2 TerminologyPrescriber – Provider, Fellow, Resident, Nurse Practitioner, or Physician AssistantService Level – The level of e-prescribing capabilities a Prescriber or Pharmacy has.SPI – SureScripts Prescriber ID (think of this as SureScripts’ version of a Prescriber’s NPI (National Provider ID).PON – Prescriber Order Number. It is an VUMC internal reference number that represents a single prescription, which identifies the prescription, patient, provider, etc.SureScripts Message ID – It is an external reference number used to track the e-Prescription.
3 Terminology, cont’dE-Prescription – Computer-based electronic generation of a prescription.E-Prescribe (or e-prescribing) – Computer-based transmission of a prescription between a prescriber and a pharmacy.NewRx – Prescriptions e-prescribed from RxStar (This does not have any association with VUMC’s Renewal prescription policy.).E-Renewal Request – A prescription request sent from a pharmacy to a provider with the intent of renewing the prescription.E-Renewal Response – The prescriber’s response to the pharmacy’s e-Renewal Request (accepted, denied, etc.).
4 Terminology, cont’dSynchronous Error – Real-time error response from SureScripts indicating that the e-Prescription was not received by the intended recipient, pharmacy or prescriber. Asynchronous Error – Delayed error response from SureScripts indicating that the e-Prescription was not received by the intended recipient, pharmacy or prescriber.
5 Prescriber registration In order for a prescriber to e-prescribe, the prescriber must be registered with a Prescribing Vendor, in this case Vanderbilt’s Prescribing Vendor (RxStar/StarPanel).To register a prescriber, we need the following information:Prescriber NamePrescriber IdentificationsClinic NameClinic AddressClinic Phone NumberClinic Fax NumberThe prescriber must also be credentialed and active within the VISTAR (Providers, NPs, PAs, and Fellows) or GME (Residents and Fellows) database.
6 Prescriber Registration, cont’d Currently, a prescriber can have one of three Service Levels:0 – Disabled: Prescriber cannot e-prescribe.1 – NewRx: Prescriber can only e-prescribe from RxStar.3 – NewRx & Renewal: Prescriber can e-prescribe from RxStar and receive/response to e-Renewal Requests from pharmacies.Prescribers can determine their e-prescribing level by looking in the top-right corner of RxStar.Admins can also see a prescriber’s Service Level within the RxStar Admin Console.
7 Pharmacy Registration Once a pharmacy certifies and completes the registration process, the pharmacy/vendor will have similar registration Service Levels:0 – Disabled: Pharmacy cannot accept or send e-prescriptions.1 – NewRx: Pharmacy can only receive NewRx e-prescriptions.3 – NewRx & Renewal: Pharmacy can receive NewRx e-prescriptions and send/receive e-renewal Requests/Responses.
8 E-PrescriptionsIn order to send/receive e-prescriptions the following must occur:Prescriber has a Service Level which supports sending and/or receiving e-prescriptions (e.g. Level 1 or Level 3).Pharmacy has a Service Level which supports sending and/or receiving e-prescriptions (e.g Level 1 or Level 3).E-Prescription qualifies for e-prescribing (i.e. transmitting/e-prescribing the prescription). – See next slide.If all of the above conditions are met, then the prescriber can e-prescribe the prescription.
9 Qualified E-Prescription Details Drug Name – Coded/Structured using FDB (First DataBank), our medication database.Directions – Coded/Structured or Free Text sig; cannot exceed 140 characters.Dispense Amount/Unit – Coded/StructuredRefill Count – 0-12 refillsSubstitution – Allow substitution or dispense as writtenWritten Date – Date prescribedNote (optional) – Currently, concatenates from several fields; cannot exceed 210 characters.Member IDSpecial InstructionsPharmacy CommentsDose Calculation (Preference Setting)
10 Troubleshooting E-prescriptions Start with the RxSummaryConfirm that the prescription was e-prescribed (submitted electronically).Some users will report an issue with e-prescribing, when they actually faxed the prescription.Next, use the e-Prescription Dashboard to confirm e-prescription state.“Accepted and verified by ultimate receiver” indicates the pharmacy received the e-prescription.
11 Troubleshooting e-prescriptions, cont’d “Accepted and pending by receiver; free standing error still possible” indicates the pharmacy has not verified receipt of the e-prescription and an Asynchronous Error is still possible. (Note: Currently, pharmacies are not required to VERIFY receipt of the e-prescription).Each e-prescription has a unique SureScripts Message ID. When reporting a Help Desk ticket for e-prescriptions, please include the MRN for RxStar-related troubleshooting and the SureScripts Message ID for e-prescription routing troubleshooting (e.g. The pharmacy said they didn’t receive the e-prescription.).