ensures patient care is not delayed while updates are evaluated.

What happens when a patient has multiple primary payers listed in their chart?

When a patient has multiple active primary payers listed and there are active TIC rules configured for each payer within the same TIC group, the system applies one payer rule at the time the regimen is ordered.

Practices can review the TIC configuration details associated with the regimen to confirm which payer rule was applied and determine whether any adjustment is needed.

How can TIC settings applied to regimen orders be reviewed across patients?

At this time, TIC settings can be reviewed at the individual regimen order level. Practices should refer to the TIC configuration details associated with each regimen to understand how Therapeutic Interchange was applied. Broader, cross‑patient visibility will be available through reporting in a future release.