Pharmacist Informaticist Training July 16, 2012 - Albuquerque, NM 1 Pharmacist Role in the CMS e-Prescribing Program & Meaningful Use e-Prescribing Measure.

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Pharmacist Informaticist Training July 16, 2012 - Albuquerque, NM

Pharmacist Role in the CMSe-Prescribing Program & Meaningful Use e-

Prescribing Measure

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Presenter:

Lori Moore, Pharm D.IHS e-Prescribing Federal Lead

USET Pharmacy ConsultantOffice of Information Technology (OIT)

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Objectives

• Compare and contrast the CMS e-Prescribing Program to the Meaningful Use e-Prescribing Measure.

• Delineate necessary steps to optimize and maintain pharmacy data management, allergies, quick orders, and medication order menus to successfully implement e-Prescribing.

• Examine the importance of the on-demand drug interaction checker in EHR.

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e-Rx HOT Topics

MU e-Prescribing Measurement

• Established 2010• Incentives/Penalties• Required Functionality

• Prescription Routing

CMS e-Prescribing Program• Established in 2008• Incentives/Penalties• Required Functionality

• Prescription Routing• Medication History• Formulary Eligibility

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E-RX OVERVIEW

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RPMS/EHR e-Prescribing Functionality Today:New Rx (Retail Pharmacy)

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E-Prescribing & Surescripts Provider Identifier (SPI) Number

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Site with Onsite RPMS 7 Pharmacy

IHS Central Ensemble Production Server

(Live)

Onsite RPMS 7 Pharmacy

Surescripts Production Server

(Live)

Wal-Mart Pharmacy 19241.0 miles from 04769

CITY DRUG STORE1.9 miles from 04769

RITE AID-320 MAIN ST2.1 miles from zip 04769

NewRx NewRx NewRx

Status (Response) Status (Response) Status (Response)

IHSRPMSEHR

IHS RPMS/EHR e-Prescribing

PRODUCTION Network

IHSRPMSEHR

Provider

Pharmacist

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IHS Central e-Prescribing Server Total Daily Incoming Messages

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IHS Central e-Prescribing Central Server Total Monthly Incoming Messages

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RPMS EHR e-Prescribing Functionality

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Participating Surescripts Pharmacies

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Pharmacist Role:

• Maintain an Optimized Drug File

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Drug File OptimizationPharmacy Drug Management Prompt

Additional Information and Guidance

DRUG GENERIC NAME

All sites moving towards E-Prescribing will need to review the drug file names to ensure a standard naming convention that aligns with Generic Name (plus) Strength (plus) Dosage Form. It is also critical to avoid special characters within the drug name that can result in transmission errors.

VA CLASSIFICATION:

The VA Classification field controls the EHR medication order checks. This includes order checks for allergies & drug-drug interactions. This field will populate automatically when the pharmacist matches the drug to the National Drug File (NDF).

DEA, SPECIAL HDLG:

Remember controlled substances are excluded from the E-Rx MU report logic. This report determines which EP’s will have to meet the 40% threshold. Therefore errors in the DEA, Special HDLG field could negatively impact your EP’s when reporting this specific e-Prescribing Measurement.

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Drug File Optimization (cont)Pharmacy Drug Management Prompt

Additional Information and Guidance

ORDER UNIT: Next 3 fields work together and impact Provider Order Entry. Pharmacy should always complete the documentation for these 3 fields based on the correct product information.

DISPENSE UNIT: See Order Unit above for more details.

DISPENSE UNITS PER ORDER UNIT:

See Order Unit above for more details.

DISPENSE UNIT NCPDP CODE:

National Council for Prescription Drug Programs (NCPDP)Provides a standard for the exchange between prescribers, pharmacies, intermediaries, and payers.

NDC: National Drug Code (NDC) is a unique number assigned to all prescription and over the counter medications approved by the FDA.

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Drug File Optimization (cont)Pharmacy Drug Management Prompt

Additional Information and Guidance

NATIONAL DRUG FILE

You MUST match each and every drug to the National Drug File (NDF) to obtain VA Drug Class. • This will allow allergy checking and Drug/Drug

interactions to operate correctly. • Without this code your providers will NOT get the

appropriate order checks, which can ultimately result in adverse patient outcomes.

DOSAGES

All medications in the RPMS drug file need to have appropriate dosages assigned to improve provider order entry, decrease medication errors, and to prevent any E-Rx transmission failures.

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Drug File Optimization Cont…Pharmacy Drug Management Prompt

Additional Information and Guidance

APPLICATION PACKAGES

• Marking a drug “O” authorizes it to be ordered in an Outpatient (aka Ambulatory Setting) and it will be processed through the Outpatient Pharmacy Drug File or it can be E-Prescribed.

• Marking a drug “X” allows you to order it as a NON-VA Medication and is not necessary for E-Prescribing functionality.

ORDERABLE ITEM MANAGEMENT

Pharmacy should optimize the orderable item file to ensure that the orderable item matches the intended dispense drug that the patient will receive in the dispensing process.

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Prescription Clinical Content Quality Report Card Indian Health Service

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Pharmacist Role:

• Maintain Drug File Updates• Be proactive with adding new medications to

your drug file

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Pharmacist Role:

• Collaborate on multidisciplinary teams to optimize clinic workflows to improve utilization of EHR medication management tools

• Work with providers to develop/enhance quick orders & quick order menus

• Stay INFORMED by attending online courses to keep up with the constant changes in RPMS packages and then share it with your providers to improve medication management

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Pharmacist Role:

• Improve patient safety• Improve quality and efficiency of the

prescribing process• Improve health outcomes• Improve cost savings

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Questions?

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National e-Prescribing TeamLori Moore, Pharm D.

USET/OIT National Pharmacy ConsultantFederal Lead

[email protected]

Carla Stearle, Pharm D., BCPSUSET/OIT National Pharmacy Consultant

[email protected]

Gail Crane Deployment Project Manager (DNC Contractor)

[email protected]

Sean Cook e-Prescribing Analyst (DNC Contractor)

[email protected]

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e-Prescribing Pharmacy Consultants

OIT• Mary Ann Niesen, OIT Pharmacy Consultant• Mike Allen, OIT Pharmacy Consultant• Carla Stearle, OIT Pharmacy Consultant• Lori Moore, OIT Pharmacy Consultant

USET• Bob Adams (PEI)• Sarah Michael (PEI)• Preston Van Curen (PEI)• Shelly Foster

CRIHB• Denise Vermilyea

Alaska• Carlene McIntyre