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I'm interested in e-prescribing thru the Sure Scripts add-on. I'm curious to see if anybody else uses it and finds it helpful.

Thanks. Mike Ribadeneyra

I tried and I didn't like it. It is more time consuming. They give you one month for free, so you can try and decide if you like it or not.

This seemed to me to be just another expense for me that saved money for others. I usually fax the prescriptions directly from my computer to the pharmacy.

Only problem I have had is that many pharmacies just don't believe 'This is an electronic signature.' They insist on faxing it back to me, getting me to sign it, and faxing it back to them. I'd love to be able to add an image of my signature to the fax on AC.

I also fax right from my exam room computer. I have a Brother MFC 8840D machine which is networked (via Jetdirect) and it works beautifully. My scripts are not signed. But, I had been printing the scripts for over a year, signing them and sending the patients out with them. I think most of the regional pharmacies have become quite familiar with my script format so, when they began showing up over their faxes, it did not phase them. I also sent each pharmacy a test script fax which explained what I would be doing and asking them to fax me back it if was received and if there were problems with the format. So far, not one complaint. Since I am in Indiana I still have to write my scheduled drugs on a special script but otherwise, being able to fax directly is a great time and paper saver for me.

quite right--I too have pharmacies, especially with staff who have gotten to know me over the years, who take the faxed 'electronically signed' prescriptions without question. they know that if there's an issue, they can call me.

We use tablet pcs for the providers. We sign the scripts on our computers before printing or faxing. Works great and really impresses the little kids. We do have to point out to the children don't go home and write on Daddy's computer. This pen is magic and for this computer only.

http://www.nationalerx.com/index.htm

FREE!

Boy, that single "AllScripts" reference was buried in small print:

"To do this, NEPSI makes secure, easy-to-use eRx software available to all physicians in America for free. Based on eRx NOW™ from Allscripts™, the program is straightforward, intuitive and well-supported."

Yes, that is the problem. I doubt we will ever be able to integrate this method of eprescribing into any EMR other than Allscripts. Smart move on their part, getting their foot in the door with paperfull offices by offering a free stepping stone.

Essentially, this means that those who use NEPSI
s free e-presciption will need to enter prescripition by e-mail and also Amazingcharts?

I see that Sure-script is a connectivity sponsor... I believe that is Amazingcharts compatible?

I am having the same problem with the pharmacies. An image of our signature should be easy to incorporate. That would be on the top of my wish list!

ah.. the question is, though, is a picture of your signature LEGAL on a Rx. Controlled substances require an ORIGINAL signature - that's federal law. State law in NY requires an ORIGINAL signature on all meds that the STATE says are controlled even if they're not considered controlled substances by the feds. For non-controlled substances, electronic signatures are OK most places.

Yes, an image of a signature is actually a pretty easy hack to put on the Rx, before writing the code, I'd want to look at all sides of this question, and maybe get a clarification from (for example, with me being in NY) New York DEA and Dept of Education (they BOTH govern prescribing in NY) as well as federal DEA.

If it's legal, though, it WOULD be way cool.

Regards,

V.

For the past 4 years I have used the EncounterPro EMR by JMJ Technologies. The signature of the person logged in IS printed on the prescription automatically (if they are assigned prescription writing privileges). According to JMJ this is a legal electronic signature stamp and is the same as using an ink signature stamp on prescriptions.

Also my nurse is able to "write my prescriptions" for me. Since EncounterPro recognizes that she does not have prescription writing privleges the scripts she writes are automatically sent to my inbox to "Review and Authorize". With the click of one button my signature is placed on the script and the now authorized and signed script is put back in her inbox. She then opens the message in her inbox and with a click it is faxed to the patient's pharmacy. I also have the option of faxing or printing the signed script myself.

My local pharmacies will not accept the AC "electronic signature statement" as a legal signature but do accept my signature printed electronically on the prescription without my having to handwrite or stamp my signature with an inked signature stamp.

Hello,
I use BluefishRx for my prescribing and it works very well. I use it on my PDA and can have Rx's faxed off my PDA to the pharmacy. Any chance this could be integrated somehow into AC or will double entry be necessary?

Jim,

I am totally confused. Are you saying that you use EncounterPro and Amazing Charts at the same time? Do you use EP only for scripts?

OK, I apologize in advance for having to give my two cents on many threads. But, I too, like Leslie fax all scripts directly from my desktop as do my MAs. I would hate to have to sign their scripts (they do send them by me). When I used eXtreme Fax, it was easy to add a print image, but I always thought it funny that the pharmacies didn't notice it was the same all the time. It was a nice sig because it was clear so it never covered any part of the script and made it more believable.

We have over 50 pharmacies in the area and all accept the scripts without a signature. Even ones that we have never sent a script to accept them. We did do like Leslie suggested and send out a test script and ask them to fax them back. All 50 sent them back and said yes. My recommendation would be for those who said no, to actually visit them and explain the situation to them. I mean if you think about it, of the three methods of sending scripts, the faxed script, even unsigned, is more secure than the other two. Certainly, calling in a script is the least secure. And, anyone could download AC presently and forge your signature especially given that they have it to practice with over and over. But, it would be rather hard to download the program, print out a script and then fax it with the fax number from the office.

Ultimately, email is the way to go especially if it is encrypted or done through a program such as Certified Mail. www.certifiedmail.com It's much faster and easier to archive copies.

I think most states require special scripts which would have to be signed for controlled substances. Here that is basically narcotics and stimulants/amphetamines.

By the way, Certified Mail is pretty cool. I can send a 300 page patient record in about 5 seconds where my digital fax machine won't even take that many pages and to print and fax would be a huge waste of paper and staff time.

Hi Bert,
To clarify any confusion--
I have been using EncounterPro exclusively for the past 4 years in another practice where I was employed physician. We used all of that programs features EMR, scripts, etc.


I will be starting a new pediatric practice and using AC "live" for the first time on August 1st. I could not afford to startup with EncounterPro in a new solo practice and hope that AC will meet my needs!

I concur with Bert. I would hate now to have sign all of my staff faxed scripts. But, then again, my employees have been with me for 20 years and I have near-complete trust in them. We still write out all controlled substances on a special script but otherwise, most everything is faxed. I have laptops in each exam room and I complete my note and fax the scripts while I am winding up the visit. I have not had one pharmacy or mail order house decline my "unsigned " fax. I personally think it is much more secure than an office staffer calling in a script and, in fact, I am suprised that is still even legally allowed anywhere in the US. At least with a fax, the phone number of origin (your office fax number) is right there on the receiving pharmacy's copy. Soon, I hope to move to receiving faxes digitally and then simply turn around and send them right back. I hope to save a few beautiful trees and cuddly toners that way.
Also, while on this subject, I write and fax all my letters and notes to consultants while I am still in with the patient. I think it gives the patient a more accurate picture of just all we do in addition to the examination. They seem to appreciate a bit more why my office charge is what it is when they have to sit there and wait for me to enter their multitude of "oh by the way" complaints. They seem to puff a little less when they get their charge for a 99214 visit. I used to spend 2 hours or better completing all my paperwork after finishing up seeing patients for the day and decided the patients really ought to see what we do and suffer with us while we do it. I just allow more time between scheduled patients.

Leslie

--> Jim Welcome to AC. I can guarantee you that you will love AC and it will do most anything you want more quickly than you want. If it doesn't do something you need, the beauty is you can post here and generally get an answer within a day if not sooner. Especially wiht the post hog.....named Bert.

--> OK, the mutual admiration society. I agree completely with Leslie. And, she brought up a couple of points I forgot. First, if done correctly, most pharmacies will take it. But, remember pharmacies now must compete with the Targets and the WalMarts of the world. They can't afford to not have your business. If AFTER meeting with the owner of the pharmacy (a pharm tech or even the pharmacist may not be able to make that decision) and they still say no, I would politely tell them that you will tell your patients that their pharmacy will not accept faxed scripts and, therefore, you will recommend one that does.

Leslie is right about called in scripts. I often wonder why this doesn't happen more often. I had an MA call in 90 Vicodin for her daughter. Ninety! Doesn't a pharmacist blink when 30 days worth of Vicodin is called in for a 7 year old?

The phone number on the fax machine is better than any signature. Plus, I worked with one pharmacy to use a COA (Certificate of Authenticity) by giving them a 12 digit key code that they kept, and I would write in the first script as the key code only. That's a beautiful workaround. Just don't give it out on paper, lol. After two months of their checking, they gave up and just took it.

What we need to do is get rid of the anonymous trial download like a lot of companies do. And, once a certified user, you can't download any betas, etc. without your username and ID.

Kudos to Leslie for typing her letters in the room. I too finish all notes and do letters in the room. This takes seconds. I used to do them in Word four days later, and they were works of beauty, but they took me forever to go back and recall while I was writing them. And the specialists didn't seem to care anyway. This is when I answer other questions. If a patietn asks a quick question after, I answer. If it is in depth, I take advantage of it to schedule a follow-up appt by saying that is something that wouldnt be fair to deal with in the two minutes we have.

Now, what does drive me crazy is a patient taking the paper script when it is clearly displayed I would be more than happy to fax it, and then asking to have it faxed at the front window.

--> Jim not to be passive-aggressive, but if you send a script to a pharmacy by fax and it is returned, you could simply fax them a quick letter stating, "It is unfortunate that your pharmacy does not accept digitally signed faxes. I have asked my patient to go to 'their competitor' to pick up her script."