E-Prescribing Lessons Learned Shared in Breakout Sessions

The messages from users and implementers of electronic prescribing systems were loud, clear — and repetitive. In real-life scenarios, repetition translates into “truth.” Here are some of the oft-cited “best practices” from breakout sessions at the National E-Prescribing Conference:

  • Training in — and use by — all physicians and staff in a group/practice site is essential. “Dabbling” or piecemeal adoption of e-prescribing does not work.
  • The e-prescribing system should interface with the practice management system.
  • Notify all local pharmacies in person that you plan to initiate e-prescribing . (More than 90 percent of the nation’s pharmacies have the capacity to handle electronic scripts, but many lack actual experience.)
  • The answer to the standalone versus integral-with-an-EHR system question depends on individual practice work patterns and available human and financial resources. (The CCHIT recently agreed to certify standalone e-prescribing systems, which should ease fears about interoperability among these “simpler” systems.)
  • Keep a trainer (or in-house “superuser”) on-site for three to five days after you go live.
  • When doing a pre-implementation cost-benefit analysis, remember to calculate annual maintenance costs. Incentives alone (from Medicare and/or any private health plan that might offer them) will probably not cover maintenance costs.

— Lloyd Resnick

  1. Debi A. McClure says:

    Here is a listing of “e-prescribing things to consider” that I wrote up. I am the Support Manager of our Clinical Informatics Department at Southwest Medical Associates in Las Vegas Nevada.
    Debi A. McClure
    Manager, Clinical Informatics
    Southwest Medical Associates – Las Vegas Nevada
    Establish joint operations committee meetings with the prescriber representatives, vendors and high volume pharmacies in advance of implementation.
     Review pharmacy and prescriber operational processes, test process from beginning to end to identify potential issues with either the pharmacy or prescriber.
    Define service level agreements that can be agreed upon between organizations.
     Amount of time necessary for pharmacies to process inbound prescriptions, the amount of time allocated for prescribers to process refill requests, who to call if there are RX related questions/issues etc.
    Develop communication plan between prescribers, pharmacies and vendors in the event issues arise; include after hours contact information.
     System or network related items; including regular maintenance activities that may impact e-prescribing should be communicated to mitigate confusion or issues.
    Work with vendors to develop audit reports to ensure transactions are being sent/received within the defined standards.
    Implement a monitoring process to identify possible issues before they escalate.
    Obtain clear documentation on how the disparate systems communicate, how transactions are passed between organizations and what matching criteria is being used.
     As with EMR’s, not all pharmacy systems use the same standards, which create challenges when implementing and supporting e-prescribing.
    Just “flipping the switch” and implementing e-prescribing without communicating with the pharmacies to review the above items has the potential to create strained relations between the prescribers and the pharmacies. Developing a cohesive partnership between the various organizations speeds up the adoption of e-prescribing by the patients, the pharmacies and prescribers. Understanding how the technology works will assist with troubleshooting reported problems and eliminate future problems. Implementing a strong communication plan will mitigate confusion, especially in the event of system or network outages or application related problems.

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