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What is E-Prescribing in relation to electronic medical records (EMR) or electronic health records (EHR) systems?
E-Prescribing systems allow providers to send prescriptions electronically, and they are also designed to allow access for medication history, eligibility checks, and benefit plan data to be retrieved from payers and pharmacy benefit managers. These systems by themselves are referred to Stand-alone E-Prescribing systems. Many technology vendors offer products for storing and retrieving patient.s medical records, lab reports, and other information about the patient which are designed to replace the traditional medical chart and to provide a secure information flow for a patient.s health records between provider points of care. These products may or may not include E-Prescribing components.
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Why should I adopt an E-Prescribing system?
Recent data indicates that adoption of Electronic prescribing services offers many benefits to both the providers and patients. Patient safety is increased as most systems offer alerts and warnings for potential drug/drug or drug/allergy interactions as prescriptions are written. The prescriptions arrive at the pharmacy in clear language and instructions, resulting in less errors and adverse events from filling prescriptions. There are also fewer calls from the pharmacy for problems with prescriptions. Renewal requests can be received electronically and processed quickly, with a few clicks of the mouse. Staff can be freed up from calling and faxing in prescriptions to provide better quality care for the patients.
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How can I determine the cost of implementing an E-Prescribing system in my office? What costs should I expect?
The cost of implementing E-Prescribing for any given practice varies greatly, and depends on which vendor, system and features are needed. If an office needs to purchase any computer equipment or services (internet access, wireless connections, computers, PDA.s) the initial expense will increase. You should usually expect to pay anywhere from $400 - $900 per year per license for a stand-alone E-Prescribing system. Full EMR systems normally run much higher than that to implement and for ongoing related expenses ($25,000 - $100,000).
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How do I go about choosing the right vendor for my office?
A good place to start is to create a list of requirements based on needs and desired functionality. There are some good resources on Surescripts.com to assist with this. Once requirements are defined, it is a good idea to shop around to find a vendor that satisfies the needs and offers the best price for the service. There is a listing of SurescriptsTM certified technology vendors on their website.
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Where can I get more information on E-Prescribing?
A good resource for E-Prescribing information can be found at SureScriptsTM. This website has a wealth of information and education materials including getting started guides for physicians, lists of certified vendors, and E-Prescribing national statistics. Other good websites are ehealthinitiative and CMS ePrescribing Incentive. .
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What medication history data can I expect using an E-Prescribing system?
Most E-Prescribing systems have a feature for providers to request medication history for their clients. Once the client is selected, requests for up to two years of data can be retrieved by requesting it through the E-Prescribing software. Information includes the drug name, dosage, last fill, and date information. To receive DMAP medication history, a client must be an active DMAP recipient at the time of the request.
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How do I obtain eligibility information for DMAP clients through E-Prescribing?
Most E-Prescribing systems have features that automatically retrieve client eligibility verification and benefit plan information as clients are selected and viewed in an E-Prescribing system. Clients that are not currently active for DMAP will not return positive eligibility verification.
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What vendors allow me to access DMAP client data (medication history records and eligibility and benefit plan information.)?
Vendors must be certified with SurescriptsTM, which is the largest nation hub for E-Prescribing data flow. Vendors also need to be sending requests in a format that is fully compatible with the DMAP system. For example, if a technology vendor does not include an NPI provider identification on the transaction request, data will not be returned regardless of client eligibility.
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Can I be the only one in my office to E-Prescribe? My staff and colleagues do not want to participate.
Although it is POSSIBLE to utilize and E-Prescribing system as a single entity, it is not recommended. Typically, long term success of E-Prescribing adoption requires the participation of staff at all level in the practice. This ensures that the workflow changes necessary for E-Prescribing are shared and each functional member of the office compliments the process. For example, if a physician is using a handheld device in the exam room to send prescriptions for a new client, it is much less cumbersome if the patient demographic data and preferred pharmacy was entered prior to the office visit by a front staff member who has the information from the initial intake interview.
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What happens if a pharmacy that I use does not accept prescriptions electronically?
If a pharmacy is not registered to accept electronic prescriptions, the process is that the prescription defaults to fax and is still received by the pharmacy without any further action from the provider.
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What incentives can I expect if I choose to adopt an E-Prescribing system?
There are incentives available through Medicare for physicians who meet the criteria for utilization of E-Prescribing. More information is available through the SurescriptsTM website and the CMS website.
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Why can't I send prescriptions for controlled substances electronically?
Current DEA regulations prohibit the sending of prescriptions for controlled substances electronically. These laws and regulations are being reviewed and the hope is that these will be allowed for electronic submission at some point in the future.
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Do I have to purchase expensive special tamper-resistant paper for printing out prescriptions that can not be sent electronically?
Some technology vendors ensure that tamper-resistant criteria are met for printed prescriptions without the need for the special paper. Check with your technology vendor on this.
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I need to send a prescription to the pharmacy for a DMAP client, but I am not seeing the formulary/benefit plan name on my screen. What does this mean?
There are several reasons why the benefit plan name is not returned for a client.
- Client's information may not have matched well enough and was not found. Make sure the demographic information for the client matches the name on their Medicaid ID card and verify the client's DOB, gender and zip code information.
- The client may not be currently an active DMAP client.
- The request may be for more than 1 day in the future. Eligibility requests can only be processed for current day and one day in advance.
- The technology vendor may not be passing the request to the DMAP system correctly. Check with the vendor if problems persist.
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When I request medication history for a client, I am not receiving any data. Why is this occurring?
There are several reasons why medication history is not returned for a client.
- The client's information may not have matched well enough and was not found. Make sure the demographic information for the client matches the name on their Medicaid ID card and verify the client's DOB, gender and zip code information.
- The client may not be currently an active DMAP client.
- The technology vendor may not be passing the request to the DMAP system correctly. Check with the vendor if problems persist.
- The client may be new to DMAP and does not yet have any medication history in the DMAP system.
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Can I participate in a free, sponsored program to get on board with E-Prescribing?
Currently, the state of Delaware does not have any programs to sponsor physicians for an E-Prescribing system. Check on the EHealthinitiave or SureScriptsTM website for any other programs that may be available.
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