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SureScripts. The Basics. Terminology. Prescriber – Provider, Fellow, Resident, Nurse Practitioner, or Physician Assistant Service Level – The level of e-prescribing capabilities a Prescriber or Pharmacy has.
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SureScripts The Basics
Terminology • Prescriber – Provider, Fellow, Resident, Nurse Practitioner, or Physician Assistant • Service Level – The level of e-prescribing capabilities a Prescriber or Pharmacy has. • SPI – SureScripts Prescriber ID (think of this as SureScripts’ version of a Prescriber’s NPI (National Provider ID). • PON – Prescriber Order Number. It is an VUMC internal reference number that represents a single prescription, which identifies the prescription, patient, provider, etc. • SureScripts Message ID – It is an external reference number used to track the e-Prescription.
Terminology, cont’d • E-Prescription – Computer-based electronic generation of a prescription. • E-Prescribe (or e-prescribing) – Computer-based transmission of a prescription between a prescriber and a pharmacy. • NewRx– Prescriptions e-prescribed from RxStar (This does not have any association with VUMC’s Renewal prescription policy.). • E-Renewal Request – A prescription request sent from a pharmacy to a provider with the intent of renewing the prescription. • E-Renewal Response– The prescriber’s response to the pharmacy’s e-Renewal Request (accepted, denied, etc.).
Terminology, cont’d • Synchronous Error – Real-time error response from SureScripts indicating that the e-Prescription was not received by the intended recipient, pharmacy or prescriber. Asynchronous Error – Delayed error response from SureScripts indicating that the e-Prescription was not received by the intended recipient, pharmacy or prescriber.
Prescriber registration • In order for a prescriber to e-prescribe, the prescriber must be registered with a Prescribing Vendor, in this case Vanderbilt’s Prescribing Vendor (RxStar/StarPanel). • To register a prescriber, we need the following information: • Prescriber Name • Prescriber Identifications • Clinic Name • Clinic Address • Clinic Phone Number • Clinic Fax Number • The prescriber must also be credentialed and active within the VISTAR (Providers, NPs, PAs, and Fellows) or GME (Residentsand Fellows) database.
Prescriber Registration, cont’d • Currently, a prescriber can have one of three Service Levels: • 0 – Disabled: Prescriber cannot e-prescribe. • 1 – NewRx: Prescriber can only e-prescribe from RxStar. • 3 – NewRx &Renewal: Prescriber can e-prescribe from RxStar and receive/response to e-Renewal Requests from pharmacies. • Prescribers can determine their e-prescribing level by looking in the top-right corner of RxStar. • Admins can also see a prescriber’s Service Level within the RxStar Admin Console.
Pharmacy Registration • Once a pharmacy certifies and completes the registration process, the pharmacy/vendor will have similar registration Service Levels: • 0 – Disabled: Pharmacy cannot accept or send e-prescriptions. • 1 – NewRx: Pharmacy can only receive NewRx e-prescriptions. • 3 – NewRx &Renewal: Pharmacy can receive NewRx e-prescriptions and send/receive e-renewal Requests/Responses.
E-Prescriptions • In order to send/receive e-prescriptions the following must occur: • Prescriber has a Service Level which supports sending and/or receiving e-prescriptions (e.g. Level 1 or Level 3). • Pharmacy has a Service Level which supports sending and/or receiving e-prescriptions (e.g Level 1 or Level 3). • E-Prescription qualifies for e-prescribing (i.e. transmitting/e-prescribing the prescription). – See next slide. • If all of the above conditions are met, then the prescriber can e-prescribe the prescription.
Qualified E-Prescription Details • Drug Name – Coded/Structured using FDB (First DataBank), our medication database. • Directions – Coded/Structured or Free Text sig; cannot exceed 140 characters. • Dispense Amount/Unit– Coded/Structured • Refill Count– 0-12 refills • Substitution – Allow substitution or dispense as written • Written Date – Date prescribed • Note (optional) – Currently, concatenates from several fields; cannot exceed 210 characters. • Member ID • Special Instructions • Pharmacy Comments • Dose Calculation (Preference Setting)
Troubleshooting E-prescriptions • Start with the RxSummary • Confirm that the prescription was e-prescribed (submitted electronically). • Some users will report an issue with e-prescribing, when they actually faxed the prescription. • Next, use the e-Prescription Dashboard to confirm e-prescription state. • “Accepted and verified by ultimate receiver” indicates the pharmacy received the e-prescription.
Troubleshooting e-prescriptions, cont’d • “Accepted and pending by receiver; free standing error still possible” indicates the pharmacy has not verified receipt of the e-prescription and an Asynchronous Error is still possible. (Note: Currently, pharmacies are not required to VERIFY receipt of the e-prescription). • Each e-prescription has a unique SureScripts Message ID. When reporting a Help Desk ticket for e-prescriptions, please include the MRN for RxStar-related troubleshooting and the SureScripts Message ID for e-prescription routing troubleshooting (e.g. The pharmacy said they didn’t receive the e-prescription.).
