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ePrescribe - Compose Rx / Med Entry

This page will address both the Compose Rx and Med Entry tabs within the ePrescribe Ability. Features that can be accessed by these tabs are as follows:

  • Creating/Sending a Prescription
  • Location Page
  • Prior Authorization
  • Progress Notes
  • Face Sheets
  • Orders
  • DME/CPAP/O2/Supplies
  • Patient Drug History
  • Imported Information
  • Drug Sets / Compounds
  • Doctor's List
  • Allergy / Intolerence
  • Monograph and Leaflet
  • EDIT Button
  • Magnifying Glass (Spyglass)

 

Compose Rx
The Compose Rx Tab is where the details of new prescriptions are created, reviewed, and transmitted. This is tab most frequently used in ePrescribe.

Note: Clerical Staff users do not have access to this tab.

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Med Entry
This tab is used for entry of existing patient medications written by a provider not in the office, or if the patient is taking over-the-counter medications. Medications entered on this tab will have a tan hue to let the user know it was not transmitted. 

Note: Nothing entered here is sent to pharmacies.

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Creating a Prescription in ePrescribe
Use the following steps to CREATE a prescription with ePrescribe.

  • Choose a patient and switch to One mode in MacPractice.
  • Retrieve results by searching for the medication with Drug Search.
  • Enter the medication information and save.
  • Additional prescriptions are added in the Pending Area.
  • Transmit or hold the prescription in the Review page.
  • Electronic prescription complete

This section of the documentation outlines each step in the process.

Choose a Patient
Before creating a prescription, a patient must be selected and MacPractice must be in One mode. The patient name will appear in the patient selector located in the sidebar of the MacPractice window.


With a patient selected, the patient selector will display the patients name.


Click the ePrescribe node in the sidebar of the Rx Ability. The ePrescribe (NewCrop) interface will display with the patient's name. Prescriptions will be created in the Compose Rx tab of the ePrescribe interface.

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Search for a Medication
In the ePrescribe window, search for a medication by exact name. If a drug is incorrectly spelled, it will not yield any results. A search can be performed with a minimum of three characters. Five or more characters are recommended.

After clicking the Drug Search button the medication results will display under Drug Search Results. If NewCrop is unable to locate the medication, verify that the spelling is correct.
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Select the appropriate result to continue creating the prescription.

Some drugs will have “Drug cannot be transmitted due to missing National Drug Code(NDC)” next to it. This means that the drug is no longer recognized as a prescribable drug, and an alternate/equivalent medication must be selected.

  • NewCrop has a link to an alternative/equivalent drug next to the obsolete selection.
  • This occurs when the patent of a brand name has expired (generic available), or when the ingredients in the drug have changed; thus requiring it to receive its own NDC.

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Enter Medication Information
Enter the prescription within the Medication Information window. The medication selected from the Drug Search Results will display at the top of this window. The Medication Information window is divided into six columns, a bottom row, and the Save Rx or Cancel box.
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Enter the Quantity, Form, Route and Frequency of the script being written. Certain scripts will autofill a Form or Route based on manufacturer recommendations. 

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Within the Quantity column, the (#) box will calculate automatically for non-liquid medications, but allows for manual adjustment. Start by entering the number of days to supply in the Days Supply field or select the number of days from the links. This will automatically calculate the dispense number. Depending on the medication there might be various Packaging Options to choose from. Refills can also be set if needed.

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Additional checkboxes are provided for PRN and DAW/DNS (Dispense as Written/Do not Substitute. To create an additional prescription with a ninety day supply for mail order pharmacies, click to check the 2nd rx 90 day checkbox. Check Save this sig and add to Doctor's List to save the Additional Sig field (directly below) for future use.

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At the bottom of the drug edit screen, additional signature information can be entered. Additionally, a message can be added that will display for the pharmacist giving additional information about the script. If the script requires a specific diagnosis to be prescribed there are two dropdown menus that will contain any active diagnosis that the patient has in their MacPractice Clinical information.


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Once all of the medication information has been entered, click the Save Rx button located underneath the packaging information. Additionally, the medication can be deleted or left pending depending on office needs.


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After Saving a Prescription
With the prescription saved, continue to the pending area in ePrescribe. Add more medications if the patient needs another prescription following the steps above.

The medication entry in the Pending Rx window lists the Drug, Sig, Count, Refills, and Source for the prescription that is to be createdClick the Edit button to edit the prescription, the Spyglass icon to enter notes and Patient Educational Information, or Cancel (X) to remove the medication without creating a prescription.

From here there are two options to move forward: Review/Prescribe or Transmit/PrescribeScreen_Shot_2019-02-20_at_2.28.46_PM.png

Review / Prescribe
The Review page displays the medication entry with an additional Sch* (Schedule) column. This column indicates the schedule of the medication. Schedules 2-5 can only be transmitted after enrolling the provider for EPCS (Electronic Prescription of Controlled Substances).

Above the medication entry is the Drug Interaction Check Interaction information with two additional buttons:

  • Approve/Leave for Staff leaves the medications in a pending state. The button will read "Leave for Staff". for a prescriber, and "Leave for Doctor" for any other staff using ePrescribe.
  • Finish / Add to Current Meds adds the medications to the patients record without creating a prescription.

The Print RX/Add to Current Meds button will print the information and add the medication to the patient's list.

Click the Transmit Rx button to access the Transmit Rx page and select the pharmacy.

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Transmit / Prescribe

The Transmit/Prescribe button will skip over the aforementioned review page and go directly to the Transmit Rx page. This is the final page before the script is transmitted and where a pharmacy is selected. At the bottom of the screen a Pharmacy List will show a list of all pharmacies added to the Location Pharmacy List from the Admin Tab. If no pharmacies are available there is a way to search on the fly by selecting 'Add Pharmacy' in the upper-left of the pharmacy table.

Selecting a pharmacy will populate that pharmacy's information in the shaded box in the middle of the screen. This should be reviewed to make sure the correct pharmacy has been selected. 

There is a legend at the bottom of the screen that shows what the various icons in the pharmacy table mean. 

  • Black Dot
    • This is a patient's previously saved pharmacy. It will appear at the top of the list.
  • Blue Dot
    • This pharmacy is a mail order pharmacy.
  • Green Dot
    • This is a SureScripts retail electronic pharmacy. 
  • Green or Blue Dot with Black "C"
    • This pharmacy accepts controlled substances electronically or via mail order. (Requires EPCS subscription).
  • Crescent Moon
    • This pharmacy is a 24 hour pharmacy.

 

To finish and submit the script, click Transmit Rx/Add to Record.

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Confirmation Page

After sending the prescription a confirmation page will appear. This is going to show an overview of what was transmitted to the pharmacy. This can be printed if needed.

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Location Page

Click the Resources link to access the Location Page.
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Check the formulary status to any saved formulary for any drug. Use the pop-up menu to select the formulary to search and type the drug name in the search field. Click on the Look up a drug button to perform the formulary search and check the formulary status.

Bulletin board messages for all users can also be posted.

 

Prior Authorization

NewCrop uses CoverMyMeds for Prior Authorizations. CoverMyMeds helps pharmacies and medical offices quickly find, fill out, and submit Prior Authorization (PA) requests for all medications from a free and easy-to-use integration in NewCrop. There are PAs for Medicare, Medicaid, and most commercial insurance plans.

This window can also by accessing by clicking on  Prior Auth: Inc-0 Pend-1 New-0 in the status bar at the top of the  page.

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Note: NewCrop Third-Party Applications are not directly supported by MacPractice Support. Contact information for the third party is included in the interface itself.

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Progress Notes

A patient progress note can be generated using ePrescribe. With a patient selected in One mode, select the Compose Rx tab or the Med Entry tab. Click the Progress Note link to open a progress note, displaying the patient's current allergies and medications, as well as some additional fields.

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Medications listed under Pending Rx will not appear on the progress note until they have been saved or transmitted.

 

Face Sheets

A patient face sheet can be generated using ePrescribe. With a patient selected in One mode, select the Compose Rx tab or the Med Entry tab and click the Face Sheet link. The Face Sheet will detail a patient's demographic information, allergies, current medications, and current diagnoses.

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Medications listed under Pending Rx will not appear on the face sheet until they have been saved or transmitted.

 

Orders

If your drug or drug compound is not found in the drug database you can use the ePrescribe Orders feature to freehand the prescription for the patient. From the Compose Rx screen, click on the Orders link. Enter the text of your drug or drug compound. Free text medications, orders, will never be used in formulary or interaction and allergy checking. Follow on-screen instructions for more information.

Note: Orders cannot be electronically transmitted. 

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Below the drug you will be able to specify where you wish the drug to be saved. If you choose to Display in Current Meds, the drug will be listed along with the patient's current medications in the Current Medications list.
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The drug cannot be electronically sent to a pharmacy. You will only be able to mark the drug as discontinued by using the D/C button, or you can use the Spyglass icon to view the drug details where you can add notes and print the drug.
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From the drug details page, click the "RePrint Batch" button to print the order as a prescription. Click "Close/Return to previous page" if you wish to return without printing.

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If you choose to save your drug in the Orders Log, you will not see the orders mixed in with the patient's Current Medications list.

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To see drugs saved in the Order Log, click on the checkbox next to Order Log at the bottom of the Compose Rx screen. Clicking on the spyglass will allow printing if desired. 

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DME/CPAP/O2/Supplies

NewCrop has integrated with eDME to bring providers an option to order Medicare supplies right from the ePrescribe interface. To learn how to use this feature, NewCrop recommends that users navigate to the Admin tab. There is a section of videos regarding Durable Medical Equipment, that will go through how to utilize this feature. 

This window can also by accessing by clicking on eDME:Inc-0 Pend-0 New-0 in the status bar at the top of the  page.

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Note: NewCrop Third-Party Applications are not directly supported by MacPractice Support. Contact information for the third party is included in the interface itself.

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Patient Drug History

NewCrop uses RxHub to provide an option for users to import patient drug history. This feature is only available with the Comprehensive (Advanced) version of ePrescribe, and will be unavailable for anyone using the Basic version of ePrescribe.

RxHub provides access to patients' prescription history as supplied by health plans with participating pharmacy benefit managers.

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Imported Information

NewCrop requires all medications and allergies to be set in the FDB (First Data Bank) format. MacPractice provides all ePrescribe users with a database that contains all FDB medications and allergies, so users experience a seamless integration. 

Legacy medications and allergies that are active on a patient's account prior to being set up with ePrescribe are in one of two formats: RxNorm or Custom (MP_MEDICATION). When entering ePrescribe, MacPractice will ask the user to map any legacy medications or allergies to their respective FDB counterpart. 

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Selecting Cancel will cancel ePrescribe from opening. Choosing Skip and do not include and selecting Done, ePrescribe will load, but the medications will load as Imported Medications/Allergies. MacPractice recommends users to select Choose Other... and to search for the FDB counterpart for all medication and allergy records that are not in the proper format. This helps to ensure users are able to use ePrescribe to its fullest.

Note: Imported medications are missing essential data required to perform any drug interaction checks. 

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Drug Sets / Compounds

Drug sets allow prescribers to create a set of medications that can be easily prescribed. Compounds will allow a prescriber to create a free-form compound that can be transmitted electronically. 

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Doctor's List

The doctor's list is essentially a Favorites list of medications prescribed. Prescribers are able to save specific signatures that may get used often to reduce the amount of time spent working in the EMR and more time to assist patients.

Selecting Doctor's List will display all signatures that have been saved to the doctors list. To prescribe from the list either click the medication name directly or check the pink box in the left hand corner and use Select to continue. The latter method allows the user to prescribe multiple scripts if needed.

To remove a signature from the list, select the check box on the right-hand side of the Doctor's list and select Remove from List.

To add additional signatures to the Doctor's List, a new script will need to be written for the signature needed. In the Drug Edit Window (See Creating a Prescription) check the box for Save this sig and add to Doctor's List.

Note: Sending the script is not required to save the signature to the Doctor's list. Once saved the script can be removed from the pending medications with the 'X' button.

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Allergy / Intolerance

With the Comprehensive (Advanced) version of ePrescribe, the patients' Allergies will be included in performed drug reviews.

Adding the Allergy in MacPractice
Add an allergy in MacPractice by selecting the Clinical tab within the Patients ability. Find the Allergy node and select the green plus button.

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Search for the allergy in question and select a record from the results window. Select OK.

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Enter in all known information regarding the allergy including: dates of identification, onset date, severity, known reactions and any additional notes. Once finished, select Done

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Access ePrescribe and find the newly added allergy listed under Allergy / Intolerance. Allergies added in this format will be included in interaction checks.

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Allergies imported in a format other than FDB will appear in ePrescribe as an imported allergy. These allergies will not be included in interaction checks. 

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Monograph and Leaflet

With the Comprehensive (Advanced) version of ePrescribe, additional information about drug interactions is available. When in the drug search list or the Doctor's List, click the Monograph or Leaflet links.

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  • Monograph is a printable informational sheet that displays the complete information on side effects, dosing, and so on for the drug in a popup window.
  • Leaflet displays patient educational materials for printing. Select the appropriate language.

If the drug information is not available in the specified language, the default language will be English.

Monograph and Leaflet information is provided by Lexi-Comp.

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EDIT Button

Next to each script in the Pending and Current Medication sections of ePrescribe there is an EDIT button. This allows the prescriber to edit the script signature if needed. Useful if a pending medication needs to be altered before it is sent out. Editing a current medication could be beneficial if the script needs to change before renewing the medication.

Note: Any edits made to Current Medications will not effect how the pharmacy previously received the script.

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Magnifying Glass (Spyglass)

Click on the magnifying glass next to a drug to see the prescription detail information.
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Click the magnifying glass on a previously transmitted or printed prescription from the Current Medications list. The resulting window will show the Original Rx, Rx NotesPrint/Transmission Log, Sig History, and so on.

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