Paxlovid Tools

The first anti-viral COVID-19 drug, Paxlovid, is now available in Ontario. The information and tools on this page will help you:

Identify high risk patients who may benefit from Paxlovid before they develop COVID-19 and give them information on what to do if they develop it
Use the Aggregate Vaccine Reports or your EMR to identify these patients

OntarioMD (OMD), Ontario Health, the eHealth Centre of Excellence (eCE), the Ontario College of Family Physicians (OCFP), the Centre for Effective Practice, and EMR vendors have collaborated to offer you these EMR tools and support.

If you have any questions about using the tools, please contact support@ontariomd.com or your vendor.

Ontario Health COVID-19 Antiviral Treatment (Paxlovid) Toolkit

This toolkit is intended to support primary care and other clinicians caring for patients in the community:

Guidance for providers on access to COVID-19 antiviral treatment (Paxlovid)
A patient handout with information on who can get Paxlovid, how to get assessed for treatment, and how Paxlovid works

Paxlovid Guidance for Primary Care Providers

The Centre for Effective Practice has developed resources for primary care providers on:

How to determine which patients should be prescribed Paxlovid
Considerations when prescribing Paxlovid
Pre-assessing patients for Paxlovid eligibility

Steps to Prescribe Paxlovid

Before prescribing Paxlovid, please consult the Ontario COVID-19 Science Advisory Table's Nirmatrelvir/Ritonavir (Paxlovid) What Prescribers and Pharmacists Need to Know

Step 1 COVaxON Reports

Primary care providers can use the reports available through COVaxON to identify unvaccinated patients who are 70+ who may benefit from Paxlovid.

For those in patient enrollment models, the COVaxON Aggregate Primary Care Vaccination Report can identify which of your rostered patients may benefit from Paxlovid (aged 70+ and unvaccinated).

As a reminder, a ONE® ID account is required to access the COVaxON Aggregate Primary Care Vaccination Report.

You are registered with ONE® ID and enrolled in the service:

if you already access the Screening Activity Report (SAR) or
if you recently received a "Welcome" email after signing up to receive the COVaxON Aggregate Primary Care Vaccination Report.

If you have a delegate for the SAR, this delegate can also help you access your vaccine list.
If you have not yet registered, please complete your ONE® ID self-registration; for instructions, please refer to the ONE® ID CPSO Registration Guide.

Step 2 Paxlovid Eligibility Searches in your EMR

Further identify high-risk patients by using the EMR searches created for the three most common primary care EMRs (Accuro®, OSCAR and PS Suite). Search by age, immunocompromised individuals, and those with risk factors such as obesity, diabetes, hypertension.

Searches have been created that use EMR data to find patients who meet Ontario Ministry of Health eligibility criteria for Paxlovid and can be helpful in finding patients who are at higher risk. The searches can be found on eCE's Digital Health Supports for COVID-19 Therapeutics page.
OMD is working to create supports for the other certified EMRs. As searches for additional certified EMRs become available, they will be added to this page.
If individuals identified by these searches don't have a recent serum creatinine, this may present an opportunity to order this for the highest risk patients while they are well.
The searches can also help clinicians identify patients for proactive outreach to alert them that if they get COVID-19 they should contact the office.

QHR/Accuro® EMR

Please access the three searches (in the Global Alerts list):

Paxlovid Eligibility search v1.0
Paxlovid Eligibility Search - Simplified (just 2 age groups) v1.0
Paxlovid Eligibility Search - Without pregnancy criteria v1.0

Author: eHealth Centre of Excellence

TELUS PS Suite

Paxlovid searches (zip file)

Author: eHealth Centre of Excellence

WELL/OSCAR

Paxlovid searches (zip file):

Paxlovid Eligibility search v1.0
Paxlovid Eligibility Search - Simplified v1.0
Paxlovid Eligibility Search - Without pregnancy criteria 1.0

Author: eHealth Centre of Excellence

Step 3 Adaptable Script for Patient Communication

An email template can be sent to patients identified in steps 1 and 2 (e.g., OCFP adaptable script or OMA letter templates).

The Ontario College of Family Physicians (OCFP) has developed an adaptable script that can be sent to patients identified as high risk through COVaxON and EMR eligibility searches.
This script provides comprehensive information about Paxlovid for patients such as answers to common questions, when to call the doctor's office, the eligibility self-screening tool and where to find clinical assessment centres and dispensing pharmacies.
The OMA has developed two letter templates for distribution to patients regarding treatment with Paxlovid. They can be adapted by your practice:

Step 4 Paxlovid Prescription Form

An EMR-integrated prescription form is available to use if indicated. It is recommended that this form be sent with your prescription to the pharmacy to prevent any delay in dispensing.

A single-page Paxlovid Prescription Form has been developed by Ontario Health Regions. It includes the eligibility criteria for Paxlovid.
Paxlovid Prescription Forms with instructions for Accuro®, OSCAR and PS Suite are available on the eCE's Digital Health Supports for COVID-19 Therapeutics (Paxlovid) page.
OMD is working with the vendors of certified EMRs to update their drug/medication lists from First Data Bank (FDB) to include Paxlovid as soon as possible. It is anticipated that most vendors will do this in May 2022. Until Paxlovid has been added to the database, you can use an online drug interaction checker.

Help with Paxlovid prescribing or how to search your EMR to identify eligible patients is available at your convenience. Simply contact support@ontariomd.com with your questions.