ePrescribe - Kaleida Health InfoClique

ePrescribe
Overview
Verify Rx Plan (continued)
ePrescribing allows a provider to electronically generate and
transmit prescriptions to the pharmacy. ePrescribing software
uses a network to provide a secure, HIPAA compliant encoded
communication link to and from participating pharmacies.
In order to use ePrescribing, providers must be medical staff
members or residents in training, and have a NPI #.
Users will have the option of receiving and responding
to prescription renewal requests from pharmacies. When
prescription renewal requests are received from a pharmacy
electronically, an eRx renewal request is viewable in the
Orders tab of the EMR and in Message Center.
Patient Pharmacy
When using ePrescribe for the first time, a Patient Pharmacy
will need to be entered. any subsequent visits will require
verification or modification of the information the patient
provides.
• While in a patient chart, click the Patient Pharmacy
button on the toolbar.
NOTE: Anyone can enter or verify the Patient Pharmacy:
Nurse, Secretary, Medical Office Assistant, Provider.
Tips for using the Pharmacy search:
Less is more - do not enter the entire pharmacy name or
address into the Search fields.
• Search by entering one word from the pharmacy name
or street name. Do not enter extra street information
into the address, like Ave, Dr, St, etc.
• For mail order pharmacies, search using the pharmacy
name (e.g. Medco)
NOTE: If the user selects a pharmacy that does not have ePrescribe functionality, the system will convert to a fax on the back end and auto fax to the pharmacy.
• If you have a pill bottle or fax from a pharmacy, search
by the Street Number. Make sure that the default city
and state are correct.
• If you do not have the street address, search by
Pharmacy Name or by Pharmacy Name in combination
with Street Name. Make sure that the default city and
state are correct.
NOTE: Have the patient present and engage them when searching for a pharmacy.
Verify Rx Plan
• One of the following displays:
a. Number of Plans available.
b. No plan; the patient does not have external prescription history.
c. In error. This signifies that there is an error in the interface; call TAC if you see this error.
4. Select Eligibility details.
5. Choose a plan if multiple plans are listed.
6. Click the OK button.
External Medication History
External Rx History is a tool to verify the accuracy of the
Medication History, gather additional details or prompt the
patient for medications that have not yet been documented.
Information is obtained electronically from SureScripts.
1. Click the External Rx History button on the toolbar.
• Nurse or Provider confirms verbal consent and clicks
the Consent Granted button.
• If the patient denies the consent, click Consent Denied.
It will display each time the External History button is
clicked.
2. From the Medication List component of the patient chart,
click the External Rx History drop-down and select View or
Import.
• It is recommended that you select the Import option.
• Using Import provides a side by side comparison of
the External Prescription History and the Documented
Medication History in the patient’s chart, allowing the
clinician to obtain a complete and accurate medication
history.
1. Open the patient chart.
2. Select the Medication List from the Menu.
3. Click on the Rx Plan button.
J:\OD\Training & Education Services\QRC\
ePrescribe 04262016
For assistance, please contact the Technology
Assistance Center (TAC) at 859-7777
ePrescribe
External Medication History (continued)
• Rx History drop-down allows you to set the history in
increments of months as appropriate.
(Page 2)
Create a New Prescription (continued)
2. Click the Sign button.
• The provider is presented with the electronic
prescription preview window.
• Click the Modify button for any prescription needing
modifications.
3. Click into the checkbox to verify each controlled
substance being prescribed.
• Review the External Medication History with the patient.
• If there is an orange icon to the left of the medication
in the External History, this indicates that it is not on the
patient’s documented history. You may convert this med
to a Documented Medication
• Click on the scroll icon to the right of the Last Fill date
column, in the Add As column.
• This step must be completed for each individual
medication.
4. Click the Sign button.
• The provider will need to provide dual authentication
for any controlled substances prescribed. This is a DEA
requirement for Multi-Factor Authentication.
5. Click to select ID Token.
Provider should review the medication history (as recorded by
the RN or pharmacist) with the patient and enter any missing
details. Use SureScripts to validate Home Medications.
Medication Home History is complete when a green
checkmark is present.
6. Enter your User Name.
Create a New Prescription
7. Enter your passcode from your soft or hard token.
The ePrescribing process begins by placing a new prescription
order.
8. Click the Log on to: field and select Kaleida.
9. Click the OK button.
10. Enter your Password.
When prescribing compounded medications or supplies:
• Use the Miscellaneous Medication order
• Select whether it is a compounded med or supply
• Enter all details into the Special Instructions field.
1. Verify the Send To field has the appropriate patient
pharmacy listed.
J:\OD\Training & Education Services\QRC\
ePrescribe 04262016
NOTE: The User ID and
Password entered here is
your Network User ID and
password. This may not
necessarily match your Cerner
password. It is recommended
that you utilize KPass to
synch all of your user IDs and
Passwords.
11. Click the OK button to send the prescription to the
pharmacy.
For assistance, please contact the Technology
Assistance Center (TAC) at 859-7777
ePrescribe
Create a New Prescription (continued)
• After the order is signed and the order profile is
refreshed, the order displays in an ordered status
and the name of the pharmacy displays in the clinical
display line.
• The user will be alerted if the SIG is over SCRIPT
standard limits.
• The pharmacy will call the phone number listed on the
script if there are any issues.
• When the system is unable to send the prescription
to the pharmacy based on the current order details,
a message will display, “Send to Pharmacy is not
available because at least one of your unsigned
prescriptions is not eligible.”
(Page 3)
Routing Errors (continued)
If transmission of an electronic prescription fails, the system
will allow for a hard copy printout that indicates that an
attempt was made to transmit the prescription electronically.
The printout will also include the name of the destination
pharmacy and the date/time the transmission failed.
Within the routing error message, the user can:
1. Click the pharmacy name to view information about
the pharmacy and the prescription to place a call to the
pharmacy.
2. Click the Med List button to open the patient’s
Medication List and print the prescription and hand it to
the patient.
3. Enter a comment to the message that includes the name
of the prescription indicating what action was taken
AFTER the prescription is called in, faxed or given to the
pharmacy/patient.
4. Save the message to the patient’s chart and delete it.
Controlled Substance Activity Log
• When viewing the order information, the additional
details tab will display the eRx status of In Process,
Error, or Delivered.
• Delivered indicates delivered to SureScripts, not to the
pharmacy.
Routing Errors
If the transmission of a prescription order to a pharmacy fails
for any reason, a routing error message is sent to the ordering
provider’s Message Center or a Message Center pool.
Providers will receive a monthly activity log in Message Center
that will display information regarding all the controlled
substances they prescribed in the past month.
• The message will be in the “Messages” folder.
• Open the message from Message Center and then you
will need to open the link to review the report.
There are four routing error messages that can be seen in
Message Center:
A. Prescription routing temporarily unavailable.
The report will display specifics for each controlled substance
ordered. After review of the report, if you suspect any
fraudulent orders, you will need to report this information to
the Bureau of Narcotic Enforcement.
B. Unable to communicate with pharmacy.
C. Prescription too long for pharmacy system. The total
length of the combined order details is currently
limited to 350 characters. The special instructions
field is limited to 255 characters, but a combination of
long special instructions, PRN instructions or other SIG
line order details may cause the character limit to be
exceeded.
D. No NDC code.
J:\OD\Training & Education Services\QRC\
ePrescribe 04262016
For assistance, please contact the Technology
Assistance Center (TAC) at 859-7777
ePrescribe
eRenewal Requests
Renewal requests are sent to the provider from the pharmacy
with the ordering provider’s information.
1. Open Message Center.
(Page 4)
eRenewal Requests (continued)
Multiple Renewal requests for the same patient, same
prescriber, same pharmacy are combined into one message
with the requests separated by a blue bar.
2. Double-click the message to open and review the renewal request.
• The Response tab includes the original request from the
pharmacy along with any modifications and responses
made by the provider.
• This information is saved to the patient’s chart.
3. Click the Request tab in the message to view the renewal
requests.
• The Diagnosis will pull into the indication field for
renewals.
6. Enter the number of refills.
7. Sign the renewal request.
4. Launch the Medication List to review the patient’s other
medications before taking action on the renewal.
5. Click the appropriate icon to either renew or decline the
renewal request.
NOTE:
• Each Renewal Request must be acted on.
• Do not use the Accept All button.
• Once signed, you will see who first ordered the
prescription and who renewed the prescription as
details in the order information.
• Renewals and associated documentation from the
response tab will be saved to the encounter that the
original order was placed on.
8. Click the Refresh button after any action in the Message
Center, or when returning to the Message Center after
taking action in a patient’s chart.
• This ensures that the information displayed is up to
date.
Clinic Process and Renewal Pools
eRx Match
• Renewal requests transmitted electronically from a
pharmacy that has all patient data and medication information matching the initial prescription.
eRx Non-Match
NOTE: The icons are displayed to the right of the prescription.
The green circle with a checkmark is the accept icon.
The red circle with a slash mark is the reject icon.
The delta icon is the replace icon and will give you the two options of (1) Same Medication Different Dose or Formulation or (2) Different Medication.
• Using the replace function will cancel the original
prescription and create a new prescription in the
patient’s chart.
J:\OD\Training & Education Services\QRC\
ePrescribe 04262016
eRx non-matches go to either the Provider Message Center or
the Clinic Message Center Pool, depending on the workflow
that was decided upon for that area. They are displayed in an
eRx Non-Matches folder. The Patient Name column is empty,
showing that no match could be made.
This includes:
• When a renewal request for an order that did not
originate from ePrescribing is received.
• A single patient match cannot be determined because
multiple or no patients meet the criteria for the suspect
match on Last Name, Gender, Date of Birth and Zip
Code.
For assistance, please contact the Technology
Assistance Center (TAC) at 859-7777
ePrescribe
Clinic Process and Renewal Pools (continued)
1. Open PowerChart to Message Center and select the
Pools tab.
(Page 5)
Clinic Pools - Renewing Controlled Substance Meds
Controlled substance renewal messages do not have the
option for Accept. The ordering provider name must be
changed to the provider who is working the pool.
1. Open the renewal message from the pool.
2. Click the Delta icon
to use the Replace function.
2. Double-click the non-match message to open it.
3. The Patient Match screen will open.
3. Select:
• Same Medication Different Dose or Formulation
4. When the order displays, right-click on the order.
5. Select Ordering Physician.
4. When the correct patient is located, select the
Ambulatory Communication Encounter Type.
• The original ordering provider’s name will display. The
name must be changed to the provider working the
pool so that the dual authentication for the controlled
substance can be completed.
• If an Ambulatory Communication encounter does not
exist for the patient, one will need to be created by
clicking on the Add Encounter button.
• Once a patient is selected, the Patient Match dialog
box closes and the system displays the renewal
message.
• Click the Cancel button and close the Patient Match
window to reject the renewal request if a patient cannot
be identified.
5. Click the Response tab to see if an addendum was added.
• This identifies who matched the patient and when it
was done.
• The message will automatically move to the eRenewals
folder once the match is made.
REMINDERS:
• RN must get pharmacy info from the patient and verify
that it is in the Patient Preferred tab.
• When building the Rx proposal, the RN must confirm
that it is going to the correct pharmacy.
J:\OD\Training & Education Services\QRC\
ePrescribe 04262016
6. Click the OK button once the name has been changed.
7. Ensure all required details are completed in the order.
8. Click the Sign button.
9. Verify the controlled substance medication details on the
electronic prescription preview window.
10. Complete Dual Authentication to transmit the prescription renewal to the pharmacy.
NOTE: If the provider name was not changed in the ordering
physician window, the dual authentication will fail.
For assistance, please contact the Technology
Assistance Center (TAC) at 859-7777