Rcopia\Dr. First User Manual - Your Local Community Mental Health

Transcription

TABLE OF CONTENTS
Quality Prescriptions...............................................................................................................................................................1
Definitions .............................................................................................................................................................................. 2
Getting Started ...................................................................................................................................................................... 3
Login to Rcopia .....................................................................................................................................................3
Passwords .............................................................................................................................................................5
Create a New Patient ........................................................................................................................................... 6
Select a Patient ..................................................................................................................................................... 7
Patient Summary Screen ..................................................................................................................................... 8
Allergy Management ............................................................................................................................................................11
Pharmacy Management.......................................................................................................................................................13
Add a Default Pharmacy ..................................................................................................................................... 13
Send to Mail Order Pharmacy ............................................................................................................................. 14
Split a Prescription .............................................................................................................................................. 15
Problem Management .........................................................................................................................................................17
Medication Management .................................................................................................................................................... 19
Medication Reconciliation ...................................................................................................................................19
Add an Active Medication ................................................................................................................................... 21
Create Prescriptions:............................................................................................................................................................ 23
Select a Drug....................................................................................................................................................... 23
Drug Search ..................................................................................................................................................... 23
Category Search ...............................................................................................................................................24
Favorite Prescriptions .......................................................................................................................................25
Active Medications ........................................................................................................................................... 27
Enter Prescription Details .................................................................................................................................. 28
Review a Prescription ..........................................................................................................................................30
Send a Prescription ............................................................................................................................................. 32
Dose Calculator ................................................................................................................................................... 33
Prescription Report .............................................................................................................................................................. 34
Renewal Requests.................................................................................................................................................................37
Medication Reports.............................................................................................................................................................. 39
Detailed Medication Report ................................................................................................................................39
Mini Medication Report ......................................................................................................................................39
Clinical Alerts ........................................................................................................................................................................ 40
Formulary Checking............................................................................................................................................................. 43
Additional Options ............................................................................................................................................................... 46
User Preferences ................................................................................................................................................ 48
Practice Preferences ...........................................................................................................................................52
Report a Problem ..................................................................................................................................................................57
Frequently Asked Questions ............................................................................................................................................... 58
Introduction
Welcome to the DrFirst Rcopia classic e-prescribing and Rcopia-MU (Meaningful Use) user manual!
DrFirst puts the power of e-prescribing in your hands. Both Rcopia-Classic and Rcopia-MU will help you simplify
your workflow, run a more efficient office, and increase patient safety. We hope you are excited to start taking
control of the prescribing process in your practice!
Rcopia-Classic and Rcopia-MU are very similar in functionality. There are several upgrades in RcopiaMU that help providers meet the 25 Meaningful Use requirements. Unique features of the Rcopia-MU
application will be marked in this training manual by a gray background as well as the ONC-ATCB
certification stamp (left). These Rcopia-MU features pertain specifically to achieving Meaningful Use
requirements.
Reviewing this manual, as well as having an Rcopia office “champion,” will allow your practice to utilize DrFirst’s
Rcopia applications to its fullest.
Should you have any questions or need assistance, feel free to email or call our support desk. DrFirst provides
free live Customer Service 24 hours a day, 7 days a week, 365 days a year. Please have the prescription serial
number ready before calling support.
DrFirst Customer Support
Toll Free Direct: (866) 263-6512
Local: (301) 231-9510 x 1905
Email: [email protected]
If you have purchased Rcopia-Classic in order to meet MIPPA eRx Incentive requirements and have decided to
upgrade to Rcopia-MU, please contact us at [email protected].
Sincerely,
Peter Kaufman, MD
Chief Medical Officer
Best Practices
1. For practices with manually installed interfaces, ensure that your interfaces are updating no less than 3
times a day: in the morning, afternoon, and evening.
This ensures that all patients are in both systems.
2. Ensure the patient demographics are filled out accurately. At a minimum, this means putting in the
patient’s legal first and last name, address, city, state, zip code, phone number, DOB, and gender.
These data elements are used for eligibility checking and also for populating the prescription
with the patient information. These fields are also required to send a controlled substance
electronically.
3. Make sure the active medication list is accurate by reviewing it with the patient. You can document
when you have reviewed the list with the patient.
If the list is not accurate, you may be missing some important clinical alerts such as drug-drug
interaction checking.
4. Make sure the allergy list is accurate and review it with the patient.
This information is important for drug-allergy interaction checking.
5. Make sure the problem list is accurate and review it with the patient.
This information is important for drug-diagnosis interaction checking.
6. When beginning the prescribing process, choose the medication either from the drug search or through
the therapeutic category search.
It is important to ensure a “coded” drug is selected for the purposes of clinical and formulary
checking. A free text drug is designated with a red triangle to alert you that clinical and
formulary checking will NOT performed.
7. Review, Review, Review
It is important that the right drug is selected for the right patient with the right directions. You
have three reviewing opportunities to ensure you create the highest quality prescription for
your patient.
Quality Prescriptions
What are the elements of a quality prescription?
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Full patient name, address, date of birth (DOB)
Medication name
Directions (sig)
Quantity
Problem
Allergies
“Substitution permissible” or “dispense as written”
What happens when the above information is missing or incomplete?
The patient may get the wrong medication, the wrong patient will get the medication, or the patient
will take the medication incorrectly since the directions are incomplete or in conflict.
To create a quality prescription in Rcopia:
1. Ensure you have the correct patient.
2. Select the drug from the drug search (unless it is a compound prescription).
3. Ensure the directions are accurate. With sticky features, you may see pre-populated, previously
entered directions that are not appropriate for this patient.
4. Use the sig dropdowns as much as possible—try not to put clinical information in the patient
notes. There are times where you need to use the patient notes for individualized directions. Try
to use one or the other if possible.
5. Review, Review, Review. Make sure the prescription is accurate for this patient.
Other key items:
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Ensure that all favorite prescriptions are inputted to easily prescribe your and your practice’s mostly
common prescriptions.
Selecting drugs from the search screen provides access to formulary and clinical warnings that may
be important. Free text drugs do not go through the edits.
By selecting a drug from the search screen, and receiving warnings, you will reduce the number of
calls from the pharmacy.
E-prescribing provides legible prescriptions, but only if you select from the drug search, review the
warnings, and do not put conflicting information in the sig dropdowns and patient notes.
Definitions
Category Search: Using therapeutic categories to find the drug you wish to prescribe
Co-pay: The flat rate or dollar amount the patient will pay for his or her prescription
Coinsurance: The percentage the patient will pay for his or her prescription
Electronic prescription: A prescription sent directly from the provider to a pharmacy through Surescripts
Eligibility: This determines whether the patient has a prescription drug benefit
Enter details screen: The screen where components of the prescription are entered, including the sig
Favorite Prescription: A medication that you routinely prescribe for your patients
Fax prescription: A prescription sent directly to the pharmacy fax machine
Formulary: A list of drugs that provide information on coverage and copays from the patient’s insurance
or health plan
Formulary coverage codes: Codes which determine prescription drug benefit coverage for a particular
medication, such as step therapy (ST), or prior authorization (PA)
Formulary status: The coverage status determined by a patient’s health plan. A drug can have formulary or
non-formulary status, or preferred status, such as P1, P2, etc
Medication: A drug that the patient is already taking
Medication History: A list of medications that the patient has taken in the past; this information may be
obtained from the health plan or PBM or pharmacy
Prescription: An oral, written, faxed or electronic order of medication
Prescription status: This status provides transmission information on the prescription you sent and
whether it has been received by the pharmacy
Provider: A health care professional such as a MD, DO, NP, PA
Refills: The number of times a prescription can be refilled at the pharmacy without requiring a new prescription
Renewal: A request from the pharmacy to obtain additional refills on a prescription or receive an updated
prescription
Sig: Instructions for the patient on how to use or take his or her prescription, including amount and frequency
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Getting Started
Login to Rcopia
1. Open your Web browser.
2. Type www.drfirst.com and press Enter.
3. Click Login to Rcopia, located on the top right of the screen. You will be taken to the Login screen.
4. Enter your username and password
5. Click Login.
Click Bookmark this page below the Login button to bookmark this page in your browser for easy
return.
If you have forgotten your username or password, click the Contact Us link towards the top of the box
to contact our Support Department or call (866) 263-6512. Please reference the Getting Started:
Passwords portion of this manual for more password help.
6. The first time you log into Rcopia, the program will prompt you to confirm your email address and
answer 5 security questions. If you want to skip this step and complete it later, click on Remind Me Later
at the bottom of the screen.
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7. Next, Rcopia will prompt you to change your password. This must be completed to access the system.
For Meaningful Use: Security Module
DrFirst has taken the necessary steps to ensure Rcopia-MU complies with all necessary
requirements for certification on this MU Objective. However, in order for users to be fully
compliant with the Security Measure, they must conduct or review a security risk assessment
for their practice.
The banner pictured below is displayed to alert the user that only authorized users may access
the system, meeting access control (which is just one of the several requirements defined by
ONC for EHR vendors to fulfill for this MU Objective). Every user is provided a unique ID and
password, meeting authentication.
Emergency access: for users assigned to a front desk role, they can be provided a second
ID/password for emergency access only, allowing for viewing of PHI information
Automatic lockout message: the message above on the right is displayed if the application idle
time of 60 minutes is exceeded.
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Getting Started
Passwords
There are two ways to change your login password:
a. Click on Change Profile when logging into Rcopia, in the top navigation toolbar on the Members Area
page.
You can change your Login Password, and if you are a provider, you can change your Signature
Password.
b. Click on Additional Options in the top navigation blue toolbar once you have entered the e-prescribing
application.
Click Change Password and you will be given the option to change your Login Password. If you are a
provider, you can change your Signature Password.
If the user is unable to login to reset his or her own password, the administrator for the group can reset it:
1. As an administrator, login to Rcopia. On the Members Area page, click on Manage Practice.
2. Choose the practice location where the user works, and you will be given four options.
3. Choose the third option, User Registration Summary, and you will see a list of all the users in
that group.
4. Find the user that is unable to login using the search boxes at the top. Then check the box to the
left of his or her username and click on Reset Password at the top or bottom of the page. If you
check more than one user you can reset each of the passwords at once.
5. Type the user’s new password in the box to the right on his or her name and click on Change.
6. The user should now be able to login into the system with his or her new password.
If the user is still having trouble logging in, please contact DrFirst Support at (866) 263-6512.
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Getting Started
Create a New Patient
Practices using a one-way or two-way interface with an EMR/PMS/billing system will rarely use this feature.
Practices that do not have an interface will need to manually add new patients by completing the following steps.
1. Click Select Patient.
2. Click Add New Patient.
3. Fill in as much information as possible including the six mandatory fields highlighted in red.
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First Name [legal name]
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Last Name
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Date of Birth
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Home Phone Number
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Gender
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ZIP Code
These six mandatory fields are used to obtain the patient’s insurance (eligibility) and formulary
information via Surescripts.
Rcopia does not auto-capitalize. Please enter information as you desire to have it displayed.
Be sure to select whether your patient is pregnant or breast feeding for interaction alerts to function
properly.
Be sure to populate weight for proper dose checking for pediatric patients
Some practices find it valuable to enter the patient’s account number or patient external ID or MRN
(medical record number) in the ID field to allow for another method of searching.
4. After you have entered all of your patient’s information, click Submit Patient Data. You will
automatically be taken to the Allergy History screen.
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Getting Started
Select a Patient
1. Click Select Patient in the blue toolbar at the top of the page.
2. Enter part of the patient’s last name or patient ID in the Patient Last Name or ID text box.
A patient’s ID is a number that is related to a medical record number, or an external patient ID
that is entered either into the Patient Demographics screen or obtained during the patient
demographic upload.
If the patient’s last name is common, e.g., Smith, enter the last name, comma, and the first
initial to narrow down the search. (Example: “Smith,J”). If you wish to search by first name, type
comma, first name (e.g., “,John”)
3. Click Find. All patient records that meet the search criteria you entered will be displayed.
4. Click the desired patient’s name.
You can Modify the patient’s information or Delete the patient from your records by clicking
the appropriate Action button to the right of the patient’s listing.
5. If your patient has no allergy information entered, you will be directed to the Enter Allergies screen.
Otherwise, you will be taken to the Patient Summary screen.
6. If your patient has no default pharmacy selected, you will be directed to the Pharmacy Information screen
to select a default pharmacy. Otherwise, you will be taken to the Patient Summary screen.
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Getting Started
Patient Summary Screen
The Patient Summary screen is an individual patient’s “homepage,” where an Rcopia user can access the
patient’s basic information: demographics, medications, allergies, problems, and pending prescriptions. The
sections on this screen will be described from top to bottom.
On any page in Rcopia, clicking Prescribe next to the patient’s name will bring you back to the Patient
Summary Screen.
Practice Information
This section alerts the user as to what provider practice he or she is prescribing from.
Patient Demographic Information
Five of the six required demographics are listed in this section: First and Last Name, date of birth (DOB),
Gender, and Phone number. The patient’s Height and Weight can be entered by clicking Change
Demographics to the right of the patient’s name.
A yellow triangle alert tells you that the PBM has returned patient demographic information from
Surescripts on the current patient that may be different than what you have stored in Rcopia. Click on the
yellow triangle to access and view this information to make sure the formulary and drug history
information is correct for the patient you are working on.
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3 fields pertaining to Meaningful Use can be entered in the patient demographics section, these are Race,
Ethnicity, and Preferred Language.
LOV (last office visit) tracks the patient’s appointments. Click Visit Today to update at the start of every
patient visit. Clicking the Show Office Visits link will display a log of previous appointments.
It is very important that you indicate the LOV (Last Office Visit) for your patients—
this will drive the reporting for Meaningful Use and ensure your data is accurate
when it comes time to attest with CMS.
The Pharmacy drop-down holds information on the last five pharmacies for this patient. Please reference
the Pharmacy Management portion of this manual for instructions on adding a default pharmacy,
including a mail order pharmacy.
Formulary information is obtained from Surescripts and payer claims data. If a patient has multiple
formularies, select the correct formulary by clicking on the drop-down arrow.
A patient’s formulary information allows Rcopia to alert users on medications that are on- or offformulary, and offer on-formulary alternatives when applicable. Please reference the Formulary
Checking portion of this manual for more information.
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Renewal Requests
The practice’s renewal requests from pharmacies can be accessed on any screen in Rcopia. Please
reference the Renewal Requests portion of this manual for more information.
Prescribe a Medication
This section allows you to prescribe a new drug for the patient through a drug or category search, or through
your Favorites list. Please reference the Create a Prescription portion of this manual for more information.
Medications
This section lists a patient’s current active medications. Please reference the Medication Management
portion of this manual for more information.
‘Last’ indicates the last date the prescription was prescribed.
The red triangle next to the drug indicates that this product has been prescribed as a free text drug. A
free text drug is commonly a compounded medication or other types of medications that cannot be found
in the Rcopia drug database. Rcopia is unable to perform many of the clinical and formulary checks with
these types of medications.
By clicking Check Interactions for Selected, you can check “on demand” potential interactions on a
patient’s medication list, even if a medication is not being prescribed. This includes drug-drug, drugdiagnosis, and drug-allergy interactions.
Current Allergies/Adverse Reactions
This section allows you to record the patient’s allergies or adverse reactions to medications. Please reference
the Allergy Management portion of this manual for more information.
The red triangle indicates the product was a free text selection, and no allergy checking can be
performed.
Problems
This section allows you to record a patient’s list of conditions, diagnoses, and symptoms by conducting a
search using name or ICD-9 code. Recording this information is particularly important for drug-diagnosis
interaction checking. In addition, by populating this information, you will be able select a diagnosis on the
Enter details screen, and the Problem will be placed on the prescription. Please reference the Problem
Management portion of this manual for more information.
Pending Prescriptions for this Patient
This allows you or your staff to write prescriptions and queue them until they are reviewed by the
appropriate person, who can then sign off on them to be sent to the pharmacy. Please reference the Create
Prescriptions: Send Prescriptions portion of this manual for more information.
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Allergy Management
Meaningful Use: Core Objective #6
Maintain up-to-date allergy list
1. Click on Manage Allergies on the Patient Summary screen.
2. Enter the patient’s allergy history. There are four different ways to enter your patient’s allergy
information.
a. No allergies: If your patient has no known allergies, click the Indicate 'No Known Drug Allergies
(NKDA)' link at the top.
b. Common allergy: Select a common allergy from the drop down menu and click Add Common Allergy.
c.
Searchable drug allergy: Enter search criteria for your patient’s allergy, click Find and select the
appropriate allergy.
d. Non-drug-related allergy: Enter the allergy (‘peanuts’) and click Find. Click Enter free text
‘peanuts’ as allergy at the top of the list.
A red triangle next to an allergy (peanuts) indicates that Rcopia does not conduct a drug-allergy
checking because the allergy was entered manually.
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3. After you select the desired allergy, select the appropriate reaction, such as hives or nausea (optional),
and onset date (if known, also optional).
4. Click Add.
5. Repeat steps 3 - 4 for each patient allergy.
6. After you have entered all of your patient’s allergies, click on Done With Allergies. You will now be
taken to the Patient Pharmacy Information screen.
In order to be compliant with Meaningful Use, the user must click on the Allergies
Reviewed link that is displayed in the Allergy section on the Patient Summary screen
during every office visit.
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Pharmacy Management
Add a Default Pharmacy
After adding a new patient into the database, you will be prompted to enter pharmacy information on the
Patient Pharmacy Information screen. You can also modify pharmacy information for any patient at any time
in the Patient Demographic box on the Patient Summary screen by clicking Change next to the pharmacy
drop-down. Another method to add pharmacy information for a patient is adding a pharmacy while entering
prescription details in the Enter Details screen.
1. Select the pharmacy list from which you would like to search. There are three ways to add a pharmacy
to a patient’s profile:
a. Favorites List: contains only the pharmacies that the individual user has previously selected to be in
his or her favorites list
b. Practice List: contains only those pharmacies located in the first three numbers of the practice’s ZIP
code
c. All List: contains all available pharmacies in the Rcopia database.
2. Enter the search criteria for the pharmacy.
The less information you enter, the more successful your search results will be. Start with the city and
ZIP code and the first few letters of the pharmacy name.
3.
Click Find.
4. Click on the ‘desired pharmacy’s name’ to attach it to the patient’s record.
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24 next to a pharmacy’s name indicates the pharmacy is open 24 hours a day.
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(E) next to a pharmacy’s name indicates the pharmacy accepts electronic prescriptions. You may
still prescribe to pharmacies without an (E) as normal; these pharmacies will receive the
prescription via DrFirst fax.
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No fax next to a pharmacy’s name means that the pharmacy does not accept any faxes.
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(C) next to a pharmacy’s name indicates the pharmacy accepts electronic controlled substance
prescriptions. Pharmacies without an (C) do not accept these types of prescriptions and you will
receive an error when trying to send them from the system. These controlled substance
prescriptions must instead be printed, signed, and given to patient or faxed (if allowed in your state).
5. After adding the desired pharmacy, you may begin to prescribe for this patient.
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Pharmacy Management
Send to Mail Order Pharmacy
Mail order pharmacies are automatically displayed on the Patient Pharmacy Information page for patients
who have been determined to be eligible by SureScripts.
1. If you would like to choose a mail order pharmacy for a patient, and it is not already listed, simply click
the ‘All Mail Order’ button shown above
2. Choose from the mail order pharmacy list by clicking on the underlined pharmacy name.
3. The mail order pharmacy will now be found in the default pharmacy list in the patient demographics
box under the patient’s name and phone number at the top of the Prescribe screen.
4. When prescribing, you have the ability to choose just the mail order pharmacy, or click the Split
Prescription button to send a prescription to a retail pharmacy as well as the mail order pharmacy
(see below).
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Pharmacy Management
Split a Prescription
When prescribing, you have the ability to split a prescription between two pharmacies. This will send a
prescription for the same medication and with the same sig to two different pharmacies.
You can split a prescription between two retail pharmacies or two mail order pharmacies, but most
commonly prescriptions are split between a retail pharmacy and a mail order pharmacy. This will allow
the patient to get his or her prescription from the retail pharmacy and begin taking the medication while
waiting to receive the prescription from the mail order pharmacy.
1. To split, click the Split Prescription button to the right of the default pharmacy.
2. An additional drop-down menu will appear, allowing you to choose an additional pharmacy.
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3. In order to send two prescriptions, you must fill out both quantity fields and both refill fields on the
screen. The second Quantity and seconds Refills menu refers to the Split Pharmacy.
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Problem Management
Maintain up-to-date problem list
1. The Problems box can be found to the left of the Allergies box on the Patient Summary screen. Click
on Manage Problems.
2. Choose whether you want to search either by the ICD-9 or SNOMED CT codes. If the patient has no
known problems you may click the ‘Indicate No Known Problems’ button at the bottom of the page.
3. Enter the ICD-9 code, SNOMED CT code, or first few letters of the patient’s problem or diagnosis.
Click Find.
4. Click on the desired code to choose the problem.
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5. To add an ICD-9 or SNOWMED CT code to your Favorite Problems list, click the Favor link next to
the text description of the problem.
6. To add a Favorite Problem to a patient’s Problem History, select the appropriate ICD-9 or
SNOWMED CT code from the drop-down menu in the top left corner. Click the Use button.
7. You can also perform an Action on the current Patient Problems, such as Modify, Inactivate,
Delete, and Resolve.
8. Once the problem has been selected, you will be given the option to choose additional codes that are
appropriate. It is best to always choose an ICD-9 code with every problem entered as Rcopia will only
provide drug-diagnosis alerts for problems entered with an ICD-9 code. It is optional to add
additional codes as well as adding an onset date.
5. Then click on Problems Reviewed and begin prescribing.
Entering this information allows you to view drug-diagnosis interaction checking, as well as add
the patient’s Problem Information to the prescription.
6. The ability to enter problems into the system by SNOWMED CT codes in addition to ICD-9
codes is controlled by a practice preference. This can be turned on by having your practice
administrator change the first practice preference to have both options highlighted.
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Medication Management
Maintain up-to-date medication list
Medication Reconciliation: Obtaining Medication History
The Medication section on the Patient Summary screen lists the patient’s current active medications,
whether they are prescribed by you or another provider.
Medications can be added to a patient’s Medication list in one of two ways:
a. Medication History – In order to use this feature, you must indicate that the patient has given
consent to view his/her medication history by choosing the Yes button, shown below.
b. Add an active medication through Manage Medications
Rcopia has the ability to obtain medication history for patients whose insurance companies provide this
information to Surescripts. To conduct a medication reconciliation, complete the following steps:
1. Click on Medication History on the Patient Summary Screen, located in the Medications section. If
Medication History has not yet been obtained, the blue button will mark ‘Unknown or Incomplete.’
Patient medication information is displayed according to his or her primary insurance company’s
records. If the patient has more than one insurance company, this information will be listed for selection
in the Formulary drop-down list.
2. PBM (Pharmacy Benefit Management)/Pharmacy History will display up to 2 years of the patient’s
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prescribed medications. Use the drop-down list to choose the timeframe you wish the PBM/Pharmacy
History to display.
3. Click on the Obtain New Data button to generate a report against the parameters you just selected.
By clicking on the + signs, you can get a detailed record of the patient’s medication history, including
sig, prescribing provider, pharmacy where it was filled, and quantity and refills (a clue to compliance).
4. Medications that are not currently on the patient’s active medication list can be added by checking the
box to the left of the medication’s listing and clicking on the Add Selected button at the top. This will
copy all of the medication’s information to the patient’s active medication list.
Once you have completed this task, click on Medications Reviewed back on the Patient Summary
screen in the Medications section, so that you will know that the medication list has been
reviewed, by whom, and the date/time to avoid duplicating the process.
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Medication Management
Add an Active Medication
To add a new active medication:
1. Click the Manage Medications link at the top of the Medications section of the Patient Summary
screen.
2. You will be taken to the Patient Medication Report/Medication List. To add a new medication to the
patient’s active medication list you have two options:
a. Choose from one of your or your practice’s Favorite list by using the drop-down menu.
b. Type in part or all of a drug’s name in the Find box. Choose the appropriate medication from the
resulting list.
3. You will be brought to the Enter details screen.This Enter details screen will have a unique feature:
the ability to add the Date Started, Date Last Filled, and Date Stopped for the medication. Type in
as much information as known.
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To view Medication History:
1. Click on Show Medication History under the patient’s current active medication.
2. A list of past active medications will appear.
3. Click on any of the Action links at the far right to Delete, Modify, or Stop a current active medication
or Delete, Restart, Prescribe, or Renew a past active medication.
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Create Prescriptions: Select a Drug
Computerized Provider Order Entry (CPOE)
Drug Search
There are four different ways you can create a new prescription for a patient. Be sure you have selected a
patient before creating a new prescription.
1. Enter the first several letters of the drug you wish to prescribe in the Prescribe a Medication box,
located on the Patient Summary screen.
2. Click Find.
Less is more: enter the first few letters of the drug name. Above is an example for entering “LIS”
and showing all the drugs that match your criteria.
3. Select the desired form and strength.
Capitalized medications are the brand name versions of the drug. Medications listed in all lower case
are the generic versions of the drug. The designation (otc) next to the strength indicates that this
medication does not require a prescription and can be purchased over the counter. Formulary
information may or may not be present.
4. Continue to the Enter details screen to continue creating the prescription.
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Create Prescriptions:
Select a Drug
Category Search
1. Click Category Search. This allows you to look up all medications within a specific therapeutic class.
2. Click the + icons to expand each category until you find the desired form of the drug.
3. Click the desired form of the drug.
4. Continue to the Enter Details screen.
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Create Prescriptions:
Select a Drug
Favorite Prescriptions
Using a Favorite Prescription:
1. Select the desired prescription from the Favorites drop-down list in the Prescribe a Medication box.
2. Click Use to create the prescription and add it to the pending prescriptions at the bottom of the page. No
further action is required.
Click View/Edit to make changes to the favorite before creating the prescription. This will bring you to
the Enter Details screen.
Creating a Favorite Prescription:
There are four ways to add new Favorite prescriptions:
a. While prescribing, on the Review Prescription screen click Add to Favorites. This method will be described
below.
b. Click the Manage link under the Favorites drop-down in the Prescribe a Medication box. This will allow
you to add a Favorite without first prescribing it.
c. Click on Manage Medications in the top toolbar. Click on the Manage link under the Favorites dropdown.
d. Click on Additional Options in the top toolbar. Select Manage my Favorite Prescriptions/Categories.
There are two types of favorite prescription lists:
a. My list: Favorite prescriptions that will be visible only to the Rcopia user who added them.
b. Practice list: Favorite prescriptions that are visible to everyone in the practice. This is the more commonly
used list.
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To create a Favorite prescription while prescribing, complete the following steps:
1. When reviewing a prescription on the Review Prescription screen, click the Add to Favorites button,
which can be found either above or below the prescription.
2. Edit the Name if desired, then click Create.
By clicking Create, you have only added this medication to your favorite list; you have NOT sent the
prescription to the pharmacy.
3. You will return to the Review Prescription screen where you can send the prescription.
26
Create Prescriptions: Select a Drug
Active Medications
This method can only be used if the patient has an active medication.
Find the desired medication in the patient’s active medication list on the Patient Summary
screen.
a. Renew: will allow you to send a prescription that has been previously inputted into the Rcopia system.
Once you click renew, the prescription will appear in your Pending Prescriptions box. You will NOT be
taken to the Enter details screen.
b. Prescribe: will allow you to change the details for the prescription (sig, duration, quantity, refills, pharmacy,
etc) and then prescribe.
c. Stop: will allow you to stop a medication. You will be prompted to enter a reason for stopping this medication
(optional, will be displayed in the patient’s medication history).
27
Create Prescriptions: Enter Prescription Details
Selecting a drug through a drug or category search, or by prescribing an active medication will bring you to the
Enter Details (Sig) screen. The drop-down tabs are filtered by drug type. The following describes the fields that
can be populated on this screen.
At minimum, each legal prescription requires a provider, pharmacy, drug and strength, and sig.
However, prescriptions without some of these elements can be created in Rcopia.
Use the tab key on your computer keyboard to navigate quickly through the tabs. Use the arrows to
navigate the drop-down menus.
1. Verify the Provider and Pharmacy fields are correct, or use the corresponding drop-down menus to
edit. For instructions on splitting a prescription, see the Pharmacy Management section of this training
manual.
2. Verify the Drug you have chosen is correct. Use the drop-down menu to change the drug strength. If
you need to change the drug, click the Change Drug button at the top or bottom of the screen.
3. Select the appropriate values from the drop-down menus for the Sig details. The last field (PRN) is
optional.
4. Choose a Duration, if desired. This will automatically populate the quantity field. If a duration is chosen,
the medication will be automatically removed from the patient’s Active Medications list once the duration
has passed.
5. Enter the Patient Weight in kilograms at the far right of the screen to use Rcopia’s Dose Calculator, if
desired. See Create Prescriptions: Dose Calculator in this manual for further instructions.
28
6. Choose a numerical Quantity and number of prescription Refills. Refills are defaulted to ‘none’.
7. Enter a Primary Dx (Diagnosis) and/or Secondary Dx, if desired. These fields will only appear if the
patient has Problem(s) listed in their Problem History.
8. Enter Directions to Pharmacist, if desired. Directions are defaulted to ‘Substitution permitted.’
9. Enter Directions to Patient, if desired. This free text box will allow you to create a tapered prescription
(ex: ‘And 2 tablets on the 2nd day, 1 tablet on the 3rd day’). There is no character limit so you can type in as
much text as needed to complete the tapered sig. (Note: If you exceed 140 characters, the prescription
will be faxed by DrFirst fax, and will not be transmitted electronically.) To create Custom Directions to
Patients that will appear as a drop-down menu, reference the User Preferences portion of this manual.
10. Enter Comments for office-use, if desired.
11. Click the Continue button. You will be brought to the Review Prescription screen.
29
Create Prescriptions: Review a Prescription
After entering prescription details, you will be brought the Review Prescription screen. The prescription
preview will show the prescription details entered on the previous screen, as well as both patient and provider
demographic information and allergies.
It is very important to review the prescription to ensure you have created the highest quality prescription for your
patient.
4. Click one of the action buttons immediately above or below the prescription.
a. OK: adds the prescription to the Pending Prescription list on the Patient Summary screen for
review and signoff.
b. Back: allows you to edit the Sig details in the Enter prescription details screen.
c. Cancel: cancels the prescription.
d. Add to Favorites: adds current prescription to your Favorites list. See Favorites section of this
training manual for further instructions.
The Add to Meds check box is selected by default so that the prescription is automatically added to
the patient’s active medication and history.
30
2. To take immediate action on the prescription, type in your signature password (if you are provider)
and click one of the four buttons on the top or bottom of the screen. See Create Prescriptions: Send a
Prescription in this manual for further instructions.
3. You will be returned to the Patient Summary screen.
If the medication being prescribed has education available to print, the Patient Advisor box will appear in the top
right of the screen. Here, a user is able to select which customized educational resources (based on the prescribed
drug) that they wish to Print, or simply Preview the material. Clicking the Submit button will then perform the
requested action. Clicking Cancel will close Patient Advisor.
31
Create Prescriptions: Send a Prescription
E-prescribe medications
1. Scroll down to the Pending Prescriptions section on the Patient Summary screen.
2. Select the desired prescription(s) you want to process by checking or unchecking the check boxes on
the far left.
3. If you are a provider, enter your Signature Password.
4. To complete your prescription, click one of the options provided:
a. Send: transmits the prescription to the pharmacy electronically.
b. Send and Print: transmits the prescription to the pharmacy electronically and prints out a
watermarked (non-legal) copy of the prescription for your records.
c. Print w/o sending: prints the prescription without sending it to the pharmacy. This option may be
used if the patient is unsure which pharmacy he or she would like to use. This is required for
controlled substance prescriptions in some states (see note below).
d. Sign w/o sending: adds the medication to the patient’s active medication list, but does not send a
prescription to the pharmacy. This is useful if the patient was given a sample.
The user meets Meaningful Use core objective Electronic Prescribing when he or she
selects either the “Send” or “Send and Print” option.
E-Prescribing of Controlled Substances
Due to DEA regulations as of 7/08, controlled substances in schedules II-V cannot be sent electronically to pharmacies.
For schedule II medications (this is denoted next to the drug as II), you must print these prescriptions and give them to
the patient. For schedule III-V, it is permissible to print the prescription, sign it, and manually fax it to the pharmacy; you
may also give the paper prescription to the patient to take to the pharmacy.
The DEA published updated legislation in 6/10 indicating that electronic controlled substances are now allowed, and
DrFirst offers an upgrade program, EPCS-Gold, that allows sending of controlled substances through Rcopia. If you
would like more information regarding the ability to send controlled substances, please contact DrFirst by sending an
email to [email protected].
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Create Prescriptions: Dose Calculator
A dose calculator is available on the Enter Details screen below the sig drop-down lists. For the dose
calculator to function, the user must know the weight of the patient and standard dosing of the drug based
on the diagnosis. The user can enter the patient’s weight in the Patient Demographics screen or directly on
the Enter Details screen. Entering the patient’s weight information in Patient Demographics will allow you
to convert pounds into kilograms and vice versa.
Using the screenshot above, below is an example of how to use the dose calculator:
1. Click on the Show Dose Calculator button.
2. Ensure the patient weight is entered correctly in kilograms (kg).
3. Enter in the number of milligrams or grams the patient should take per kg per day.
4. Enter the frequency (how often the patient should take the medication).
5. Choose the units (teaspoons or tablets).
6. Once the provider has reviewed the information, he or she can click on the Apply to Rx button; this
will populate the sig information.
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Prescription Report
The Prescription Report allows the user to manage all prescription activity in one convenient location.
1. Click Prescription Report in the blue toolbar at the top of the screen.
2. Select the appropriate provider or select ‘All Providers’ from the drop-down list.
3. Select either ‘All Patients’ or the ‘Current (patient).’
4. Select the appropriate Status:
a. All: displays pending and completed prescriptions.
b. Pending: displays only those prescriptions that have not had an action taken on them.
c. Completed: displays all completed prescriptions (signed and sent or signed and printed).
When Completed is selected, a date filter is displayed. Select the appropriate date range.
d. Undeliverable: displays prescriptions that have not been delivered to the pharmacy.
5. Select maximum number (up to 200) of prescriptions to display on one screen.
6. Click Display Report to show the report on screen. All prescriptions that match the criteria will be
displayed.
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7. The report contains multiple columns and will show you the Status of the prescription and sig details,
allowing you to take Action on each prescription.
a. Status: shows whether or not a prescription was successfully sent to the prescription’s final
destination. Clinical and formulary warnings associated with the prescription are also displayed.
WARNING: A RED warning indicates a drug and/or allergy interaction.
WARNING: A BLUE warning indicates a formulary warning.
b. Action: depending on the status of the prescription, different Actions will be displayed.
All prescriptions:
 Favor: adds the prescription to your Favorites List.
Pending prescriptions:

Modify: allows you to modify the prescription before completing it.

Delete: allows you to delete any instance of the prescription.
Completed prescriptions:

Cancel: cancels the prescription and sends a notice to the pharmacy.

Reprint: reprints a completed prescription.

Resend: resends a completed prescription.

Renew: renews a completed prescription.
8. Select the prescriptions to complete by checking the box to the left of the desired prescription.
Pending prescriptions can be completed from the Prescription Report.
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9. Enter your Signature Password at the top or bottom of the Prescription Report. You can take Action on
up to 10 pending prescriptions at a time.
10. Click an action button, listed below, depending on healthcare provider.
Provider Options:
a. Send: transmits prescription(s) to the pharmacy.
b. Send and Print: transmits prescription(s) to the pharmacy and prints the scripts to the local office
printer.
c. Print without sending: sends the prescriptions to the local office printer, but does not send it to
pharmacy.
d. Sign without sending: adds medication(s) to the patient’s active medication list but does not send
to pharmacy (often used when giving samples).
All options require a valid Signature Password.
Provider Agent Options:
Provider agent options are identical to the Prescriber options displayed above with the following two
exceptions:
a. A Send, signature to follow button will display instead of the Send button. This sends the prescription
to the pharmacy (who will dispense the script to the patient), and to the Prescriber’s pending
prescription queue to review and validate the prescription with his or her signature at a later date.
b. An Archive without sending button will display instead of the Sign without sending button. Both
buttons have the same functionality: adding a medication(s) to the patient’s active medication list, but
not sending it to pharmacy to fill (often used when giving samples).
Staff Options:
a. Hold for Signature: sends the prescription request to the appropriate prescriber so they can review
and act upon it as he or she desires.
b. Print without sending: sends the prescription(s) to the local office printer, but does not send to the
prescriber’s queue.
c. Archive without sending: adds medication(s) to the patient’s active medication list, and does not
send to a prescriber.
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Renewal Requests
Renewal requests are electronic requests generated by a pharmacy for the patient once his or her medication
refills have been completed. When your practice group has pending renewal requests, a message is displayed
on every screen in Rcopia.
If you have not selected a patient, this link is located below the Practice Information section. If you have
selected a patient, this link is located below the Patient Demographic section.
1. Click XX renewal requests (XX will be replaced with the number of pending renewal requests).
2. Select the appropriate provider from the drop-down list next to ‘View messages for’.
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3. Select the desired action from the dropdown menu for each renewal request.
a. Deny : will deny the request for a Renewal and sends a denial message to the pharmacy.
b. Change: allows you to change the prescription and/or pharmacy information. When change is
selected, and the prescription is changed, the prescription becomes a pending prescription in the
appropriate provider’s prescription report. This will alert the pharmacy that the requested
renewal has been denied, but a new prescription will follow.
c. Renew plus, X refills: renews the prescription with the desired amount of additional refills.
When you choose the appropriate refills, you are authorizing this fill plus X fills of the
medication.
d. Forward: allows a staff member to forward the prescription request to another qualified
prescriber in his or her practice.
e. Remove: should only be used if you have previously handled this request and it is a duplicate.
4. If desired, select appropriate Pharmacy Notes from the drop-down list or type them into the box to the
right.
5. If desired, enter Comments in the box. These comments are visible only to you and your office staff.
6. After you have selected an action for each request, enter your Signature Password at the top or
bottom of the screen and click Perform.
You can take action on up to 10 renewal requests at a time: choose the appropriate option from the
drop-down menus for up to 10 requests, type in your signature password, and click Perform.
7. All requests that have an action selected will be executed and delivered to the respective pharmacy.
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Medication Reports
Detailed Medication Report
The Detailed Medication Report lists the patient’s current and past medications, including sig and start and
stop dates. It also contains the patient’s allergy, diagnoses, and pharmacy information, as well as your provider
information. It is a very useful tool when transferring patient care to another provider.
1. After selecting a patient, click Detail at the top of the Medications section of the Patient Summary
screen.
This same report can also be generated using the Manage Medications link in the top toolbar of
Rcopia. Click Display Detailed Medication Report.
2. The Detailed Medication Allergy and Problem Report will open in a new window.
3. To print this report, click file on the browser window and select Print from the menu.
If you have pop-up blockers enabled, the print window will not display. You will have to turn this
feature off to view and print the browser.
4. Click Close in the upper right corner of the window to close the report and return to the previous screen.
Mini Medication Report
The Mini Medication Report is a wallet-sized version of a patient’s current medication, allergy and problem list.
This is an ideal way for patients to keep track of the medications they are currently taking.
1. Click Mini on the Patient Summary screen once you have selected a patient.
2. The Mini Medication Report will open in a new window.
3. See steps 3-4 above under Detailed Medication Report to view and print report.
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Clinical Alerts
Implement drug-drug, drug-allergy interaction checks
Rcopia has a variety of clinical alerts within the system to ensure that you have information that may be
pertinent in the prescribing process. All clinical alerts appear in red. Below is the list of all the clinical alerts
within Rcopia:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Drug-Drug interactions
Drug allergy
Drug diagnoses
Pregnancy
Lactation
Dose check
Duplicate warning
Geriatric precautions
Pediatric precautions
When a drug is chosen that prompts a clinical alert, Rcopia will bring you to the Confirm Prescription Despite
Warning screen. This screen will inform the user of the clinical implications of prescribing this medication, and
prompt you to choose between Prescribe anyway and Cancel buttons. If you choose Prescribe Anyway, you
can provide a justification for prescribing the medication despite the warning (optional).
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Drug interaction alert
When prescribing medications, Rcopia will check against the active medication list for drug-drug interactions.
The alerts will appear after you have chosen the drug and corresponding strength. These alerts will appear in
RED, as shown here:
DRUG INTERACTION ALERT! This patient is being given Lipitor (atorvastatin), which has a severe
incidence of adverse effects when combined with the drug you have just prescribed, erythromycin. [See
Reference]. Proceed with extreme caution.
These alerts will have a ‘[See Reference]’ link that allows the user to view documentation associated with this
interaction.
Allergy interaction alert
When prescribing medications, Rcopia will alert you if you are prescribing a medication that is associated
with a drug on the list of allergies and adverse reactions. The alerts will appear after you have searched for
the drug and chosen the strength. These alerts will appear in RED, as shown here:
ALLERGY ALERT! This patient is listed as having an allergic reaction (unspecified) to penicillin, which is
identical to the drug you have just prescribed, amoxicillin. Proceed with extreme caution.
Drug-Diagnosis interaction alert
When prescribing medications, Rcopia will alert you if you are prescribing a medication that may interact with
a diagnosis or Problem documented for your patient. The alerts will appear after you have searched for the
drug and chosen the strength. These alerts will appear in RED, as shown here:
DRUG-DIAGNOSIS ALERT! Gastrointestinal Ulcer should be carefully evaluated before beginning
therapy with Feldene (piroxicam). The patient has Ulcer of Esophagus With Bleeding (530.21) on the
problem list, a condition related to Gastrointestinal Ulcer.
Pregnancy and Lactation interaction alert
You can input a patient’s pregnancy or lactation status in the Patient Demographics screen. Once selected, you
will receive any precautions associated with pregnancy or lactation.
PREGNANCY PRECAUTION ALERT! This patient is pregnant. The drug you have just prescribed,
Tussionex Pennkinetic ER (chlorpheniramine-hydrocodone), has known risks when given to pregnant
animals, but unknown risks in humans (Pregnancy category C). Proceed with great caution. [More
information]
LACTATION PRECAUTION ALERT! This patient is lactating. The drug you have just prescribed,
Percocet (oxycodone-acetaminophen), has unknown risks when given to breastfeeding mothers.
Proceed with caution. [More information]
Clicking on ‘[More information]’ will provide you with documentation on the alert.
41
Duplicate check
A duplicate check alerts the user if he or she has prescribed two drugs in the same therapeutic class.
DUPLICATE THERAPY ALERT! This patient is being given Cortef (hydrocortisone), which is in the same
therapeutic category (Glucocorticosteroids) as the drug you have just prescribed, prednisone.
Dose check
A dose check alerts the user if he or she has prescribed a medication amount that is above or below
the maximum or daily dose for that medication.
DOSE CHECK ALERT! The dose for your prescription (amoxicillin Suspension for Reconstitution 400
mg/5 mL) is 4 teaspoons (400 mg/5 mL) twice a day (total: 3200 MG/DAY). This exceeds the
accepted maximum daily dose for this drug (3000 MG/DAY). Please evaluate this dose for
appropriateness.
Geriatric Precautions
Geriatric precautions are based on the Beers list, which indicates that certain medications may not be
appropriate in the elderly.
Pediatric Precautions
Pediatric precaution alerts pertain to medications prescribed for the pediatric population. In some cases,
certain drugs are not recommended for this population.
42
Formulary Checking
Meaningful Use: Menu Objective #1
Implement drug formulary checks
All Rcopia users have formulary checking enabled; therefore, those users that are utilizing Certified Rcopia or
Rcopia-MU will successfully meet this Meaningful Use objective. Formulary information in Rcopia is obtained
from Surescripts.
1. When you select a patient, Rcopia will automatically search for his or her eligibility using the patient’s
first and last name, ZIP code, and DOB.
Surescripts provides formulary information from health plans, Pharmacy Benefit Managers’s and
payers such as Blue Cross, Anthem, MAMSI, etc. Surescripts may not provide eligibility for all
government-funded formularies such as Medicaid or some small regional payers.
2. Once the formulary information is obtained, the display can tell you what medications may be
preferred by the patient’s prescription drug benefit using formulary designation codes (F, NF, PA, T1,
T2, etc).
Click on the ‘What do these Codes Mean?’ link on the bottom or left side of the screen for further
information.
43
If you try to prescribe a medication that is not covered, or has higher co-pay, you will receive a formulary
alert in the system:
FORMULARY ALERT! This patient’s insurance coverage, Medco Health (MHS), provides the
following guidance for the drug you have just prescribed, galantamine.

This drug is non-formulary. Please prescribe an alternative.
3. The user can override the alert, or select from the list of alternatives and prescribe a medication that
may have lower co-pay.
44
A yellow triangle alert next to the patient’s name tells you that the PBM has returned patient demographic
information in the eligibility response on the current patient that may be different than what you have stored in
Rcopia, or that Rcopia has detected a difference in demographics from the PBM/Payer. This is to ensure that
you have received prescription benefit information on your patient. Click on the yellow triangle to access and
view this information.
45
Additional Options
There are many additional options available in the Rcopia application. To access them, click on the Additional
Options link in the blue toolbar at the top of your browser.
Several of these additional Rcopia features are for reference, or have already been configured and performed
for your practice upon purchasing the software. Briefly, these Additional Options include:
a. Batch Patient Entry: allows a practice to add a number of patients at a time. Rcopia has, in most cases,
performed a data load of your patient information prior to training.
b. Configure Formularies: Rcopia is connected to Surescripts, so it automatically provides most formulary
information regarding your patient’s insurance preferences. However, DrFirst does host some formularies,
which are enabled within the application for linking to patients.
c. Terms of Use: document that displays the Rcopia terms of use that all participants must agree to prior
to utilizing the application.
d. Manage my Favorite Prescriptions/Categories: allows users to add prescriptions to their Favorites
list (My List or Practice List) without being used in a patient’s record previously. A current list of your
favorite prescriptions is provided in the Favorites drop-down list.
You will be directed to Find a medication. Please reference the Create Prescriptions: Select a Drug
portion of the manual for further instructions.
Merge Duplicate Patients
Use this option to merge two independent patient records into one. An example: a Chuck and a Charlie Young
were entered independently when they are in fact the same person.
1. Click on Merge Duplicate Patients in the Additional Options menu.
2. You will be prompted to Find a patient. Enter the patient’s last name (to search by first name, enter a
comma before the name).
3. Click on Find. All patients meeting the search criteria you entered will appear. You can click on the patient’s
name to view his or her record in a pop-up window.
4. For each record, you can pick from two options:
a. Select to Keep: selects this patient record to be the “master” record
b. Select to Merge: Selects this patient record to be the one that merges with the “master” record
It does not matter which record you choose to select first, the one to Keep or the one to Merge. You
will be prompted to select the remaining option in the process next.
46
5. Once you have chosen a patient record to Keep and a patient to Merge, click the Merge Selected Patients
button.
You have the ability to merge any number of patient records into one record by repeating the
process outlined above.
You have the ability to Make each merged patient into an alias for kept patient by checking the box
under the Merge Selected Patients button. This option allows an Rcopia user to search for any
combination of names that may have been added into the system for this one patient prior to having
their records merged into one. For example, Charles Young vs. Charlie Young vs. Chuck Young, once
merged with this option, will all point towards the kept/master record.
Pharmacy Data
This option allows users to add or modify the practice’s pharmacy data list without having to be in a patient’s
record.
You will be directed to the Add a Default Pharmacy screen. Please reference the Pharmacy Management: Add
a Default Pharmacy portion of this manual for further instructions.
Schedule
The Schedule feature in Rcopia connects to either your local Practice Management System or your Billing
Service to display daily/weekly/monthly scheduled patient visits. By clicking the Schedule link in Additional
Options, users can add or modify appointments.
The Rcopia Schedule module of the program is automatically connected to either the practice’s PMS or
Billing Service if your practice signs up for:

A one-way connection, or

A two-way connection
Some billing services may charge a monthly fee for this connection. Also, a one-way interface with Rcopia will
be required. Additional charges may apply.
47
Additional Options: User Preferences
1. To Access User Preferences, you will first need to select Additional Options, located in the Rcopia
task bar.
2. Within Additional options, select Preferences -- user.
The following is detailed information about each user preference, and the resulting changes in Rcopia:
Use this practice as your starting practice in Rcopia: Allows users who are connected to more than one
location to set their default location when starting Rcopia.
When starting Rcopia go to: Determines which screen a user will begin on when entering e-prescribing.
a. Report Screen
b. Patient Selection (default)
c. Message Screen – Renewal Request Page
d. Schedule Screen
When searching for pharmacies, start with: Determines which list will be defaulted when searching for
a pharmacy.
a. All List (default)
b. Practice List
c. Favorite List
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When reporting, warn if a patient has had no office visit in the last: Sets a time period for last office
visit warnings when reporting.
a. No Warning (default)
b. 30 days
c. 90 days
d. 180 years
e. Year
When reporting, use as default: Chooses all providers or one specific provider when reporting in Rcopia.
When reporting, show by default: Determines which prescription status a user’s screen will show when
reporting.
a. Pending (default)
b. Completed
c. All
When reporting, retrieve by default prescriptions for: Sets a default time range for reporting.
a. Pending Prescriptions (default)
b. Completed Prescriptions
c. All Prescriptions
When reporting, retrieve up to: Sets the total number of reports to be displayed when reporting.
a. 10 reports
b. 50 reports
c. 100 reports (default)
When reporting, view prescriptions assigned to me in other offices: Determines if a user will view
prescriptions from all other offices they are connected (user has to be connected to more than one
location in order to set this user preference).
When displaying medication history, show medications for last: Sets a limitation for medication
history results.
a. No Limit (default)
b. 3 months
c. 6 months
d. 1 year
e. 2 years
Show cancelled prescriptions in reports: Allows user to determine whether or not they wish to view
cancelled prescriptions when reporting.
49
Use Practice or Provider address on prescriptions and medication reports: Determines which address
to display on prescription headings. By default, the program will put the practice address on a provider’s
prescription. If their profile is updated with a different address, a provider can have this address show up
on their individual prescriptions.
Show prescriber’s email address on retail prescriptions: Determines whether a provider’s email address
will be displayed on retail prescriptions or not.
Print at most 1, 2, or 4 prescriptions on a single page: Determines how many prescriptions a user will
print per page. A user can print 1, 2 or 4 prescriptions on a single page (depending on the length of each
prescription).
Display patient allergies on printed/faxed prescription: Determine whether or not a patient’s allergies
will display on printed/faxed prescriptions.
Display patient problem on printed/faxed prescription: Determines whether or not a patient’s
Problems will display on printed/faxed prescriptions.
Default duration for schedule appointments: Sets a specific duration on scheduled appointments.
Notify me of All messages or Only messages sent to me: Sets a user’s specific preference for receiving
messages. Messages are renewal requests that are sent by pharmacies to a practice. A user can choose to
view all messages or messages specific to him or her only.
Ignore previously seen warnings on refills from patient medication list: Determines whether or not a
user will see or ignore previous warnings on refills on a patient’s medication list (i.e. if the drug triggered a
clinical or formulary alert when first prescribed, alerts will NOT be displayed when refilling the same
drug).
When encountering an insurance warning, show confirmation screen for: Determines the setting for
insurance warnings.
a. All warnings
b. Exclusion and Intermediate Warnings (default)
c. Exclusion Warnings Only
Allow two, or more medications for a single patient that differ only in quantity: Determine whether
or not a user will allow for prescribing two or more medications for a single patient that differ only in
quantity. If you change this to ‘No’, you will not receive a ‘Duplicate Therapy’ warning anymore.
Show patient weight on details screen: Determines if a user will see a patient’s weight on the Enter
[Prescription] Details screen. If you change this to ‘No’, you will not have the ability to use the Dose
Calculator without first editing this User Preference.
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Custom prescription notes (one per line):
a. A custom prescription note may be no more than 210 characters in length. If a prescription
exceeds the 210 character limit, it will be sent via fax to the pharmacy.
b. Do not hit the return key while typing the prescription note. Let the text wrap on its own.
c. Hit the return key to delineate between individual prescription notes.
d. You will find these notes in a drop-down list on the sig page above the Directions to Patient
box.
e. These can be very helpful and are the next best thing to creating favorite prescriptions.
3. When finished with user preferences, click on the Make These Changes button at the bottom of the
screen to save any changes made.
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Additional Options: Practice Preferences
To access Practice Preferences, click on Additional Options in the top toolbar. Then click Preferences –
Practice.
If your practice is an enterprise and you have multiple groups / locations setup within the enterprise,
these settings must be done for each individual group / location.
Warn users when they prescribe a drug that may not be covered by insurance: If ‘Yes’ is chosen the
application will display a formulary alert when the medication is not covered. If ‘No’, the system will not
pull a patient’s formulary information into the system and will not display formulary warnings.
When an insurance warning is displayed and the user desires to prescribe the medication
notwithstanding the warning:
a. Require users to enter a reason
b. Allow users to enter a reason, but do not require it (default)
c. Do not permit users to enter a reason
When renewing an active medication, retain the Office Comments and Directions to Pharmacist from
the previous prescription by default: Automatically enters previous notes to the pharmacist and staff
when performing prescription renewals.
When selecting a drug, show users formulary statuses for:
a. All Restricted Drugs only
b. All Drugs (default)
Show the prescriber's DEA Number (NOTE: All states require DEA number for scheduled drugs):
a. On prescriptions for scheduled drugs (default)
b. On all prescriptions
c. Never
By default, check the "print pharmacy name" checkbox: If ‘Yes’ is chosen, the system automatically
prints the pharmacy name on printed prescriptions.
Allow prescription "print" button to instead fax to the following fax numbers (separate by commas):
Automatically faxes prescriptions to a fax number of your choice, entered into the text field provided. This
can be used in the event there is no office printer and a hard copy is required.
Allow users to send a prescription directly from the Review Prescription screen: If ‘Yes’ is chosen, this
allows practice to add the “Action” buttons to the Review Prescription screen.
Require staff to specify a provider before saving a prescription: If ‘Yes’ is chosen, automatically prevents
prescriptions from being created without a provider selected. (Default)
Require provider signoff for prescriptions printed by staff: If ‘Yes’ is chosen, the providers signature is
needed on printed prescriptions.
52
Allow creation of prescriptions missing sig or quantity data: If ‘Yes’ is chosen, this allows prescriptions
to be generated and saved without including sig or quantity data. This is useful for the staff because
sometimes they do not know the sig but can still create and send to the physician’s queue for approval.
(Default)
When reporting, start with pending prescriptions checked: If ‘Yes’ is chosen, all pending prescriptions
on the pending prescription report are checked. ‘No’ is recommended, so providers must choose the scripts
they desire to approve and don’t accidentally approve another provider’s scripts.
When reporting, display patient Primary care provider, if any: If ‘Yes’ is chosen, automatically displays
primary care provider on all reports.
When reporting, show date of last patient visit: If ‘Yes’ is chosen, automatically displays last patient visit
date on all reports.
When reporting, show date of next patient visit: If ‘Yes’ is chosen, automatically displays next scheduled
patient visit date (if available) on all reports.
When reporting, show office comments in full: If ‘Yes’ is chosen, office comments are added to all
reports.
When reporting, show pharmacy name: If ‘Yes’ is chosen, the pharmacy name will be displayed on the
reports.
Automatically set the medication stop date when the prescription has a set duration: If ‘Yes’ is chosen,
an active medication automatically discontinues when the duration expires, removing the drug and sig
details from the Medication box on the Patient Summary screen. This medication can still be found in the
patient’s medication history.
Display patient's responsible provider in status bar at top of screen: If ‘Yes’ is chosen, the patient’s
primary care provider (PCP) is displayed in the status bar.
Use practice name on prescriptions and medication reports: If ‘Yes’ is chosen, automatically displays
practice name on prescription and medication reports.
Show prescriber name on medication reports: If ‘Yes’ is chosen, automatically displays prescriber name
on medication report.
Display drug interaction, allergy, and exclusion warnings on the printed/faxed prescription: If ‘Yes’ is
chosen automatically includes any drug and/or allergy interaction and/or exclusion warnings on all printed
and/or faxed prescriptions.
53
Show a link to a free drug information reference site. If ‘Yes’ is chosen will automatically provide a link
on the ‘Enter Details’ screen to access a drug reference website (RxList). (Note: Site has ads and is not
affiliated with Rcopia.)
External ID system name to require for each patient, if any: This is the identifier used to link Rcopia to a
Practice Management or EMR. If selected, this would be a required entry for all new patient added to
Rcopia.
External ID system name to display on prescriptions and reports, if any: Text box provided to
automatically display patient/external ID on all prescriptions and reports. Not used by smaller practices.
Label to use for above external ID, if any: Text box provided to provide an External ID label for
aforementioned External ID name.
Signature Password Duration:
a. None (default)
b. 5 minutes
c. 15 minutes
d. 30 minutes
e. 45 minutes
f. 60 minutes
It is recommended to select ‘None’ so that a Signature Password must be entered every time,
ensuring proper credentials are always entered for utilizing this e-prescribing application.
Warn provider for Renewal requests more than:
a. No Warning (default)
b. 1 Day Old
c. 2 Days Old
d. 3 Days old
54
Warn provider for pending prescriptions more than:
a. No Warning
b. 1 Day old (default)
c. 2 Days old
d. 3 Days old
e. 7 Days old
A warning after one day is recommended so that prescribers are aware that they have prescriptions
that need sign-off.
Show patient problems on prescription summary page: If ‘Yes’ is chosen displays patient problems on
the patient summary page.
When checking for drug-drug interactions, show:
a. All interactions (default)
b. Severe and Contraindicated Only
c. Contraindicated Only
When checking for drug-drug interactions, check against patient's PBM drug history if available: If
‘Yes’ is chosen Rcopia utilizes a patient’s PBM/Pharmacy history (if available) for drug-drug interactions.
(default)
When checking for drug-disease interactions, show:
a. Contraindicated for exact diagnosis
b. Contraindicated for exact and related diagnosis
c. Contraindicated or Evaluation needed for exact diagnosis
d. Contraindicated or Evaluation needed for exact diagnosis or related diagnosis
e. All warning for exact diagnosis
f. All warnings for exact and related diagnosis
When checking for duplicate therapy, check against patient's PBM drug history if available: This is
defaulted to ‘No’ and if changed to ‘Yes,’ make sure to confirm that the patient is taking the medication on
the medication history before making a clinical decision. (Note: For both interaction and duplicate
checking, the PBM history will include prescription fills within the last 120 days, if available.)
Automatically search for patient PBM drug history:
a. No automatic search
b. Over last 30 days (default)
c. Over last 90 days
d. Over last 180 days
e. Over last year
Automatically record created charges: If chosen, created charges will be recorded in the Rcopia Charge
Capture area of the application. This feature is not widely used among our user community so it is no longer
supported by Rcopia. ‘No’ is the default.
In the patient medication list, display the initials of the provider who last renewed the medication: This
is defaulted to ‘Yes’ and is helpful when renewing medications in the future.
55
Patient Group Names (one per line): Text box provided to enter desired patient group names. Remember:
do NOT press return until finished with the entire patient group name, no matter how long, let word-wrap
work. Only hit the return button to delineate one name from another.
Description of any additional security features to include on printed prescriptions (at most 100
characters): This will allow for a printed message to appear on all prescriptions practice wide.
When finished setting Practice Preferences, click on the Make These Changes button at the bottom of the
screen to save any changes made.
56
Report a Problem
If at any time a user has difficulties with the system when creating a prescription, or needs to report a failed
prescription that was undeliverable to the pharmacy, the best option for reporting a problem to DrFirst is by
email.
1. To select the problematic prescription, click on Prescription Report on the blue navigation toolbar on
the top of the page. Use the filter at the top of the screen to find the problematic prescription.
2. Click on the status, e.g., signed, sent or sent, saved.
3. A Contact Us About This Prescription link will appear at the top of the screen. Click on this link.
4. You will be brought to an email page. Please enter as much information as you have, including the serial
number at the top of the page on the problem prescription, and submit it to our Support Department.
If the issue needs immediate attention, please contact the DrFirst Support Department at (866) 263-6512.
57
Frequently Asked Questions
Logging in
Q: Why can’t I login?
A: If you are having trouble logging in, you should ask yourself the following questions:
1. Am I connected to the Internet?
2. Did I type my username and password in correctly? (If unsure, please contact your office manager.)
3. Is the CAPS Lock on? Rcopia’s password is case-sensitive.
Q: I forgot my login password.
A: First you should contact your office manager/DrFirst administrator or IT Specialist to reset it. If they
are not available, contact DrFirst at (866) 263-6512 to have it reset. Please have your credentials
available, as we will be verifying your information.
Q: I forgot my signature password.
A: Contact DrFirst at (866) 263-6512 to have it reset. Please have your credentials available, as we
will be verifying your information.
Q: I remembered my password, but now I’m locked out. What do I do?
A: Wait five minutes until your account is unlocked and try again. In case of an emergency, contact DrFirst
at (866) 263-6512 and ask for an account unlock. Please have your credentials available as we will be
verifying your information.
Eligibility and Formulary
Q: Why isn’t my patient’s insurance and formulary information being displayed in the drop-down
menu? I entered the correct demographic information.
A: If formulary information is not displaying for your patients, (i.e. the display says “none”), there are a
few possible causes:
1. The information doesn’t match what the insurance company has on file: double check that the patient’s
information in your system matches the information on their insurance card. If it does match, we
recommend that you ask if he or she has recently changed his or her address or insurance companies. For
example, if you listed a patient as Bill and his legal name is William, then change the first name to reflect
that.
2. The patient may be insured by a non-participating PBM/Insurance Company. Some payers are not yet
sharing information electronically.
58
Prescriptions
Q: How can I find a prescription that I already sent? What if I want to delete or modify a prescription?
A: You can either go to the Prescription Report in the top toolbar, or if it’s for a single patient, go to Select
Patient. Find your patient, scroll all the way down to Pending Prescriptions for this Patient, and select [Show All
Prescriptions] for a complete list of all pending and completed prescriptions. To delete or modify the prescription,
scroll all the way to the far right in the Show All Prescriptions section, select Delete or Modify and alter the
prescription to fit your needs. “Deleting” anything that has been sent in Rcopia doesn’t actually remove it from the
database—it just hides it from view and records it as “deleted.”
Q: The drug I want to prescribe is not in the system. How can I add it?
A: DrFirst researches and incorporates new drugs into Rcopia every month at the end of the month. Please be
patient. If you do not see your drug in the system, you can send it through as a “Free Text Drug,” and/or send
an “add drug” request to [email protected]. Note: It is better to use a medication from the med list than to
free text whenever possible in order to utilize the clinical alerts functionality.
Q: The sig drop-down list doesn’t meet my needs. What should I do?
A: DrFirst continually researches and develops new ways to make your prescribing experience Simple, Powerful, and
Fast. If the available drop-down list is not sufficient for the medication at hand, please use the Directions to Patient
section and enter the sig as free text. This section functions the same as the drop-down sig does, but it gives the
user more freedom to tailor the sig to match his or her specific directions. Please make sure you do not leave data
entered in the drop-down sig boxes and then put conflicting data in the Directions to Patient section.
Q: The pharmacy says that my prescription didn’t go through. What should I do?
A: There are a few reasons this may be the case:
1. The prescription may not have been sent. To vertfy, go to the Prescription Report in the top toolbar or, if
it is for a single patient, go to Select Patient, find your patient, scroll all the way down to Pending
Prescriptions for this Patient, and make sure it is not still pending.
2. Try to resend it. Many times when a prescription does not go through, it is because the pharmacy may have
mishandled it during a “training error” (e,g,. their machine was not set up correctly; they were out of ink or
paper or while resetting their machine all the incoming prescriptions were erased; some pharmacies still need
to print out electronically-received prescriptions and can lose the print-out).
3. If they still have not received the prescription and you have called to confirm, please contact DrFirst. On
the Prescription Report of completed prescriptions find the prescription, click Status and then click
Contact Us About this Prescription on the upper right of the prescription image. If you cannot send us
the message electronically, call DrFirst at (866)263-6512. Be sure to have the prescription handy. Support
will ask you questions about the prescription including the serial number, which can be found along the
bottom. It will be an “AA-” or “BB-” number, e.g. AA-5555555.
59
Q: I got an alert/warning. What does this mean?
A: As you prescribe, the system will show you clinical and formulary alerts when applicable.
a. Clinical Alerts: When you receive an alert in RED, this indicates a clinical alert. Examples are: Drug-Drug
Interaction, Drug-Allergy Interaction, Dose checking, and Duplicate Therapy. It is very important to make
sure the patient's medication list is accurate and up-to-date to receive complete clinical alert checking.
b. Formulary Alerts: When you receive an alert in BLUE, this indicates a formulary alert. Examples are: nonformulary drugs and drugs that offer a preferred alternative(s) with lower copay for the patient. If you
receive a formulary alert, you can switch to an alternative drug provided in the dropdown by clicking on
the drug name.
When you receive an alert, you can click Prescribe Anyway to create the prescription despite the warning. You
can type in a justification, if desired. You can also click Cancel to cancel the prescription and return to the
Patient Summary screen. This is used when the user decides not to prescribe the selected medication.
Q: I canceled a prescription, but it still shows up. How do I get rid of it?
A: To remove Canceled prescription notifications, go to Additional Options, Preferences—user, go down to Show
canceled prescriptions in reports, and select No.
To remove a Canceled medication that the patient HAS taken from the active medication list, click Stop just to the
right of the medication listing, and enter a reason for removing the drug from the active list if desired.
To remove a Canceled medication that the patient has NEVER taken from the active medication list, click
Manage Medications on the blue menu at the top of the screen, and click Delete to the right of the
medication.
Pharmacies
Q: I can’t find a pharmacy in DrFirst. How do I add/delete a pharmacy?
A: To add or delete a pharmacy:
1. Click the Pharmacy link in the patient demographics section to search for a new default pharmacy, or click the
Change link on the Enter Details screen of a prescription to change the pharmacy associated with that
particular prescription.
2. Choose a list from which to search. DrFirst recommends using the All Lists option because that contains our
entire nationwide list of pharmacies, plus any pharmacies you have added to your Practice or Favorite List.
You can set the default for which list you would like to search from under the Preferences--User in the
Additional Options menu.
3. When searching for pharmacies, less is more. If you fill out every field and something does not match, you
will not get a result. Try searching with, for example, only the State and ZIP code, or just the street name
in the address but leave the City field blank. It is rare that the pharmacy is not in the database, but
common that someone in a hurry adds it as a new pharmacy anyway – and prescriptions cannot go
electronically (only by DrFirst fax) to pharmacies added by the practice.
Only after you are certain a pharmacy is truly not in the database, you may add a pharmacy by clicking Add a new
pharmacy to the practice list and entering the required data. You will not be able to receive renewal requests
electronically for pharmacies entered manually into the system.
60
Printing
Q: Why can’t I print?
A: If you are not able to print, please check the following:
1. Is your printer turned on and ready to receive new printing jobs?
2. Is your computer set up to print to that printer? Is it defaulted to a different printer?
3. Make sure your popup blocker is turned OFF.
In Internet Explorer, you can find this under Tools, Pop-up Blocker, Turn Off Pop-up Blocker.
For Firefox, you can find this under Tools, Options, Content. Uncheck Block Pop-up Windows.
Q: How can I print more than one prescription per page? Every time I print multiple prescriptions, the last
one(s) are getting cut off. What should I do?
A: To print multiple prescriptions per page:
1. Go to Additional Options in the blue toolbar at the top of the page.
2. Go to Preferences – User.
3. Scroll down until you see: Print at most [1] prescriptions on a single page. Choose your preferred view.
Note: Sometimes 4 prescriptions will not fit well on a single page—we are currently working to improve this.
Q: What sort of printer should I use?
A: Any inkjet or laser printer (such as HP, Epson, or Canon) should work well with DrFirst Rcopia. Beware of using
a Dot Matrix printer, as those won’t work as well.
Note: DrFirst users writing prescriptions electronically with Rcopia now meet the Medicaid Tamper Proof requirement
without special paper due to new modification-resistant printing of prescription information and microprinting text on
original prescriptions in order to combat improper prescription duplication. DrFirst Rcopia meets the Medicaid
requirements through innovative features such as quantity fields, which are bordered and spelled out as text; filler
characters to prevent alterations to data fields; and microprinting to prevent copying.
Users
Q: I have a new staff member. How do I get him or her access to DrFirst Rcopia?
A: To register a doctor/provider or a provider agent (a nurse with Rx sending capabilities) you must fill out
the required paperwork and fax it in to DrFirst at (240) 331-9195. To obtain new paperwork, please call the
DrFirst Registration Department (888) 271-9898, Option 4.
To register a new staff member who will not have the capability to send prescriptions, you must have
administrator privileges to our site. Please contact your office manager or another Rcopia administrator to
set up a new staff member.
If you are the office manager/administrator, please login on to www.DrFirst.com and click on Manage
Practice. Click on the practice in which you would like to register the new user and go down to User
Registration Summary. Scroll down until you see the blue font with the words Register New User, and
follow the prompts to create a new user. Note: If your new user has a common last name, please add a number
after the desired username to create a new user, as there cannot be duplicate usernames in Rcopia.
If you have any other questions or if you require additional assistance, please call DrFirst Customer Service at
61
(866) 263-6512 or email us at [email protected]. Please have your DrFirst username/login name handy to
help us expedite your service request.
62

Rcopia\Dr. First User Manual - Your Local Community Mental Health

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