ePrescribingMichael Peterson, Alysan Pohlmeyer, Cecilia (Sam) Ruffing, Ahmed Haque

1

Product Shall Cross-Directionally and Electronically Transmit Prescription Data Through the SureScripts and RxHub Networks

Reduce the risk of data entry errors. Increases workflow and reduces time required to refill prescriptions

Product Shall be Certified by SureScripts and RxHub

Works in accordance with industry-accepted standards for the electronic exchange of prescription data between physicians and pharmacies

System Shall Check for drug-drug interaction

Vital for patient safety

System Shall Check for drug-allergy interaction

Vital for patient safety

ePrescribing Functional Requirements

2

System Shall Meet Requirements and Standards Released by HITSP and CCHIT

Requirements for certification and compliance

System Shall Comply with HIPAA Regulations

Patient privacy, system security, and transaction processing

System Shall Allow Nurse to Write Prescriptions and Physician to Confirm Electronically

Prevents disruption of normal workflow

System Shall Export Patient Data 

Ability to export historical data in a generalized format that can be imported into other systems

ePrescribing Functional Requirements

3

Information Architecture

4

EHREHR

InpatientPharmacyInpatientPharmacy

Interface Engine

MPIStandards-

NCPDP, HL7 (ASC) X 12

Commercial Pharmacy

Commercial Pharmacy

SureScript

PatientPhysician

ADTADT

Pharmacy Benefit

Manager

Pharmacy Benefit

Manager

Traditional Data flow forPrescriptions

5

Healthcare Data sources can connect to Patients, Physicians, PBMs, and Pharmacists

6

Complete Pharmacy Data Elements Available Through RxHub to Participants

7

E-Prescribing Transaction Flow

8

Most information originates in the RxHub

Physician is linked to PBM

Physician utilize real-time decision support to generate prescriptions

RxHub has Master Person Index which already covers 200 million Americans

Improved workflow and access to information

9

Data Set Flow

10

Rx Order Data Set contains the order details to complete the dispensing process, including- authorizing provider, provider license number, location, date, medication, dose, quantity, SIG, route, controlled/non-controlled flag, formulary exception reason, reason for canceling, and order change requests etc.

Dispensing Order Data Set retains the original order details and adds the dispensing details, including any changes made by a pharmacist, the identification of the pharmacist and demographic details of the dispensing pharmacy.

Refill Request Data Set contains order data for the requested refill, as well as, any patient’s comments, the reason for request, and/or zero refill authorization message.

Rx Order, Dispensing and Refill Request Data set contains order details for New, Refill, Cancelled and Changed orders

Interface Engine and RX Aggregator

Clinician Order Entry

Pharmacy

Orders From

Orders To

Orders From

Orders To

Patient Information Data Set contains the patient’s name and demographics, benefits plan, eligibility criteria, status of eligibility, and plan formulary.

Payer Data Set contains the claims, insurers formulary and confirmed eligibility status of the patient’s benefits for the pharmacies.

Formulary Data Set contains the hospital’s IP formulary database which clinicians use at point of ordering.

Alerts are configured within the Electronic Health Record and the IP Pharmacy System so no message interfaces were needed.

Data Set Flow

11

Interface Engine and

RX Aggregator

Clinician Order Entry

Payer

Pt Info From Benefit Status From

Pt Info To

Pt Info FromBenefit Status From

Pt Info To

Pharmacy

Benefit Status ToClaims To

Benefit Status FromClaims From

Data Set Flow

12

EHR System(CPOE)

RX Aggregator Interface Engine

(HL7, NCPDP, ANSI X12)

RX Orders(new, refill,

cancel, change)

RX DispenseFill Status

DetailsCommercial

Pharmacy Systems

IP Pharmacy System

Patient Information

(Eligibility, Benefits, Formulary, Demographics)

Rx Orders(new, refill, cancel, change)HL7

Rx Dispense DetailsHL7

Patient Information

Rx Dispense, Fill Status, DetailsNCPDP

Formulary

SureScriptsVendor

Pharmacy Hub

Refill Requests

Rx Orders(new, refill,

cancel, change)

Rx DispenseFill Status

Details

Pharmacy Benefit Management

Systems

SureScriptsVendor

PBM Hub

Patient Info(Benefits, Formulary,

Demographics(ANSI X12)

Rx Orders(new, refill, cancel, change)NCPDP

Rx Refill RequestsNCPDP

FormularyHL7

Payer Information (Eligibility, Claims, Benefits, Payer Formulary)