e-Prescribing 101, Part III: End Users

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As we discussed in our previous post, e-Prescribing is the electronic transmission of a prescription from the prescriber’s device to the patient’s pharmacy of choice, therefore replacing the traditional paper prescription.

How does e-Prescribing work for end users?

While e-Prescribing software comes in many shapes and sizes, e-Prescribing integration is directly integrated into healthcare software such as an Electronic Health Record / Electronic Medical Record, telehealth application, or dental practice management solution. By way of integrating e-Prescribing into a healthcare software, the e-Prescribing platform becomes an integral component of a healthcare software’s product offering.

e-Prescribing integration seamlessly allows a prescriber to log into their existing healthcare software, select a patient, then search for, enter and send an e-Prescription for the patient in a few short steps. The process saves the prescriber time while improving patient outcomes.

What are the benefits of a custom, white labeled solution?

When an e-Prescribing solution is “white labeled”, this means the e-Prescribing user interface mirrors the look and feel of the healthcare software in which the e-Prescribing solution has been embedded. Colors, fonts, font sizes, layout – you name it – can all be completely customized to provide a seamless experience for end users.

Furthermore, mobile optimization has become a major trend as more healthcare software solutions are operating in the cloud and prescribers are accessing applications from multiple devices and multiple locations. This is why it’s important that the e-Prescribing functionality performs well in different environments, but most importantly, on smaller screens.

Responsive design is critical in ensuring that any e-Prescribing solution is accessible on every device. It’s the best one size fits all solution as this type of design allows the webpage to expand and contract in order to perfectly fit within any screen in both the traditional office and mobile settings. Ultimately, responsive design cuts down on development time as the e-Prescribing user interface does not need to be adjusted manually for each type of device (i.e. mobile, tablet, laptop, or desktop).

What does it take to cross the finish line and go live?

To go live with e-Prescribing and be able to send prescriptions electronically, all healthcare software companies must go through a Surescriptsâ„¢ e-Prescribing integration review. Surescripts operates the largest health information network that connects the diverse and expansive community of care partners nationwide, including pharmacies, providers, benefit managers, and health information exchanges.

As part of this e-Prescribing integration review, healthcare software companies will have to successfully execute various test scenarios during a web meeting with Surescripts. Test scenarios will be provided for the following services:

• NewRx: Route new prescriptions to the patient’s pharmacy of choice
• Refills: Receive prescription renewal requests and submit responses between doctor and pharmacy
• Medication History: View aggregated medication history data from pharmacies and pharmacy benefit managers (PBMs) upon receipt of patient consent.
• Prescription Benefit: Surescripts’ Prescription Benefit service puts eligibility, benefits and formulary information at a prescriber’s fingertips at the time of prescribing. This enables prescribers to select medications that are on formulary and are covered by the patient’s drug benefit.
• Electronic Prescribing of Controlled Substances (EPCS): Product has achieved Surescripts EPCS certification and has provided third-party audit documentation as required by the DEA.

Upon completion, healthcare software companies will be listed on the Surescripts website.

Healthcare software companies also looking for the ability to Electronically Prescribe Controlled Substances (EPCS) will need to go through a similar testing process with an approved e-Prescribing of Controlled Substances auditor such as the Drummond Group Inc., one of the first DEA approved certification bodies for EPCS.

Learn about DoseSpot’s e-Prescribing integration process by downloading our latest Integration Tool Kit.

Don’t miss the other parts of our e-Prescribing 101 series:

e-Prescribing 101, Part I: The Basics

e-Prescribing 101, Part II: Controlled Substances

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

e-Prescribing 101, Part II: Controlled Substances

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To continue our e-Prescribing 101 blog series, we shine light on controlled substances. What they are, their relationship to e-Prescribing, as well as the correlation between prescription drugs and the current opioid epidemic.

What is a controlled substance?

A controlled substance is a drug or chemical, such as illicitly used drugs or prescription medications, that is regulated by a government based on the drug or chemical’s manufacture, possession, or use.

Why are certain drugs categorized as a controlled substance?

A drug is typically classified as “controlled” due to the potential detrimental effects on a person’s health and well-being. As a result, state and federal governments have seen fit to regulate such substances.

It’s for this reason that drugs, substances, and certain chemicals used to make drugs of this caliber are classified into five categories. The drug segregation is dependent upon the drug’s acceptable medical use and the drug’s abuse or dependency potential.

What are the medication schedules for controlled substances?

Schedule I

• Drugs with no currently accepted medical use and hold a high potential for abuse.
• Examples: Heroin, Marijuana (Cannabis), LSD, and Ecstasy

Schedule II

• Includes drugs that are accepted for medical use, but have a high potential for abuse, with use potentially leading to severe psychological or physical dependence.
• Examples: Vicodin, OxyContin, Adderall, and Ritalin

Schedule III

• Drugs with a moderate to low potential for physical and psychological dependence, with less abuse potential than Schedule I or Schedule II drugs.
• Examples: anabolic steroids, testosterone, and Tylenol with codeine

Schedule IV

• Drugs within this category have a low potential for abuse and dependence.
• Examples: benzodiazepines (Xanax, Valium, Ativan), Tramadol, and Ambien

Schedule V

• The lowest schedule for controlled substances, these drugs have lower potential for abuse and consist of preparations containing limited quantities of certain narcotics.
• Examples: Robitussin AC, Lyrica, and Motofen

What is EPCS?

EPCS stands for the Electronic Prescribing of Controlled Substances and is a technology that has been put into place to help address the rising issue of prescription drug abuse in the United States.

Understanding two-factor authentication

This two-step process is part of EPCS and ensures that only an authorized prescriber can electronically sign and send controlled substance prescriptions to a pharmacy, thus increasing patient safety. The process includes the entry of something you have, such as a token generated one-time code, and something you know, like a password. There are various options for two-factor authentication including: fob tokens, mobile phone applications, smart cards, USB thumb drives, and fingerprint scanners.

What is an opioid?

Opioids are substances that act on the body’s opioid receptors to produce euphoric effects, better known as a “high”, and are most often used medically to treat moderate to severe pain that may not respond well to other pain medications.

Why are opioids so addictive?

Opioid drugs work by binding opioid receptors in the brain, spinal cord, and other areas of the body to reduce the sending of pain messages to the brain, thus simultaneously reducing the physical feelings of said pain. They create artificial endorphins, the body’s natural painkillers, which tap into the “reward” sector of someone’s brain. However, with chronic use, opioids eventually trick the brain into stopping the production of these endorphins naturally. In doing so, the tolerance level increases and a patient is left with taking more medication to achieve the same effect.

They are most dangerous when taken in certain ways to increase the “high”, such as crushing pills and then snorting or injecting the powder, or combining the pills with alcohol or drugs, especially benzodiazepines. While some patients do take them for their intended purpose, they can still risk dangerous adverse reactions by not taking them exactly as prescribed, i.e. they take more at one time, or combine them with other medications not checked by their doctor.

Unfortunately, the fear of the intense withdrawal symptoms is often the biggest culprit when it comes to patients remaining addicted and ultimately leads them to continue taking the medication even if they no longer want to.

The correlation between prescription opioids and the opioid epidemic

In 2012 alone, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills. In comparison to ten, even five years ago, this number is dramatically increasing as time goes on and more and more opioid overdoses are being reported on a daily basis.

Physicians and dentists are collectively responsible for providing 81.6% of opioid prescriptions in the United States and because of this, they have a very unique role in mitigating the impact of this opioid epidemic. Opioid addiction often starts at the hands of healthcare professionals simply trying to do their job, prescribing pain medications to relieve their patients of painful woes, especially during post-operative recovery.

While many prescriptions are meant for initial, short-term treatment, some doctors and dentists authorize refills time and time again because they want to help patients whom claim that they are still in pain. However, when the pill bottle and refills run out, patients are left seeking alternatives to create that euphoric escape they’ve become so accustomed to. This could mean an endless search of several different doctors to prescribe more substances (also known as doctor shopping), purchasing pills on the black market, or worse, turning to heroin as a cheaper and more readily available alternative.

Furthermore, the associated stigma often deters patients from receiving proper rehabilitation treatment and even if they do seek treatment, the government currently limits the number of patients a single provider may treat with drugs such as buprenorphine or methadone, which are both proven to reduce cravings and save lives. This leads to many patients relapsing.

How does e-Prescribing help?

• e-Prescribing diminishes the possibilities of duplicate or lost prescriptions since the prescription is sent directly to the patient’s pharmacy.
• A patient will no longer have a paper prescription where the dispense quantity can be altered.
• Prescriber’s will have access to a patient’s medication history, therefore they can determine if a patient is doctor shopping or has a history of substance abuse.

Don’t miss the other parts of our e-Prescribing 101 series:

e-Prescribing 101, Part I: The Basics

e-Prescribing 101, Part III: End Users

Sources: DEA; DrugAbuse.gov; FDA

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

e-Prescribing 101, Part I: The Basics

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Another year has come and gone. Time to start fresh, gain new perspective, and bring it back to basics. e-Prescribing basics, that is.

During our reflection on 2016, the DoseSpot realized that there’s so much information out there regarding e-Prescribing and its different components; so many key opinion leaders and incredible resources to tap into to help educate the world about e-Prescribing. However, how could we make it easier? How can we assist those who just want to learn more about e-Prescribing in general without the endless Google searches?

That’s why we decided to create a three-part blog series covering all e-Prescribing basics; a one-stop-shop to answer all of your e-Prescribing questions and curiosities.

We can promise you this – this is one New Year’s resolution we won’t give up on.

Let’s get started.

What is e-Prescribing?

The term e-Prescribing has become a popular buzzword in the healthcare industry, but what exactly does it mean? To put it simply, electronic prescribing, known in short as e-Prescribing, is a method of prescription transaction that allows prescribers to write and send prescriptions to pharmacies electronically instead of writing, phoning-in, or faxing. It ultimately replaces the costly paper prescription pad and tamper-proof printing paper from a prescriber’s office for good.

e-Prescribing solutions have the following capabilities:

• NewRx: Route new prescriptions to the patient’s pharmacy of choice.
• Refills: Receive prescription renewal requests and submit responses between doctor and pharmacy.
• Medication History: View aggregated medication history data from pharmacies and pharmacy benefit managers (PBMs) upon receipt of patient consent.
• Prescription Benefit: Surescripts’ Prescription Benefit service puts eligibility, benefits and formulary information at a prescriber’s fingertips at the time of prescribing. This enables prescribers to select medications that are on formulary and are covered by the patient’s drug benefit.
• Electronic Prescribing of Controlled Substances (EPCS): Product has achieved Surescripts EPCS certification and has provided third-party audit documentation as required by the DEA.

What are the benefits?

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

• Eliminates the time and effort of trying to understand the prescriber’s handwriting, as well as the chance of an error in that translation.
• 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 prescriber’s instructions.
• Ensures that any drug-drug and drug-allergy interactions based on a patient’s medication history are found and reported to the prescriber before the prescription order is completed.
• Checks a patient’s pharmacy benefit and associated formulary at point of care to encourage the prescriber to choose the best medication option, both medically and financially.
• Increases patient medication pick-up adherence. Between 28% and 31% of all paper prescriptions either never make it to the pharmacy, or are not picked up once patients see how much it will cost.
• Drives down healthcare costs and improves patient satisfaction by getting medications to patients in a timely, convenient, and secure manner at the patient’s pharmacy of choice.
• Curbs prescription drug abuse and increases patient safety. No longer will a patient have access to a paper prescription, therefore no more altered dispense quantities, stolen prescription pads, or lost or duplicate prescriptions.
• Lowers costs associated with purchasing expensive paper prescription pads and the time and resources spent on redundant administrative tasks.
• Simplifies clinical workflows and allows prescribers to do what they do best and spend more time with their patients.

Who can e-Prescribe?

State or provincial legislation governs who can write a prescription, and under these rulings, any licensed physician, dentist, nurse practitioner, etc. allowed to write prescriptions by hand can also prescribe electronically.

Many electronic prescribing vendors also allow the use of proxy users, such as nurses, medical assistants, or office staff. While they cannot legally send a prescription to a pharmacy, they are able to access the e-Prescribing solution and fill in all required fields of the prescription for a prescriber to then approve and send.

What pharmacies allow e-Prescribing?

All 50 states and D.C. allow the e-Prescribing of both controlled and non-controlled substances and more than 90% of pharmacies can receive e-Prescriptions. Of course this includes the larger retail pharmacy chains such as CVS and Walgreens and mail-order pharmacies like Catamaran and Express Scripts.

Don’t miss the other parts of our e-Prescribing 101 series:

e-Prescribing 101, Part II: Controlled Substances

e-Prescribing 101, Part III: End Users

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

Luminello Adds The DoseSpot e-Prescribing Platform to New Psychiatry EMR

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NEEDHAM HEIGHTS, MA – DoseSpot, an industry leader in e-Prescribing integration platforms for medical, dental and telehealth software, today announced that Luminello, a user-friendly, psychiatrist-designed EMR, has successfully integrated DoseSpot.  Through the partnership, Luminello successfully completed Surescripts certification and their prescribers can now e-Prescribe controlled and non-controlled prescriptions to more than 65,000 pharmacies nationwide.

Luminello is a new psychiatry EMR for mental health providers designed by Dr. Ken Braslow, a board-certified psychiatrist in Child/Adolescent & Adult Psychiatry with an active private practice in San Francisco and Berkeley, California and Assistant Clinical Professor of Psychiatry at the University of California, San Francisco (UCSF). Luminello was built to help solve the challenges of running a psychiatry practice and Dr. Braslow needed an e-Prescribing solution to tightly integrate with his psychiatry specific workflow. The DoseSpot platform was Luminello’s top choice due to DoseSpot’s quick e-Prescribing integration process and quality customer service. The DoseSpot platform not only meets the e-Prescribing integration needs of Luminello, but it also provides prescribers with a simple and intuitive user interface for e-Prescribing controlled and non-controlled prescriptions.

To read the complete Press Release please visit DoseSpot.com/luminello-press-release.

Parsing the Patient Portal: Why Engagement Strategies Must Go Beyond It

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According to a recent survey from HIMSS Analytics¹, major healthcare organizations are assessing current portal use and looking for ways to further enhance patient engagement. The survey found the top motivating factors for patient engagement to be the following: to enhance and improve community health (77%), to build brand loyalty for patients (77%) and to meet meaningful use requirements (60%).

Reasons for portal adoption—the current “go to” engagement tool on the healthcare scene—were also somewhat varied:

• Meeting meaningful use requirements for functionality and data sharing from a single source (71%)
• Using portals that offer patient services, technology and content (54%)
• Using portals as a configurable, interoperable information exchange platform with multi-source data sharing (51%)
• Using portals provided by electronic health record vendor of choice (66%)

With a predominant and short-term focus on meaningful use, many healthcare IT companies are in the process of designing products that span the entire care continuum—from the time a patient first engages with a provider until treatment is completed. These “next-generation” portals will allow patients to become partners in their own care, by offering features such as e-visits or e-consultations (80% of respondents are seeking), interoperability across multiple providers (70% seeking), health evaluation and coaching (70% seeking) and televisits (50% seeking)

Overall, healthcare leaders are looking to better align portals with the definition of patient engagement and ensure that accessible healthcare tools provide patients with appropriate decision-making powers when it comes to health and wellness.

For more details on HIMSS’ recent patient portal survey, check out Healthcare Informatics’ coverage here!

SOURCE: Healthcare Informatics

About DoseSpot 
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

¹HIMSS Analytics is the marketing intelligence division of HIMSS.

Taking a Peek at Patient Engagement in Beantown: Beth Israel’s New Pilot Study

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Further initiatives to end incessant EMR entry during medical appointments may now be in place within one of Boston’s own. Beth Israel Deaconess Medical Center (BIDMC) recently received a $450,000 grant from the Commonwealth Fund to solidify a program allowing patients to add to and update their own medical records during visits. This program, called OurNotes, is an extension of the larger and well-known OpenNotes initiative. The idea for OpenNotes began 5 years ago and quickly mobilized into an approach that gives patients access to their physicians’ visit notes. OpenNotes has spread rapidly across the U.S. and is now used by more than 5 million patients and providers nationwide.

Throughout this pilot, Beth Israel will collaborate with a number of health sites and providers across the country, including Pennsylvania-based Geisinger Health System, Seattle-based Harborview Medical Center, Seattle’s Group Health Cooperative and Mosaic Life Care in St. Joseph, Missouri. The OpenNotes initiative started making waves in Boston during the 2012 calendar year, when researchers conducting a survey at BIDMC found that patients with access to clinicians’ notes were more engaged and witnessed more positive health outcomes. Results from this year-long study included data from more than 13,500 primary care patients and 100 physicians.

The OurNotes Pilot will initially focus on primary care, with the intent to later expand into other specialties. Jan Walker, RN, MBA and co-founder of OpenNotes hopes that the pilot will further increase patient engagement and improve adherence to medications. Walker also stated that patients in the OurNotes pilots at both BIDMC and additional sites will have access to other parts of their medical records, including problem and medication lists. After this initial phase of testing, each of the five sites will have the opportunity to develop its own prototype for further implementation.

SOURCES: mobihealthnews and OpenNotes.org

For more information on the OpenNotes initiative, check out Beth Israel Deaconess Medical Center’s official press release here!

About DoseSpot 
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.