SURESCRIPTS CERTIFICATION

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WHY DO YOU NEED IT?

In order to electronically route prescriptions and search patient specific eligibility, formulary, and medication history, your application must achieve Surescripts certification.  Even when integrating with a Surescripts certified vendor such as DoseSpot, Surescripts still requires a quick certification meeting to “go live”.

WHAT DO YOU HAVE TO DO IN ORDER TO ACHIEVE SURESCRIPTS CERTIFICATION?

When using DoseSpot, your application will have to pass a quick screen demo test that includes different validation scenarios and the ability to send Surescripts messages appropriately in the backend.

WHAT’S THE MINIMUM FUNCTIONALITY THAT YOU NEED TO PASS?

If you are using DoseSpot’s e-prescribing application, the minimum functionality to pass Surescripts certification is the following:

– Method to pop the DoseSpot application in a browser from your application (using credentials & passing your patient information) and receive the DoseSpotPatientID back from DoseSpot.

– Prescribe within DoseSpot (nothing you need to do here)

– Use the DoseSpot API to check for refill requests and transmission errors in DoseSpot and provide a link within your software to DoseSpot for fulfillment.

– Appropriately validate a patient’s demographic information before sending it to DoseSpot

Electronic Prescribing for Dentistry!

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The medical industry has been using electronic prescribing (“e-Prescribing”) for over a decade now. The dental industry hasn’t quite caught up.  In fact, in a recent personal survey I noticed dental practice management systems don’t provide medications in a coded format.  Meaning, the medications are free text fields and the practice hand enters the medications into the system.  This will end up limiting the user of these systems from ePrescribing, drug-to-drug alerts, drug monographs and many other features common in electronic medical record (EMR) systems.

The advantages for adopting ePrescribing are vast:

Patient Safety

The electronic prescription reduces prescriptions errors caused by illegible hand writing, drug-to-drug interactions, incorrect dosing, drug allergy reactions, duplication of drugs, etc.

Fraud and Crime

The medication history his saved electronically and can be monitored easier than paper.

Medication Adherence

Patients are more likely to fill prescriptions as they’ll be waiting at the pharmacy for pickup.  The refill process is also expedited without multiple phone calls between patient, provider, and pharmacy.

Real-time communication

Providers can write notes that follow the prescription to the pharmacist. Pharmacists can submit refill request on behalf of the patient for approval by the physician (no phone call needed).

Decision Support

Health care professionals will have critical drug alerts and patient specific information at the time of prescribing.

Government Regulations

In January 2011, the state of Minnesota released a mandate for all Prescribing Providers to electronically prescribe medications.  This mandate includes dentists.  The rule wasn’t put in place to punish dentists.  It was actually designed to bring dentist into the fold of sharing health information.

Most dental Practice Management Systems don’t have electronic prescribing capabilities.  In the next few years a number of these companies will begin adding ePrescribing capabilities.  A company called DoseSpot has developed a dental e-prescribing application accessible from the web.  The dental industry is about change the way it prescribes medications.  Stay tuned…

A CCHIT Based Guide to Qualified E-prescribing System – The First decision

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Now that we’ve taken a look at the whole of what is deemed a qualified e-prescribing system in the eyes of CCHIT, I think its time to get into the weeds a bit and see what those high level requirements really mean.  Just as we have to crawl before we walk, I’m going to address the primary goal of getting a prescription order from your EHR to the pharmacy for fulfillment.  It’s a straightforward requirement, but there are a lot of things you must think about before being ready to e-prescribe.

The reality is that any transactions between your system and the pharmacy system will be handled by a third party delivery service.  This service company is Surescripts RxHub.  Some may be familiar with the history of the company, but for those not, in a nutshell they used to be two companies serving two very different user bases.  Surescripts worked with the retail pharmacies, while Rx Hub worked with the Pharmacy Benefit Managers (in other words, the insurers).   I’m sure Surescripts RxNorm are working towards a unified system, but until then you can still think of Surescripts RxHub as two different systems.

Implementing ePrescribing for the first time will be a lot of development work, so if you wanted to stage the development over time and get more bang for your buck it may be a good idea to start with one group rather than the whole kit and caboodle.

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A CCHIT Based Guide to a Qualified E-prescribing System – Part I (The 2008 requirements)

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As I mentioned briefly in my previous post, Medicare is providing incentives for practices to implement a “qualified” e-prescribing solution.  The Medicare Improvement for Patients and Providers Act of 2008 (referred to lovingly as MIPPA) describes in detail the schedule of payments for practices (found here), but it falls short on detailing what a qualified system is.  Instead, the Center for Medicare and Medicaid Services (CMS) points to certification authorities to provide the guidance of qualifying a practice’s system. As the Certification Commission for Healthcare Information Technology(CCHIT) will be the basis for the EHR incentives that come with the healthcare stimulus package, I thought it might be a good exercise to see what they had to say about e-prescribing.

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E-Prescribing 101

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Electronic prescribing is not just the ability to send prescriptions electronically to pharmacies. E-Prescribing can also increase care quality in a number of ways:

• E-prescribing makes sure that the prescriber is providing enough specific information for the pharmacist to fill the prescription, including the name of the drug, the dosage, its physical form, the route, and the physician’s instructions.
• Electronic prescribing software eliminates the time and effort of trying to understand the prescriber’s handwriting, as well as the chance of an error in that translation.
• E-prescribing significantly reduces the chance that the prescriber’s intentions are misinterpreted.
• E-prescribing is often used in conjuction with clinical decision support to ensure that any drug to drug interactions or drug to diagnosis issues are found and reported to the physician before the prescription order is completed.

Electronic prescribing is considered one of the most important areas of Healthcare IT, which is why Medicare created payment incentives for physicians who use a qualified e-prescribing system. In 2009, the incentives are an increase of 2% in revenue for each patient when e-prescribing is used. Due to the 2009 HITECH Act, electronic prescribing is required as part of any EMR (EHR) which qualifies for Medicare reimbursement in 2011.