GETTING STARTED What is MedCheck? MedCheck is an application used to electronically enter and approve home medication orders. MedCheck will act as the place for maintaining the home med lists for your DaVita dialysis patients, replacing the current Snappy med lists. MedCheck connects via Surescripts to provide direct electronic transmission of prescriptions to the patient s pharmacy. The Surescripts connection also provides automated downloads of medication history to the patient s home med list. What is the purpose of MedCheck? MedCheck supports DaVita s MedsMatter initiative. It helps improve prescribing efficiency and home medication list accuracy through: 1. Direct connection to pharmacies through electronic prescribing. 2. Satisfies some state requirements for electronic prescribing (e.g., NY) 3. Standardized drug lists provided by the Medi-Span database. 4. Surescripts med history downloads. 5. Alerts for due and overdue home med reviews and verifications. How should I utilize MedCheck and why should I use it? You can give verbal or written home medication orders to the RN (or RD as allowed by state regulations) to enter into MedCheck. Or you can enter the orders directly yourself. Physicians and certain Allied Health Professionals (AHP), i.e., nurse practitioners (NP) with National Provider Identifier (NPI) number and signing rights from their collaborating physician(s), can approve orders and transmit prescriptions electronically to the patient s pharmacy. How will MedCheck make med lists more accurate? Medications in MedCheck are selected from a comprehensive list populated and updated with data from Medi-Span. Often times the data entered into Snappy today is free form and does not include all necessary information. Additionally, Surescripts can help keep the med list accurate and up-to-date with med history downloads of prescriptions that have been filled for the patient. What is Medi-Span? A provider of prescription drug information which provides a standardized medication list of manufactured drugs. This standardized med list replaces the current table that is used to select home medication names in Snappy. Page 1 of 6
What is Surescripts? Surescripts is a third party vendor that enables MedCheck to electronically transmit prescription information between physicians and pharmacies. Surescripts can also send the patient s history of all meds filled by participating pharmacies and populates the information directly to the home med list in MedCheck. Some pharmacies, including Walmart, Veterans Administration (VA) and Indian Health Services (IHS), do not currently participate with Surescripts. How will patients be impacted if they fill a prescription at a non-surescripts participating pharmacy? The MedCheck system will not allow you to send a prescription electronically to a pharmacy that does not accept electronic prescriptions via Surescripts. In those cases, the prescription must be called in to the pharmacy or printed, signed manually by the physician or NP, and faxed or given to the patient to take to their pharmacy to be filled. Even if patients use a nonparticipating pharmacy, if their insurance pays for the medication and that insurance uses Surescripts, then the medication data will still populate in MedCheck. Refer to the Select a Pharmacy job aid for instructions on how to add a non-surescripts participating pharmacy in MedCheck. What if a patient does not consent to using MedCheck? Prescriptions for patients who do not consent to using MedCheck cannot be sent to pharmacies electronically. In addition, no Surescripts med history downloads will occur for non-consenting patients. The RN or RD will enter home meds in MedCheck and prescriptions will be either printed or called in to the pharmacy. The RN will manage the patient s home med list and complete home med reviews in MedCheck. Will patients have to change pharmacies, or be required to use DaVita Rx, if they consent to use MedCheck? No. Patients will continue to select whichever pharmacy they choose for their medications. The use of DaVita Rx is not required with MedCheck. However, if the patient is a bundle patient, certain bundled meds must be filled by DaVita Rx. Where can I find the MedCheck job aids for physicians and NPs? 1. Physicians can access their MedCheck job aids via the Physician Portal Web: http://www.falconehr.com/physician-portal/. a. Log in with the same username and password you use for Falcon Dialysis. b. VPN is not required. c. Or access the training materials from the Resources tab in Physician Portal. 2. The MedCheck physician job aids are also available on NephLink. Page 2 of 6
Who do I contact with questions? If you are having issues with MedCheck, please contact the Physician Hotline at 1-866-722-6025 or email PhysicianSupport@davita.com. In addition, the MedCheck Champions (usually the FA, RN and RD) in the center are a resource for you. The MedCheck Champions have been trained on how you, as a physician or nurse practitioner, can access and use the MedCheck system. Page 3 of 6
USING THE SYSTEM How do I access MedCheck? Physicians may access MedCheck through the Physician Portal Web or via Falcon Mobile on their mobile phone (iphone or Android). Or, you can log into Falcon Dialysis at the center or remotely from your home or office. Nurse practitioners may access MedCheck via Falcon Mobile on their mobile phone (iphone or Android). Or, you can log into Falcon Dialysis at the center or remotely from your home or office. Note: MedCheck is not currently supported on ipads. The MedCheck mobile app will not work on my handheld device while I am in the center. What should I do? Due to security restrictions, you cannot use the MedCheck mobile application while connected via Wi-Fi to the DaVita network. If using MedCheck on a mobile device, you must utilize your own wireless network to access the system. What is the recommended browser setting for MedCheck? Internet Explorer 11 is the current supported standard browser for the Village. What if I have my own electronic prescribing system? DaVita nephrologists have options for how they will utilize MedCheck to manage patients home medications. If you use another electronic medical record (EMR) that includes an eprescribing component, you may choose whether or not to use MedCheck to prescribe home meds. You may continue to use your own electronic prescribing system if desired, but it is encouraged to at least order ESRD-related home meds through MedCheck. How often do I need to review and approve home med orders for my patients in MedCheck? On a daily basis, you must review all your pending orders (entered by the RN and/or RD) for which you are the prescriber. Prescriptions cannot be sent electronically to the pharmacy until they are approved by the ordering physician or NP. It is imperative that you review pending items daily so that prescriptions can be filled and patients can begin taking their meds as ordered. Page 4 of 6
What if I write and sign a home med order in the patient s chart? When the nephrologist or NP writes and signs an order in the Orders page/section of the patient s chart, the RN enters that written order into MedCheck and submits it manually (via phone, fax or printed prescription) to the pharmacy. Because you wrote and signed the order in the chart, you are not required to approve it in MedCheck; it will automatically be marked as approved. The written med order goes directly to patient s home med list. Note: This does not apply in New York State. New York State regulations require that all prescriptions be transmitted electronically. The RN would enter the written order in MedCheck and send it to you (the prescriber) to approve and send to the pharmacy electronically. Besides reviewing and approving pending prescriptions, what else do I need to do in MedCheck? It is important to check the alerts for any pending Pharmacy Refill Requests and Pharmacy Change Requests. These alerts can only be resolved by the prescriber of the prescription and must be addressed in order for the patient to receive their prescription. A Pharmacy Refill Request is when a pharmacy forwards a request electronically in MedCheck for you to enter the number of dispensings you approve for the patient. A Pharmacy Change Request is a request from the pharmacy for a medication substitution (a generic or therapeutic substitution) or a pre-authorization. A third type of alert you may see on your Prescriber Worklist is the Surescripts Issues alert. This alert means there was an error in the electronic transmission process of the prescription order to the pharmacy, i.e., the prescription you approved did not make it to the pharmacy and hasn t been filled for the patient yet. Physicians, NPs, or any teammate may resolve the Surescripts Issues. Are there differences in electronic prescribing from state to state? Yes. It is your responsibility to know your state requirements and what falls within your scope of practice. Page 5 of 6
My center is in New York State. How do the New York State requirements affect how home med orders are handled in MedCheck? New York State regulations require that all prescriptions be transmitted electronically. RNs (and RDs as allowed by state regulations) must enter prescriptions for verbal, written and per protocol home med orders received directly from the DaVita nephrologist or nurse practitioner into MedCheck and must send them to the prescriber for review/approval. Then you, as the prescriber, must approve the orders in MedCheck and send them electronically to the pharmacy to be filled for the patient. Prescriptions can only be printed or called in, in special circumstances such as in case of a temporary system outage. Refer to the job aid, MedCheck - Temporary System Outage (New York), for details. Patients in New York who do not consent to MedCheck need to handle their prescriptions directly with their physician. The physician will submit prescriptions to the pharmacy electronically using an alternate electronic system that he/she (physician) utilizes and operates. All the MedCheck training materials include instructions specific to New York State where applicable. How does the State of Ohio s Positive Identification law affect MedCheck? DaVita centers in Ohio must take measures to comply with Ohio s Positive Identification law mandating prescribers to provide additional prescription attestation, which is not currently provided in MedCheck. To satisfy Ohio s Positive ID requirement, clinical staff will print a hard copy of the MedCheck Home Medication Orders (HMO) Confirmation Report. That report includes multiple home medication orders as well as specific prescriber, prescription and patient details, so that a prescriber can provide a manual signature as the attestation. Page 6 of 6