What to think about during your introductory, electronic medication prescribing demonstration
As you view the demo on the Web or visit another practice using electronic medication prescribing, you’ll need to be thinking about how the product will support your day-to-day needs and how you and your nursing staff can benefit from this technology.What is the current work flow in your practice? For example, does the nurse gather the patient’s medication list during the intake process? If so, the nurse will need to update that in the electronic medication prescribing system so it is ready for your review. Future medication reconciliation will be more efficient because this information will be easily retrieved in your system. Do you have a phone nurse station that handles incoming requests for prescription refills or pharmacy calls? The nurse should have access to the electronic medication prescribing system at the phone nurse station to reduce the need for pulling charts to determine which medications the patient has had prescribed from your office.
Work flow changes will drive technology decisions. Do you want to use wireless devices such as PDAs or tablets to write prescriptions? Adding wireless connectivity to your network is not expensive, but may require help from a computer technician. Consider a mix of desktop PCs for nursing stations and wireless units for the prescribers in exam rooms for optimal use.
Qualified systems are capable of all of the following:
- Generating a complete active medication list that incorporates electronic data received from applicable pharmacies and benefit managers (PBMs), if available.
- Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all alerts.
- Providing information related to lower cost, therapeutically appropriate alternatives, if any.
- Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan.
E-prescribing Integration planning — getting the pieces in place
The first point to consider is how to transfer patient demographics from your practice management system to your prescription management software system. If your patient demographics (name, address, phone numbers, and insurance information) are copied from your practice management system, your nurses will not have to enter all that information for every patient during a visit or on the phone. It can take two to four minutes to enter a new patient record and at the phone nurse station, which costs about $20 per hour (approximate hourly rate of $16 plus benefits).Coordinate the implementation with your office calendar. To allow time for training the nursing staff, you may want to schedule your conversion and training for a time when physicians are out of the office. If the nurses are secure and confident using the e-prescribing tool, they will be able to provide support on the first day the physicians begin to use the system. Prepare for the launch date by building lists of “favorites” so the physician doesn’t have to search the entire database all the time. Typically providers prescribe the same medications about 80 percent of the time, so you can easily create a list of “favorite” medications by looking at your patients’ medication lists. To save time at the point of care, build custom SIG (signature or transcription, which gives instructions for taking the medication) lists, too.
Another important step is to modify your fee slip (also called an encounter slip or super bill) to accommodate the new G-codes5 for reporting the use of e-prescribing. The G-codes must be transmitted with your claim CPT codes for each patient visit to document the method of prescribing that occurred with that visit.
ROI — Return on Investment (Per FTE physician TOTAL PER YEAR savings 336.7 hours and $15,769!)
The Medicare incentives for e-prescribing are indeed a welcome bonus, but the operational benefits you’ll realize will accrue even more dollars to your practice. You and your nursing staff will more efficiently handle phone calls regarding prescriptions. Your staff will not need to pull as many charts for phone calls, and that translates to a savings of $75 to $1506 per day per physician!With electronic medication prescribing implemented in the practice, you’ll have access to a patient’s benefits data, copayments, formulary, and lower cost alternatives. Access to the patient’s medication history ensures that duplications are avoided and drug interactions are captured. The database can provide allergy and food-drug interactions as well as contraindication alerts. Those post-visit phone calls from patients who forgot to request a prescription reissue will be eliminated because the system can identify that patient’s prescription status. Any refill request can be easily routed electronically, eliminating any chance of lost telephone messages and delayed responses.