E-Rx implementation

Electronic prescribing, or e-prescribing, is a paperless way of prescribing medication. More specifically, a physician uses a computer or handheld device with software that has been tested and certified to:
  • Electronically access a patient's prescription benefit information.
  • With the patient's consent, electronically access that patient's prescription history.
  • Electronically route the prescription to the pharmacy of the patient's choice. When the patient runs out of refills, his or her pharmacist also can electronically send a renewal request to the physician's office for approval.

How does one successfully e-prescribe?

For your system to qualify as a certified e-prescribing system, it must meet all of the following requirements or be part of an ONC-ATCB certified EHR:
  1. Generate a complete active medication list incorporating electronic data received from applicable pharmacy drug plan(s) if available.
  2. Select medications, print prescriptions, electronically transmit prescriptions and conduct all safety checks (includes automated prompts that offer information about the drug being prescribed, potential inappropriate dose or route of administration of the drug, drug-drug interactions, allergy concerns and warnings/cautions).
  3. Provide information related to the availability of lower-cost, therapeutically appropriate alternatives (if any).
  4. Provide information about formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient’s drug plan.

There are several options for selecting an e-prescribing program that fulfills all of these components. You can purchase either (1) a certified electronic health record (EHR) system that has an e-prescribing component integrated within it, (2) a free-standing e-prescribing software system, or (3) use a free e-prescribing Internet portal. If you decide to purchase either an ONC-ATCB certified EHR system or free-standing e-prescribing system, you should only purchase it from vendors who are also certified for Part D standards. There are several free e-prescribing Internet portals, including Practice Fusion and Allscripts.

Vendor selection

There are numerous e-prescribing vendors available to clinicians. One factor that can influence your decision is if the vendor meets the Centers for Medicare and Medicaid Services' (CMS) definition of a qualified e-prescribing system under Medicare Part D's e-prescribing standards or as an ONC-ATCB certified EHR. Use of a such a system can help to make you eligible to receive e-prescribing incentive payments described under the Medicare Improvements for Patients and Providers Act (MIPPA). More information about these standards, and MIPPA, is available at the CMS website.

For any vendor you are considering, it is important to ask if its application meets the standards of a qualified system under MIPPA.