ePrescribing

E-Prescribing System –How does it work

Prescriber

• First, a system user-clinician or staff-signs into a system through a verification process authenticating their identity.Standard authentication requires username and password. Once authenticated, the system provides functionality specific to a user's role and authorization level.Different user types (e.g. clinicians and office staff) have different legal permissions to enter, review, or modify prescriptions.
• The prescriber identifies the patient record within the e-prescribing system.Records can be identified by typing in identifying information (first name, last name, date of birth, zip code, etc.) to the e-prescribing system.If the e-prescribing system is connected to the practice management system, the e-prescribing system can recognize all patient records matching the day‘s schedule, providing a quick, simple way of accessing relevant patient records.
• The next steps in the process correspond to reviewing the medical history, entering, and editing a prescription.
  

• E-prescribing systems should allow the prescriberto perform the following functions:

• Review patients' current medication list and medication history information within the practice.
• Work with an existing medication within the practice, this can involve viewing details of a medication, remove a medication from the active medication list, change dose, etc., for a medication or renew one or more medications
• Prescribe or add new medication and select the pharmacywhere the prescription will be filled

The information is then sent to the Transaction Hub, where information on the patient eligibility, formulary, and medication history/fill status is sent back to the prescriber.
 

 Transaction Hub

• The Transaction Hubis the common link between the prescriber, pharmacy, and pharmacy benefits manager (PBM).It maintains a master patient index and list of pharmacies and it routes inquires to the PBMand prescriptions to the pharmacy.

• Once the Transaction Hub receives the patient demographics and medication from the prescriber, it will verify the patient against the master patient index sending an electronic message to the PBM.In response the PBMwill send information on the patient eligibility, formulary, and medication history back to the Transaction Hub. The Transaction Hubthen sends this information back to the prescriber, who then can make a decision about the prescription based on this information.

•  The prescriber then:

• Completes the prescription and authorizes (electronically sign)

• One item
• Multiple items
• Items created by ancillary staff, residents, or

•  Transmit prescriptions

• Choose print, fax, or transmit options in
• Handle restrictions on certain medications (e.g. medications requiring prior authorization from the PBM)

• Ensure prescription is sent to preferred patient designated authorized pharmacy. The prescriber may also select the pharmacyduring the patient encounter.

 
Pharmacy

• Once the pharmacyreceives the prescription data from the Transaction Hubit provides confirmation back to the Transaction Hub.All pharmacy systems are enabled to send messages back to the provider offices letting them know that a prescription has been filled.Systems are changing so that a message can be sent back indicating if a patient picks up their prescription(s) or if the patient is late picking up the prescriptions.This can help prescribersand patients better manage their care.