eprescribe Brittany Partridge, Clinical Informatics
What is eprescribe? eprescribe is an electronic transmission of prescriptions to the SureScripts national network. It takes the place of the typical paper or faxbased transmission of a medication prescription to the patient s pharmacy of choice. With the adoption of the SureScripts national eprescribing network, Seton is now able to connect COMPASS to 94% of the pharmacies in the United States.
Why this change? eprescribe was selected by Seton leadership as a module for ARRA/Meaningful Use II (MUII) criteria. It will ensure Seton will receive an increased reimbursement rate for meeting MUII criteria, but also prevent Seton from incurring penalties if other MUII criteria are not met.
Expected benefits Improved patient safety Reduced Adverse Drug Events (ADEs) Better assessment of patient compliance with chronic medications due to direct viewability of patients prescriptions Reduced costs Improved medication reconciliation process via consistent and reliable data from a trusted primary source
Key Points eprescribe phase 2 is going live March 24, 2015 All narcotics (class II-V) will stay on paper Rx. Four new functions Data entry of patient s preferred pharmacy Data retrieval of patient s prescription history Data retrieval of prescriptions covered by patient s insurance Electronic transmission of non narcotic Rx to patient s preferred pharmacy
What is impact to nursing? Acute, Critical Care, Surgical Services and, WH nurses will continue to collect and update home medication history Nurses will start to collect preferred pharmacy info Nurses will start to import medication history to assist with data reconciliation of the home medication list Would require a process change for those clinical areas that do not enter all details of the home medication list ED nurses Radiology nurses
What is impact to medical providers? Medical providers will Continue to perform admission, transfer and discharge medication reconciliation Start to see community pharmacy information Start to see formulary information (insurance coverage) on prescriptions. Start sending legend medications electronically Medical providers may continue to print paper Rx if the patient prefers this method. Will require attention to the defaulted route of transmission Need to remain attentive MUII requirements
What is the impact to our patients? Patients may receive 3 types of Rx Paper based for controlled substances (Class III-V) Triplicate tamper proof Rx (Class II ) Electronically submitted Rx (Legend) Home medications histories will be easier to obtain, so patients should experience a more comprehensive & complete medication reconciliation erx will decrease wait times for Rx at pharmacy Improve patient satisfaction
Impact to other roles? Pharmacy techs will have access to functions for viewing and importing patient s medication history. Improved productivity for staff Radiology techs be able to view patient s medication history Will assist with IV contrast contraindication assessment in outpatient areas where full medication reconciliation is not typically performed Improvement to patient safety
Risks with new process If patient s preferred pharmacy is not documented, then medical providers will need to enter this pharmacy or will need to print the prescription. < 0.1 % of erx will not transmit successfully on first attempt (based off national data) Providers will need to monitor Message Center tool bar Patients or pharmacies may need to call prescribing practitioner or unit charge nurse to notify physician to call Rx to pharmacy ED Rx call the ED phone # on discharge paperwork Residents call the main hospital phone # Physicians and allied health providers- call the phone # on discharge paperwork
Patient Preferred Pharmacy
External Prescription History
Formulary Checking
Electronic Prescribing
Checking Rx Routing Errors
Education Initiatives Train the Trainer Sessions for COMPASS experts and educators March 5, 12 & 17 Nursing web based training on mylearning Acute care, critical care, WH, Surgical Services, ED, Radiology & SPS Pharmacy techs Tips and Tricks All staff Job Aids Nursing and Providers Provider videos loaded to YouTube http://www.youtube.com/playlist?list=plariacyzmhww I_v5nTQEyGUMMERffTnwe