Frequently Asked Questions

Electronic prescribing or “ePrescribing” is a way of prescribing medications for your patients that is paperless and more informed. Specifically, a prescriber ePrescribes when a computer or handheld device is used to electronically send the medication order to a pharmacy with software that has been tested and certified to electronically route the prescription to the patient’s choice of pharmacy. Also, when the patient runs out of refills, their pharmacist can electronically send a renewal request to the physician’s office for approval.

No, not at this time, but there are numerous incentives to do so. And, starting in 2012, CMS will reduce payments to providers who do not prescribe electronically.

ePrescribing can lead to a reduction in medication errors and injuries, greater convenience for patients, a more streamlined refill process, better management of medication costs, and healthier patients by helping people remember to take their medications properly.

It is important that your patients understand that you are ePrescribing in your practice and how that will benefit them. Here are some best practices that we recommend to inform and familiarize your patients with the valuable new service to them:

• Ensure they understand that it is safer and more efficient.
• Ensure they come prepared with their preferred pharmacy.
• Direct them to call the pharmacy rather than the practice for prescription renewals.
• Consider using signage, recorded phone messages, patient reminder cards to reinforce the message.

Start by defining your needs. You will need to consider your payer mix, the prescribing needs of your patients, pharmacy access and geography, your office readiness for new technologies, plans for EMR and integration, business organization, computer accessibility, and workflow. ePrescribing is offered as a way to prevent medication errors that arise due to difficulties in reading or understanding handwritten prescriptions. In addition, ePrescribing could reduce Adverse Drug Events (ADEs) by making information such as drug interactions and contraindications available to prescribers at the time they are preparing a prescription. ePrescribing may reduce patients’ out-of-pocket costs by placing formulary, coverage and copayment information at prescribers’ fingertips.

There are a number of tools available that allow you to assess your practice readiness. One such tool is an ePrescribing Readiness Assessment offered by The Center for Improving Medication Management, which offers access to readiness assessments by professional affiliation. The AMA also has several assessment tools for physicians at their Impact Calculator.

No. MediWeb does not limit the physician's authority to prescribe whatever therapies he or she deems appropriate.

No. Again, WVeScript does not prevent a prescriber from prescribing the drugs that they feel are necessary to treat patients appropriately. But the system does offer relevant decision support including the formulary status of alternative medications to help you make better decisions and identify ways to realize cost savings.

With WVeScript there are no fees to the prescriber or the patient for ePrescriptions. With ePrescribing, however, a physician may have information at the time of prescribing that enables him or her to select a lower-cost medication that is equally effective.

With WVeScript all you will need is a computer with Internet access and an Internet browser. Patients pay the same amount in the same way for electronic prescriptions as they do for traditional paper ones.

With ePrescribing, however, prescribers will likely have information about the patient’s formulary at the time of prescribing, which may allow prescribers to prescribe a medication that does not require prior authorization.

According to CMS:
"Physicians for whom office visits, consultations, eye exams, psychotherapy or other services listed in the CMS E-prescribing Measure Specifications represent at least 10 percent of their Medicare charges are eligible. Analysis completed by the American Medical Association suggests nearly all physicians who have an office practice will meet this threshold. The incentives are based on allowed charges for professional services covered by the physician payment schedule provided during each calendar year. Although eligible professionals do not have to start reporting on Jan. 1, 2009, in order to receive incentive payments for e-prescribing, eligible physicians must report one of the e-prescribing G-codes included in the CMS E-prescribing Measure Specifications on at least 50 percent of all their Medicare office visits and consultations, as well as the other listed services for the calendar year. All physicians for whom these codes comprise 10 percent or more of total Medicare payments will be subject to the penalties that start in 2012 if they are not e-prescribing."

At this time, prescriptions for controlled substances cannot be sent electronically and must be written on tamper resistant prescription blanks for Medicaid patients. Hand-signed hard copies of prescriptions for Schedule III through V drugs can be sent using manual fax technologies. Be sure to follow DEA regulations and refrain from sending controlled substance prescriptions electronically. Do not approve prescription renewal requests for controlled substances that are sent electronically.

The security and privacy of personal information, whether electronic or on paper, is critically important. Concerns about privacy and security are legitimate, and the BMS takes them very seriously. ePrescribing complies with the federal privacy law, HIPAA, as well as with stronger state laws. ePrescribing systems use role-based security for access, so only those users with appropriate authorization levels may access sensitive patient data. Systems also employ firewalls and appropriate levels of encryption.

Surescripts is the company that operates the only national ePrescribing network and is used by the WVeScript program. The company states, "Surescripts is dedicated to giving healthcare providers secure, electronic access to prescription information that can save their patients’ lives, improve efficiency and reduce the cost of healthcare for all. Available during emergencies or routine care across all 50 states and Washington, DC, the Surescripts network is used every day by thousands of physicians, pharmacists and payers nationwide to exchange health information and prescribe without paper."

To learn more see: Surescripts

Busy medical practices that manage a lot of renewal requests typically realize time savings with ePrescribing, generating new prescriptions usually takes a few more seconds to accomplish, so yes it is faster. But equally important is that ePrescribing accomplishes much more than traditional prescribing. For example, it performs DUR, formulary coverage, histories, and benefit verifications. The system also automatically presents alternatives when drug alerts are generated.

While faxing is an electronic transmission of a prescription to a pharmacy, a faxed prescription is not a "true" electronic prescription since the transaction is not processed automatically by a computer system. Faxed prescriptions must be manually entered into the computer system at the pharmacy after it is received, which increases the chance of errors. In addition, fax machines may be turned off, out of paper, or simply not be checked, all leading to your patient not being able to pick up their prescription. Additionally, a fax does not provide the other services that WVeScript through its connection with Surescripts offers such as DUR, medication histories, drug interactions, formulary and benefits information.

You will not be subjected to advertising with WVeScript, and your registration information will not be shared with anyone.

Not at this time.

Yes.

The Surescripts service meets the Medicare criteria for certified ePrescribing software that is required for the Medicare EHR Incentive Program. If you are ePrescribing through WVeScript, you are eligible for the Medicare Incentive Program.

The tamper-resistant prescription pad requirement is waived for all electronically prescribed prescriptions.

The DEA’s rule “Electronic Prescriptions for Controlled Substances” revises the DEA regulations to provide practitioners with the option of writing prescriptions for controlled substances electronically. The rule also permits pharmacies to receive, dispense and archive electronic prescriptions for controlled substances. It was published in the Federal Register on March 31, 2010, and became effective on June 1, 2010. These regulations will take time to implement and ePrescribing software applications used by both prescribers and pharmacies will need to be upgraded to comply with the new regulations.

You will need to have a digital signature (two factor credentials) with extra security set up for you to send eRxs for controlled drugs. This requires the provision of two of the following: something you KNOW (a PIN or password), something you HAVE (a card, USB key or other hard token), or something you ARE (a fingerprint or other biometric) to set up your signature. If a prescriber already has a digital signature, the two-factor authentication credential can be a digital certificate specific to the practitioner obtained from a Certification Authority that is cross certified with the Federal Bridge Certification Authority.

ePrescribing of controlled substances can begin only after proof of certification of ePrescribing software applications used for both prescribers and pharmacies. This certification must be done by an approved certification body. The software application provider must provide a copy of the certification report to the user to demonstrate that the application is compliant and approved.

More information and updates regarding ePrescribing for controlled substances can be found at the U.S. Department of Justice website.