INSTRUCTIONS FOR USE: OA-RX - Office Ally

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O f f i c e A l l y | P O B o x 8 7 2 0 2 0 | V a n c o u v e r , W A 9 8 6 8 7

w w w . o f f i c e a l l y . c o m

Phone: 360.975.7000

Fax: 360.896.2151

INSTRUCTIONS FOR USE: OA-RX

Contents OA-Rx Registration: ................................................................................................................................................................. 2

Provider/Staff Required Fields ................................................................................................................................................ 4

User Roles and Staff Permissions ............................................................................................................................................ 5

Accessing the OA-Rx Module: ................................................................................................................................................. 6

Prescribing Medications in OA-Rx ........................................................................................................................................... 7

Coupons ................................................................................................................................................................................ 10

Drug History .......................................................................................................................................................................... 11

Using Pharmacies and Pharmacy Favorites .......................................................................................................................... 12

The Prescribers Favorite List ................................................................................................................................................. 13

Prescriber Review Button ..................................................................................................................................................... 14

OA-Rx Reports ....................................................................................................................................................................... 15

OA-Rx Settings ....................................................................................................................................................................... 16

Medication Details ................................................................................................................................................................ 17

Copay and Coverage Information ......................................................................................................................................... 18

Welcome to Office Ally’s Electronic Prescription module, called OA-Rx. This web-based program has been designed to integrate into Office Ally’s Practice Mate and EHR 24/7 applications for a seamless workflow. This module gives you the abilities to create prescriptions to transmit or print, reply to renewal requests, identify drug and allergy interactions, view patient eligibility for prescription benefits, and view formulary alternatives.

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Phone: 360.975.7000

Fax: 360.896.2151

OA-Rx Registration: OA-Rx registration can be done in two easy steps.

1. Take the identity proofing quiz. 2. Take an OA-Rx training with a OA-Rx certified technician.

Step One – Take the identify proofing quiz Begin by navigating to Manage Office then clicking the Registration link under the ePrescribe section. If this link is not available, refer to the FAQ below. Click to begin the Identity Proofing Quiz. The Identify verification will be completed by our partner IDology in the form of five multiple choice questions.

Step Two – Take an OA-Rx Training Once the quiz is completed Office Ally will automatically be notified and contact you to set up an OA-Rx Training. After the training is completed OA-Rx will be activated. Frequently Asked Questions: Q: Why don’t I see the OA-Rx Registration link in Manage Office? A: To see the Registration link you must be logged in as a user name that is linked to a staff member or a provider. If the user name is not linked to a staff member or provider you will not see the link. In addition, the user name must be linked to an OA-Rx prescriber type staff member [Resident, Physician Assistant, Nurse Practitioner, and Locum Tenens] or a provider. Q: Why does Office Ally need personal information to verify my identity for OA-Rx? A: Office Ally uses Surescripts to route electronic prescriptions to pharmacies throughout the US. As part of our Terms of Use Agreement with Surescripts, there is a requirement that Office Ally verify the identity of our customers to the federal standard called, "NIST Level 3," which requires that individuals verify their identity using unique pieces of information. This verification will be completed by our partner IDology, in the form of five multiple choice questions. Q: How does IDology verify my identity? A: IDology generates questions based on your personal history. The questions and answers provided by IDology are not influenced by Office Ally. Office Ally is only given access to the "Pass" or "Fail" result that IDology delivers.

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Phone: 360.975.7000

Fax: 360.896.2151

Q: I have entered this information into Office Ally before, why must I provide it again? A: To achieve a high level of safety and security we want to ensure we have the most up to date information available. Q: If I fail the ID proofing, what happens next? A: You may take the ID Proofing quiz up to three times a day. If you fail three times, you must wait 24 hours to retake the test or call Office Ally support. If ID Proofing fails please check the following:

• Ensure your name matches your legal name on your government issued photo ID. • In the address field, use your personal address rather than your business address. • If your name has changed in the past six months, use your previous name.

Q: Why do I see OA-Rx features when I do not have OA-Rx activated? A: If any user in the company has OA-Rx enabled then all users in the company will be able to see the following:

1. The Notification links at the top of the application for renewals/failed transmissions/ pending meds. Users who do not have OA-Rx access will not be able to perform any actions on renewals, transmissions or pending meds. 2. The eRx Notifications link in EHR > Document Center > Medications > eRx Notification – This is an alternative way to reach the renewals/failed transmissions/ pending meds. 3. The eRx link in Manage Patients – This allows other users to patient Problems, Allergies, and Current Medications.

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Phone: 360.975.7000

Fax: 360.896.2151

Provider/Staff Required Fields To access the OA-Rx module certain fields are required to be completed on the staff and provider form. Required fields vary depending on the user type and role. See the supporting diagram below.

(*) Notice the three role types in the diagram above marked with a red asterisk. The Drug Enforcement Administration (DEA) number for these role types is optional. If the DEA number is populated for these role types, they can complete prescriptions as the sole prescriber. If they do not have a DEA number a supervising provider is required. Advanced Practice Nurse (APN) Number and Certified to Prescribe (CTP) Number are two fields that are required only for the three roles types marked with a red asterisk in the diagram above. These fields will only be visible and required when Texas or Ohio are selected in the staff form.

• Texas requires - Advanced Practice Nurse (APN) number • Ohio requires - Certified to Prescribe (CTP) number

If the required fields are not completed a pop up will appear when opening the OA-Rx application indicating the fields that need to be completed. Note: The CTP and APN requirements are based on the office that is selected when opening OA-Rx. If the office is located in Texas, then an APN number is required. If the Office is located in Ohio the CTP number is required.

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Phone: 360.975.7000

Fax: 360.896.2151

User Roles and Staff Permissions User roles and staff types dictate user accessibility to the OA-Rx module as well as capabilities within the module. These rules are defined by Surescripts requirements and state laws that govern e-Prescribing protocol. See the supporting diagram below.

Provider – Can prescribe medications and respond to renewal requests without any oversight. A DEA# and NPI# are required for a Provider to access OA-Rx. Locum Tenens - Can prescribe medications and respond to renewal requests without any oversight. A DEA# and NPI# are required for a Locum Tenens to access OA-Rx. Nurse Practitioner - Can prescribe medications and respond to renewal requests. NPI # is required.

• With DEA#: Nurse Practitioners can prescribe without any oversight. • Without DEA#: Nurse Practitioners can prescribe with supervision of a licensed prescriber.

Physician Assistant - Can prescribe medications and respond to renewal requests. NPI # is required.

• With DEA#: Physician Assistants can prescribe without any oversight. • Without DEA#: Physician Assistants can prescribe with supervision of a licensed prescriber.

Residents - Can prescribe medications and respond to renewal requests. NPI # is required.

• With DEA#: Residents can prescribe without any oversight. • Without DEA#: Residents can prescribe with supervision of a licensed prescriber.

Medical Assistant - Cannot electronically submit prescriptions. Can write and print prescriptions. Nurse - Cannot electronically submit prescriptions. Can write and print prescriptions. The following user types will not have access to OA-Rx, but can set up pharmacy favorites in Manage Office.

• Therapist • Administrative Assistant • Billing Staff • Lab Technician • Office Manager • Receptionist

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Phone: 360.975.7000

Fax: 360.896.2151

Accessing the OA-Rx Module: The OA-Rx module can be accessed in both the Practice Mate and EHR 24/7 applications. Access OA-Rx in Practice Mate: 1. Manage Patients Tab > eRx link > Online e-Prescription Button

2. OA-Rx functions can also be accessed by using the OA-Rx links located on the top right of the application. These links allow for quick access to Renewals, Failed Transmissions, and Pending Medications.

Access OA-Rx in EHR 24/7: 1. Patient Charts Tab > Select a Patient > Open a Progress Note> Online e-Prescription Button Note: If you do not see the Online e-Prescription please refer to the FAQ below

2. OA-Rx functions can also be accessed by using the OA-Rx links located on the top right of the application. These links allow for quick access to Renewals, Failed Transmissions, and Pending Medications

Frequently Asked Questions: Q: Why don’t I see the Online e-Prescription button in the Progress Note? A: Please take the following troubleshooting steps:

1. If you are a Physician Assistant, Nurse Practitioner, Resident, Nurse, or Medical Assistant, make sure the Provider selected on the Progress Note has OA-Rx enabled. 2. The Medications section must be enabled in the SOAP Note Layout to see the e-Prescription link. To enable Medications in the SOAP Note Layout, navigate to the Manage Office Tab > SOAP Note Layout > Edit the SOAP Note Layout > Enable the Medications checkbox in the Plan Section.

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Phone: 360.975.7000

Fax: 360.896.2151

Prescribing Medications in OA-Rx Prescribing a Medication through OA-Rx can be done in seven easy steps.

1. Search for a medication 2. Select a medication 3. Create the Sig 4. Process medications 5. Review interactions (if applicable) 6. Review medication / select pharmacy 7. Submit Electronically or Print Prescription

Step One – Searching for a Medication Open OA-Rx and in the Medication Search field use at least three letters then click the button or enter key.

Step Two – Select a Medication Once the search is performed the System Medication list will open. Click the select link to select a medication. Medications with a star ( ) next to the name indicate they are a Prescriber’s Favorite. To learn more about Prescriber’s Favorites refer to the Prescriber’s Favorites section. Selecting a medication will advance the system to the Sig Information page.

Step Three – Create the Sig The selected medication will display at the top of the page with relevant copay and coverage information. Use the menus and/or the Additional Directions field to create the patient directions which display in the gray box labeled Patient Directions.

Important Note: The patient directions are what will appear on the prescription.

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Phone: 360.975.7000

Fax: 360.896.2151

Associate Dx code to the Prescription. The Problem/Dx drop down can be used to associate the Prescription to an active patient diagnosis. Add Pharmacy Notes to the Prescription. Pharmacy Notes can be added to the prescription. Pharmacy Notes are sent to the pharmacy electronically and will also appear on printed prescriptions. Add Medication/Sig combo to Prescribers Favorites. The Store Sig & Add to Prescriber’s List will add the Medication and Sig combination to the Prescriber’s Favorite list if checked when the update button is clicked. Specify Dispense as Written. Check DAW/DNS to indicate to the Pharmacy this drug must be Dispensed as Written/ Do not Substitute. Select Alternative Medications. If there are preferred drugs, Alternative Medications will display at the bottom of the Sig Information page. Clicking select for an alternative medication will change the selected medication.

When the Sig information has been completed click the button. Step Four - Process Medications After a medication has been added the pending medications will show on the landing page. Sig information can be edited by clicking . Pending medications can be removed by clicking . Click to initiate OA-Rx’s interaction checking process.

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Phone: 360.975.7000

Fax: 360.896.2151

Step Five- Review Interactions OA-Rx has built in Drug to Drug, Drug to Allergy, and Drug to Disease interaction checking. If OA-Rx detects interactions they will be displayed on the Interaction page. If no interactions are detected, the Interaction page will be skipped and the system will advance to the Review page.

On the Interaction Checking page, an override reason can be selected from the drop down menu and additional comments can be added. These details can be viewed later from the Medication Details Page. To learn more about Medication Details refer to the Medication Details section of this document. Click the to advance to the Review Medication Page. Step Six- Review Medication Page From the review medication page select a Pharmacy by clicking Find a Pharmacy. Alternatively, favorite pharmacies will display in the pharmacy drop down as well as the most recently used pharmacies for this patient. To learn more about Favorite Pharmacies, refer to the Favorite Pharmacies section. Review the Medications before printing or submitting. Step Seven- Submit Electronically or Print Prescription Use the checkboxes in the Pending Prescriptions grid to select medications ready to be prescribed.

To Print Prescriptions –Use the checkboxes in the Pending Prescriptions grid to select Prescriptions that are ready to print then click To electronically submit Prescriptions - Use the checkboxes in the Pending Prescriptions grid to select Prescriptions that are ready to submit then click A prescription confirmation page will appear specifying the pharmacy location and the prescriptions that were sent to the pharmacy. If there are coupons available for the medications a dollar sign icon ( ) will display in the coupon section. To learn more about Coupons, refer to the Coupon section in this document.

Click the button to be redirected back to the main OA-Rx page.

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Phone: 360.975.7000

Fax: 360.896.2151

Coupons The OA-Rx module is integrated with a service that offers coupons and educational material to patients. If coupon and educational material are available a dollar icon will display ( ). The icon is visible on the Sig Information page, the Pending Medications grid, the Review Medication Page, and the Prescription Confirmation Page.

Clicking from the Sig Information Page, or Prescription Confirmation page will print the coupons. Additionally if the prescriptions are printed from the Medication Review page, coupons and educational material will automatically be included. When a medication has an available coupon or educational material, a message will automatically be entered in the Pharmacy Notes section of the Sig Information page. This note is sent to the Pharmacy when the prescription is electronically submitted indicating there is coupon or educational material available.

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Phone: 360.975.7000

Fax: 360.896.2151

Drug History OA-Rx provides a Drug History feature which allows a patient’s prescription history, provided by their health plans, to be imported into the patient’s current medications. The Drug History feature is located on the OA-Rx landing page. To import Drug History, patient consent must be confirmed by selecting Yes, depicted in the figure below.

Click to open up the Patient Prescription History Request pop up. Select how far back the prescription history request is for, and then click . Use the checkboxes in the medication history grid to select medications then click Import Record(s).

Medications imported using the Drug History tool will be flagged in the current medication list within the OA-Rx module as [Imported]. These medications will not be included in interaction checking.

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Phone: 360.975.7000

Fax: 360.896.2151

Using Pharmacies and Pharmacy Favorites Pharmacy Favorites Pharmacy Favorites are a company specific list that can be created in Manage Office in both Practice Mate and EHR 24/7. The Pharmacy Favorite list can be found by navigating to Manage Office > Pharmacies. The list defined here populates the pharmacy drop down on the Medication Review page under the Pharmacy Favorites section. To Add a pharmacy. Go to Manage Office > Pharmacies > Add New > Search > Click Select To Delete a pharmacy. Go to Manage Office > Pharmacies > Click the Del Icon

Using Pharmacies in OA-Rx The pharmacy drop down on the Review Medication page displays the last three pharmacies used by the patient and the Favorite Pharmacies added in Manage Office. The default pharmacy value on the Review Medication page is the last pharmacy used for that patient.

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Phone: 360.975.7000

Fax: 360.896.2151

The Prescribers Favorite List The Prescribers Favorite list is a prescriber specific list that is built dynamically within the OA-Rx application to save commonly used Medication/Sig combinations. Prescriber specific is defined as the user types that are able to prescribe in OA-Rx, this includes:

• Provider • Locum Tenens • Resident • Physician Assistant • Nurse Practitioner

Each of these user types will have their own unique Prescriber’s Favorite list. There are two additional user types that are able to access OA-Rx but do not have the ability to submit prescriptions electronically. These user types are the Nurse and Medical Assistant. When accessing OA-Rx with one of these user types, the Prescriber’s Favorite list that is populated is based on the Provider that is selected in the Provider dropdown within the progress note or the ePrescription page. The Prescriber’s Favorite list is built dynamically as the OA-Rx application is used. To add a Medication/Sig combination to the prescriber’s favorite checks the Store Sig & Add to Prescriber’s List checkbox on the Sig Page.

When saving to the Prescriber’s Favorites, all the SIG Dropdowns + Additional Directions, days supply, dispense amount, potency unit code, refills, pharmacy notes, and DAW/DNS are saved.

The Prescribers Favorites can be used by clicking the Prescriber’s List button under Medication Search.

Alternatively, when using the medication search, Prescribers Favorites will appear in the System list with a star ( ).

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Phone: 360.975.7000

Fax: 360.896.2151

Prescriber Review Button The Prescriber Review button serves as a way for a Midlevel, Nurse, or Medical Assistant to put a prescription in a status of Prescriber Review. The Prescriber Review button is located on the Review Page in place of the Submit button for the following roles types:

• Physician Assistant (without a DEA) • Resident (without a DEA) • Nurse Practitioner (without a DEA) • Nurse • Medical Assistant

When a medication is put into Prescriber Review the status of the medication will change in the Pending Medication list signifying it is ready for a Prescriber to Review, then submit or print the prescription.

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Phone: 360.975.7000

Fax: 360.896.2151

OA-Rx Reports OA-Rx Reports show detailed information about prescriptions and pharmacy communications. OA-Rx Log The OA-Rx Report displays all prescriptions that have been authorized by a prescriber. The log can be generated for up to 90 days and will provide detailed information about the prescriptions including route, status, and user who processed the prescription. This report shows all the events that have happened with prescriptions via OA-Rx. The report is available in both Practice Mate and EHR 24/7

• Practice Mate: Manage Patients tab > Reports > OA-Rx > OA-Rx Report • EHR 24/7: Document Center tab > Reports > OA-Rx > OA-Rx Report

Pharmacy Communication Log The Pharmacy Communication Log displays all communications that have been received and processed back to a pharmacy. The log can be run for up to 90 days and will provide detailed information about the prescription request, status, and who processed the request. Note: Prescriptions without a patient will appear on this report. The report is available in both Practice Mate and EHR 24/7

• Practice Mate: Manage Patients tab > Reports > OA-Rx > OA-Rx Report • EHR 24/7: Document Center tab > Reports > OA-Rx > OA-Rx Report

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Phone: 360.975.7000

Fax: 360.896.2151

OA-Rx Settings OA-Rx has prescriber specific settings that can be customized for interaction checking and alert settings. By default these settings are turned on.

Manage OA-Rx settings as an Admin. Log in with an Admin User > Manage Office > OA-Rx Settings Manage OA-Rx settings from OA-Rx. Go to OA-Rx > Click on at the top right corner Manage the Custom settings by switching the desired features on or off then clicking

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Phone: 360.975.7000

Fax: 360.896.2151

Medication Details After a medication has been prescribed the mediation will be added to the Current Medications. Details about the prescription can be viewed by clicking on the blue medication name.

The Medication Details show relevant information about the prescription instance. The Transmission history records actions related to this prescription instance including, electronic submission, printing, reprocessing, faxing, and printing summaries.

Print a Prescription Summary. Click on the Print Summary button to generate a printed summary. Reprocess a Medication. Click on the Reprocess Prescription button to reprocess the medication. Report a Missing Rx. If the pharmacy has received and verified the prescription, indicated in the status column, but the prescription is missing, please report the missing Rx to Office Ally. Click on the link Report a Missing Rx and complete a short form to help Office Ally identify how and why the Rx is missing. The Interaction History represents any interactions that were detected at the time of the prescription. Any comments or reasons for override will be displayed in this grid as well as the Prescriber who acknowledged the Interaction with a date stamp. Q: Why are some medication names not blue links? A: Only medications that are prescribed through the OA-Rx application will appear with blue links. Other methods of adding current medications such as, importing medications via drug history and adding through the current medications in Practice Mate and EHR 24/7 will not have medication details.

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Phone: 360.975.7000

Fax: 360.896.2151

Copay and Coverage Information OA-Rx is able to retrieve drug benefit information from the patient’s Pharmacy Benefit Management/Health plan. After a medication is selected, the copay information displays at the top of the Sig Information page if available.

Additional coverage information can be viewed by clicking the View Coverage link.

Q: Why don’t I see Copay and Coverage Details? A: Copay and Coverage Details are not always returned. Depending on the patient’s health plan and the drug selected results may vary.

Documents

INSTRUCTIONS FOR USE: OA-RX - Office Ally