Objective
More than 50% of all permissible prescriptions written by the eligible provider (EP) are queried for a drug formulary and transmitted electronically to the pharmacy using certified EHR technology.
Description
Providers must transmit permissible medications (new prescriptions and renewals) electronically.
Electronic refill requests received from Surescripts will count in the denominator of the performance metric. Surescripts or InfoScan formulary data always will be available when prescribing, as long as it has been downloaded successfully and is current.
Performance metric
Denominator
The number of prescriptions issued by a provider during the reporting period, for which
transmission is permissible. This includes all such prescriptions faxed, printed, and transmitted (excludes prescriptions marked as “do not print” or “sample given”) AND all electronic refill requests received by that provider.
Numerator
Portion of the prescriptions in the denominator that were transmitted electronically AND the number of electronic refill requests that were transmitted back to the pharmacy electronically.
Ratio
The resulting percentage should be more than 50%.
Exclusions
• Any provider who prescribes a total of fewer than 100 medications during the reporting period.
• Any provider who does not have a pharmacy within his/her organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the provider’s practice location at the start of his/her EHR reporting period.
Notes
If a provider wishes to claim exclusion, he/she may be asked to enter the total number of prescriptions issued during the reporting period at the time of attestation. A provider can use the Prescription Output Log report available in the EHR to determine this. For more information, see the Prescription Output Log Report topic in the online help.
The concept of only permissible prescriptions refers to the current restrictions established by the Department of Justice on electronic prescribing for controlled substances in Schedule II-V. The substances in Schedule II-V can be found at http://www.deadiversion.usdoj.gov/schedules/
orangebook/e_cs_sched.pdf.
Configuration for e-Prescribing Chapter 2 - Core Objective 2- E-Prescribing and Use of Formulary
Any prescription not subject to these restrictions is considered permissible.
Configuration for e-Prescribing
All users who need to transmit prescriptions must have appropriate access to do so.
Access Levels > Records tab > Rx/Medications
Access Levels > Records tab > Print from Rx/Medications
Steps to access and edit access levels have not changed since previous versions of the product.
Follow the same steps as before.
Configuration notes
None.
End user workflow for e-Prescribing
New prescriptions and renewals (from the patient’s chart)
In the 2014 certified version of the product, a prescription now is required to have an NDC associated with it.
Chapter 2 - Core Objective 2- E-Prescribing and Use of Formulary Data Responding to electronic refill requests
The end user workflows for electronically transmitting new prescriptions and renewals have not changed from previous versions. Providers may e-Prescribe using their existing workflows.
Figure 11. Prescription screen
Responding to electronic refill requests
The end user workflows for appropriately responding to electronic refill requests has not changed from previous versions. Providers may respond to electronic refill requests using their existing workflow.
End user notes
No specific actions need to be taken by the end users when prescribing “non-permissible”
medications. The system automatically calculates the number of permissible prescriptions written to determine the denominator for this objective (controlled substances like morphine and
Oxycontin are NOT counted).
As long as electronic refill requests from Surescripts are responded to correctly and in a timely manner (always reply to the Surescripts request message within 48 hours of receipt), it will count toward the numerator of the metric for this objective.
A provider can choose to Approve, Change, or Deny a refill request and successfully help increment the numerator for the metric.
Configuration for formulary implementation Chapter 2 - Core Objective 2- E-Prescribing and Use of Formulary
Configuration for formulary implementation
ePrescribing Configuration utility setup
Once a provider has successfully enrolled in Surescripts for e-Prescribing, he/she will have access to the Surescripts formulary.
Formulary updates are set up for automatic downloads on a weekly basis.You may have to modify the formulary download schedule to avoid conflict with other automated services.
In some environments, you may have to direct the download through a proxy server.
To access the e-Prescribing formulary download settings in Patient Records, launch the ePrescribing Configuration utility.
To launch the ePrescribing Configuration utility:
1. In the PPart folder, double-click ePrescriptionConfiguration.exe. The ePrescribing Configuration Utility screen appears.
Figure 12. ePrescribing Configuration Utility screen
2. Enter the Days and Time information as desired to set the time and day of the automatic download each week. All users must be out of the system when this takes place for successful installation of the updates.
Chapter 2 - Core Objective 2- E-Prescribing and Use of Formulary Data End user workflow for formulary checks
• First name • Last name • Date of birth • Gender • Zip code
End user workflow for formulary checks
For formulary checking to occur, the ePrescribing utility must perform a query on the patient to match the demographic data, which occurs automatically when the patient’s chart is opened.
The patient’s Rx eligibility displays if the query is successful. A provider prescribing medications will be able to see a color-coded and numbered system that corresponds with the patient’s coverage for that medication on the Select Rx Template screen.
Figure 13. Select Rx Template screen • Red X (1): drug is not on formulary
• Yellow triangle (2): drug is on formulary, but is not preferred • Green circle (3): drug is on formulary and is preferred
If you click this button in the Formulary area on the Prescriptions New screen...
Then...
Details the screen displays more information, such as
alternative drugs that may have a better formulary status.
End user notes Chapter 2 - Core Objective 2- E-Prescribing and Use of Formulary
Figure 14. Prescription New screen
End user notes
McKesson recommends that you capture and save screen shots of the appropriate areas of the application at the beginning (on day 1), during (regular intervals like monthly or quarterly), and at the end (last day) of the reporting period as supporting documentation for meeting this objective successfully.
Alternative the script will be altered.
If you click this button in the Formulary area on the Prescriptions New screen...
Then...