Best Practices with E-Prescribing
Best Practices to help you get the most out of e-prescribing. Read specific best practices for physicians and pharmacists below.
Best Practices: Acquiring, Implementing, and Utilizing
Assess your practice's readiness for e-prescribing.
If your practice uses an Electronic Health Record (EHR) system, determine if it can be enabled for e-prescribing via the Surescripts network. Find a list of technologies certified to connect to the Surescripts network.
Set a clear vision and objectives for what you hope to accomplish through e-prescribing and communicate this within the practice.
Integrate patient demographic information from practice management system into the e-prescribing application.
- Most vendors can do this
- There may be a fee
- It is likely worth the cost because it is time consuming and creates a barrier to using e-prescribing if not set up in advance
Implement and use all e-prescribing services to achieve greatest benefit. This includes Prescription Benefit, Medication History, and Prescription Routing (bi-directional).
- To be eligible for Medicare incentive payments under MIPAA, prescribers must be using all of these e-prescribing services
- Using prescription benefit information will ensure selected medications are covered by the patient's drug coverage, meet therapeutic guidelines and are cost-effective.
- Bi-directional prescription routing enables automating of prescription renewals which reduces phone calls and faxes to the practice and saves prescriber and staff time while ensuring better patient service. Be sure to check the system regularly throughout the day and always respond within 24 hours. It is helpful to assign this responsibility to an individual in the practice
Avoid batching or queuing prescriptions before sending them to the pharmacies electronically. This reduces the chance of the patient arriving at the pharmacy before the prescription is ready.
Follow DEA regulations and refrain from sending controlled substance prescriptions electronically. Do not approve prescription renewal requests for controlled substances that are sent electronically.
Think through workflow changes; understand how prescriber and staff roles and responsibilities may change when automating medication management.
Designate a practice expert for e-prescribing. That staff member, by becoming increasingly adept at using the electronic prescribing system, will elicit additional value from your investment by making the process run more smoothly.
Ensure complete and effective training.
- Pace yourself
- Consider decreasing patient load when first implementing
- Learn how to access and use prescription benefit information such as eligibility and formulary, as well prescription history information
- Learn how to generate new prescriptions and respond to electronic renewal requests
Encourage independent pharmacies in your area to become enabled for e-prescribing, particularly patient favorites. A letter template has been developed to help you with pharmacy outreach. Click here to access this document.
Inform your e-prescribing software vendor of any technical issues through their support process.
If a patient shows up in a pharmacy and is told the prescription is not there, please report these cases so technical issues can be identified and pharmacy staff can be re-trained if necessary. If you receive fax prescription refill requests from connected pharmacies, please report these cases so corrections can be made to the pharmacy database on prescribers. Here's additional information on how to handle faxed renewal requests.
Orient patients to e-prescribing.
- Ensure they understand that it is safer and more efficient.
- Ensure they come prepared with their preferred pharmacy.
- Direct them to call the pharmacy rather than the practice for prescription renewals.
- Consider using signage, recorded phone messages, patient reminder cards to reinforce the message. Here's more information on patient education materials.
Getting the most from e-prescribing
"Best Practices" and answers to critical questions, drawn from pharmacies experienced with implementing electronic prescribing
- Inform local physicians that you are enabled to accept
prescriptions electronically, and that you can start sending
renewal authorization requests immediately.
Once your pharmacy software vendor activates your connection to the Surescripts network, your pharmacy becomes visible to prescribers that use Surescripts certified e-prescribing software. You may review a list of which physicians in your area e-prescribe by visiting www.surescripts.com and using the "Find Physicians" tool.
It can be beneficial to contact prescribers that send a high volume of prescriptions to your pharmacy to inform them of your new electronic prescribing capability.
A letter or call from your pharmacy will prompt those physicians who are not yet connected to do so, and will remind physicians who are connected to respond promptly to your pharmacy's renewal authorization requests. Surescripts provides some sample faxes and letters here, you can download and customize to inform physicians about your new connectivity.
- Educate your entire staff about electronic prescribing
and how it works within your pharmacy management
As with any new technology, it is important that each member of your staff understands what e-prescribing does, what its benefits are, and how it works. This is important to help them understand how their daily workflow or responsibilities will be affected by e-prescribing and to also answer common questions from customers and practices.
Staff should be aware of how an e-prescription differs from a prescription that is fax based. If your pharmacy system places electronic prescription messages in a different queue from one your staff commonly uses, make sure you put a process in place to regularly check that queue for new prescriptions and renewal responses.
View a list of common e-prescribing questions and answers here.
- Identify a staff member to become your local expert on
your pharmacy's electronic prescribing ability.
Although everyone should be taught to use the software, having a thoroughly knowledgeable person on hand for other staff members to ask questions will help eliminate any confusion with the new functions, and, resolve any problems quickly.
- Take full advantage of managing renewal authorization
Managing prescription renewals electronically is an important way to strengthen your relationship with e-prescribers in your area. Physicians that e-prescribe have a very strong preference to receive prescription renewal requests electronically. This is a key benefit of their e-prescribing connectivity and will help to significantly reduce the number of faxes and phone calls your pharmacy will need to initiate for this process.
- If you do not receive a prompt response from a
physician for a prescription renewal authorization request you've
sent electronically, please do not resend another request for the
same prescription within 24 hours.
Just as with faxed or called-in renewal authorization requests, sometimes a physician may not be able to provide a prompt response to an electronic renewal request. Duplicate electronic requests for the same prescription may cause additional review and confusion in both the physician's office and your pharmacy.
Prescriber training, and Surescripts messaging, encourages prescribers to respond to prescription renewal requests within 24 hours. Calling the physician's office to follow up on a delayed response in an emergency situation will be more effective than resending the request.
- Communicate with practices that you believe are sending
problematic e-prescriptions to your pharmacy
E-Prescribing supports a significantly more secure and accurate way of managing prescription information than on paper or by fax. However, prescribers may occasionally make an error when using their software to transmit an e-prescription. For instance, their software may incorporate a 'drop-down' menu of medications and a prescriber may inadvertently select a medication that is above or below the one they intended to prescribe.
If you believe that an e-prescription you have received contains an error please contact the prescriber's practice to confirm or correct the prescription you have received and then dispense as appropriate to your customer. It is important that practices are aware of issues as they develop so they can self-correct the problem if they are able.
- Report issues with e-prescriptions that are causing you
If there are ongoing issues with the e-prescribing functionality within your pharmacy software system, or if errors with e-prescriptions that prescribers send you are frequent enough to be a problem, it is very important that you report them to your pharmacy software vendor so they can help resolve them and prevent future occurrences.
When reporting errors related to an e-prescription that a prescriber has sent you, it is important to provide as much of the following information as possible to your vendor:
o Transaction Date
o Name of Prescriber
o Message ID (noted within e-prescription)
o Prescriber SPI (noted within e-prescription)
o Your Pharmacy's NCPDP ID
Your vendor will then document the problem and, if necessary, open a case with Surescripts to help affect a resolution.
Specific to issues with a prescriber or practice, Surescripts will research the issue and present feedback to a practice's technology vendor as appropriate for resolution. Resolution can include adjustments to a prescriber's software, or training for the practice itself.
- Communicate prescription fill-time expectations to
local physicians and their staffs, as well as
With the speed that electronic prescriptions reach the pharmacy, some patients and physicians mistakenly believe that the prescriptions will be ready for pickup immediately. It is helpful to inform your patients and physicians that adequate preparation time is still required along with the time frames they should expect. You can also remind the physician to note on the electronic prescription that a patient plans to come immediately to your pharmacy. They can do this by utilizing the free text or comment section of the electronic prescription.
- Ensure that information in your pharmacy system about
local prescribers is up-to-date.
Your pharmacy software vendor, who assisted you in connecting to the Surescripts network, should also work with you to keep your prescriber file up to date as new prescribers in your area become activated for e-prescribing. If you maintain files store by store, you should ensure that all data is updated in each store to be consistent.
As additional prescribers in your area become accessible through the network, you should institute a regularly scheduled process to update their information in your doctor file. Your vendor should provide updates on which physicians are eligible to receive prescription renewal requests. You can also obtain this information on our Web site at the following link.
- Turn over every leaf before turning away a
While electronic prescribing is not new, in some markets the volume of prescriptions received electronically may be low in comparison to your overall prescription volume. As a result, the staff may forget to look in the electronic prescription queue or check only the fax and phone queues when a patient arrives to pick up a prescription that has been sent electronically.
Ensure all possible locations are checked before telling the patient the prescription was not received.