Print
Email
Can the software be used to generate prescriptions from a laptop without needing an EMR?
Dr. Soreya Dhanji
Family Physician
This is a great question! There isn't a standalone portal for generating prescriptions independently of an EMR system. This means that to use PrescribeIT for e-prescribing, it needs to be integrated with an existing EMR.
The seamless integration with various EMRs (instead of a separate website login) actually offers several significant advantages. Firstly, it streamlines your workflow. By integrating directly with your EMR, PrescribeIT allows you to manage patient records and prescriptions in one place, without the need to switch between different systems or interfaces. This can save valuable time and reduce the risk of errors that can occur when transferring information between separate platforms. Another key benefit is the absence of an additional login process. In a busy clinical setting, having one less login to remember is more convenient and improves workflow efficiency.
How do I get started with PrescribeIT? Is it for current patients only?
Pharmacist
Pharmacist
For a pharmacy to get started with PrescribeIT, the initial step entails expressing interest by filling out an application form on the PrescribeIT website.
Once your pharmacy is enrolled and connected with PrescribeIT, you can receive electronic prescriptions. The service provides a "search provider registry" button that helps users search the PrescribeIT pharmacy database to automatically add a pharmacy with all the contact details, facilitating the connection between pharmacies and prescribers.
PrescribeIT enables the digital transmission of prescriptions, connecting prescribers to pharmacies and allowing prescribers to send electronic prescriptions directly from their Electronic Medical Record (EMR) system to the patient's pharmacy of choice. The service works for the pharmacy’s current patients or any potential new ones.
I am a manager at a community health centre in Ontario and I am wondering if podiatrists can use PrescribeIT?
Andy Donald
Pharmacist
The PrescribeIT platform is used for interactions between pharmacists, physicians and nurse practitioners. It is not currently available for other health care professionals at this time.
I am a public health researcher from Chile investigating e-prescription systems. I´ve investigated PrescribeIT but cannot find out whether physicians or pharmacists are able to see the patient´s prescription history in the system. Could you clarify that for me?
Dr. Soreya Dhanji
Family Physician
Thank you for your question! A patient's prescription history is an important part of being able to provide exceptional care for both a physician and pharmacist.
When a physician sends a prescription to a specific pharmacy, PrescribeIT facilitates the secure digital transmission of a prescription from an electronic medical record (EMR) to a pharmacy management system (PMS.) The patient’s prescription history is stored in the physician’s EMR and in the pharmacy (PMS) where it remains confidential.
It's important to note that all personal health information is maintained in accordance with all provincial, federal and legal regulations. By facilitating secure electronic prescription transmission, PrescribeIT contributes valuable information to the prescription histories in the EMR/PMS, and aims to streamline healthcare processes, improve patient outcomes, reduce errors, and enhance medication management for both prescribers and pharmacists.
My wife is a hospital-based specialist and doesn't use an EMR. Can she use PrescribeIT?
Pharmacist
Pharmacist
Currently, the service is not yet available to hospital practitioners, but PrescribeIT is currently completing a pilot with a hospital information system (HIS) at The Ottawa Hospital. The service will soon be available to more than 2,500 prescribers. Further, PrescribeIT is negotiating with one of the largest HIS providers to expand access to hospitals nationwide. More to come on this announcement in the next few weeks.
As for the TPP Controlled Medications in Alberta including Methadone, do we still need triplicate form to be sent in addition to the e-prescription?
Pharmacist
Pharmacist
Alberta TPP has approved that if send as an electronic prescription directly to a PrescribeIT® enabled pharmacy, with indication for therapy and other TPP required elements included, the secure TPP form is no longer required for methadone or other OAT medication prescriptions. The electronic prescription can serve as the authoritative copy.
As it pertains to other AB TPP Type I medications, PrecribeIT is in discussions with AB TPP as it is updating its requirements and approval process.
How do I know, with PrescribeIT, that the pharmacy received and processed my communication?
Dr. Soreya Dhanji
Family Physician
Unlike the uncertainty with faxed communications, electronic prescriptions are sure to be delivered to the pharmacy.
When a prescription or refill request is sent to the pharmacy, a 'Dispense Notification' is sent back to the physician when the order is processed through the pharmacy system. If a patient does not pick up the prescription and the order is cancelled in the pharmacy system, a 'Cancel Dispense Notification' will be sent to your EMR.
If a clinical communication is sent to the pharmacy regarding a certain patient, there is no way to determine if it has been read as there isn't a "read message" notification. To ensure your clinical communication sent to a pharmacy has been received, I will end my message with "please confirm receipt of message" and the pharmacist will often reply that my message has been acknowledged.
Does the prescription information in PrescribeIT directly interface with the pharmacy software product? For example, would this free up order entry and prevent this duplicate process, or would a pharmacy assistant/technician still need to enter the order in the pharmacy system? Also, is this available for Accuro-EMR?
Pharmacist
Pharmacist
PrescribeIT integrates seamlessly with pharmacy management systems (PMS) so that the received e-prescription is pre-populated with all the information you need to process it accurately and fairly quickly compared to a faxed Rx, where you need to input all the information manually into the system. As for Accuro EMR, an agreement has been signed between PrescribeIT and Accuro, and the integration is currently under development. A launch date will be determined in the near future.
I'm interested in using PrescribeIT, but who pays for this service, physicians, patient, government systems? If I set myself up as an Alberta physician, can I as a physician expect to pay a fee for using it?
Dr. Soreya Dhanji
Family Physician
This is a great question, especially in light of rising clinic overhead costs. Currency, Infoway works with each province to implement PrescribeIT through Health Canada funding resulting in no fees for physicians or pharmacies to use PrescribeIT in their practice. Nominal transaction fees will be implemented for pharmacies when the service reaches scale and only after significant stakeholder consultation. If you want to register to use PrescribeIT, the registration process is easy! Simply fill out the registration form and a member of the PrescribeIT team will be in touch.
Hello, Is it possible to deactivate prescribe it if I do not like it? Will prescribe it allow us to deactivate it. thanks.
Dr. Soreya Dhanji
Family Physician
The goal of PrescribeIT is to increase the efficiency of current clinical workflows and reduce the pharmacy-related administrative burden. However, if you feel that PrescribeIT isn't the right fit for your workflow, you can deactivate it. Of note, even while PrescribeIT is activated within your EMR, you will always have the option to use your previous prescribing workflow instead of utilizing PrescribeIT. As every clinic has its own way of managing prescriptions and pharmacy communications, PrescribeIT can be integrated however you choose. You can choose to use the electronic prescribing feature or utilize the clinical communication tool based on your preference. If you are having difficulty navigating PrescribeIT within your EMR, there are detailed training materials and support from the PrescribeIT/EMR team available.
Is there any way to use this system to help desk with medication shortages (to find out what is available at a pharmacy when you prescribe it?) The current system seems to involve patients/parents going between multiple pharmacies trying to find a medication. Eventually a pharmacist faxes back a prescription asking it to be changed to something they have.
Pharmacist
Pharmacist
PrescribeIT, an electronic prescription, has no access to other parts of the pharmacy management software, including the perpetual inventory. Yet, the pharmacist can still use the clinical communication tool to notify the prescriber of any shortages, which would alert the prescriber to cancel the prescription and issue a new one accordingly. For more information, you can check this helpful resource (module 2): https://bit.ly/3uRq1Xc
How do I start an e-prescribing conversation with a pharmacist (who is also registered with PrescribeIT) without launching a prescription? I am in Ontario and on the Telus program.
Dr. Soreya Dhanji
Family Physician
Thank you for this question! Clinical communication is an efficient and secure way to communicate directly through your EMR with the pharmacist to provide patient/medication updates, ask clarifying questions, discuss medication questions and align on patient care-related activities. It's a fantastic tool to streamline communication between physicians and pharmacists to optimize the patient's care.
For physicians using Telus Health's MedAccess, to send a clinical communication, you access the patient's chart, and create a new task. You can then select "Clinical Communication," the preferred pharmacy, write your communication, and press ‘Send.’ The response will return as a Task. However, sending a clinical communication varies slightly between EMRs. Reach out to the PrescribeIT team who can provide you with the appropriate how-to documents.
We currently receive PrescribeIT prescriptions. Do we need to pay to request refills? We are having trouble in that area.
Pharmacist
Pharmacist
Currently, PrescribeIT services are free. To be able to sustain the service and even grow it in the future, PrescribeIT may need to apply a nominal transitional fee. This fee model has successfully been applied in other countries with mature electronic prescription services, with no issues noticed. PrescribeIT is committed to conducting extensive stakeholder communication before implementing any transactional fees in the future.
What is the status on this with BC?
Andy Donald
Pharmacist
The PrescribeIT team at Infoway has let me know that they are currently in discussion with BC about integrating and deploying PrescribeIT within the province. Discussions are going well, so stay tuned.
Are prescribers going to be paying a "nominal fee" as well? Or is the financial burden only going to be passed on to the pharmacies?
Dr. Soreya Dhanji
Family Physician
Hello! I appreciate this question as it's important for both prescribers and pharmacies to understand how e-prescribing is implemented within our health care system. Currently, Infoway works with each province to implement and scale electronic prescribing using PrescribeIT through Health Canada funding. Fees will be implemented once the service reaches scale and only after significant stakeholder consultation.
Currently, there are two funding models that exist in jurisdictions with existing and mature electronic prescribing models (the United States and throughout Europe). In one model, jurisdictions cover the cost of the service as part of the health ministry mandate. In another model, pharmacies are responsible for the nominal fee. This alternative funding has demonstrated an increased use of e-prescribing through increasing physician adoption of the process.
Why isn't Shoppers sending us the request for refills using PrescribeIT? They won't do it even for prescriptions that I have already sent at least once by PrescribeIT.
Andy Donald
Pharmacist
At the moment Shoppers has opted to do a staged approach to adopting PrescribeIT. At the moment they only have limited functionality to receive e-prescriptions and refill requests on the platform, but do not currently have the functionality to send communication back on it. They are adopting the technology slowly to ensure all of their 1,000+ stores are operating properly. Hopefully they will soon rollout the return communication functionality, which will allow them to:
This means that as a prescriber you are able to
- Send a new e-prescription to the pharmacy
- Send a refill request to the pharmacy
In the future, once full functionality has been implemented prescribers will be able to
- Receive and respond to a pharmacy-initiated e-renewal request from the pharmacy
- Send and receive communications securely using the clinical communications tool
- Initiate a cancel e-prescription request and receive responses to and from the Pharmacy
- Receive dispense and dispense cancel notifications
Thanks,
Andy
Does a clinic need to be apart of the EMR system in order to use this? We are a paper clinic and do not use EMR.
Andy Donald
Pharmacist
PrescribeIT is integrated directly into a physician’s EMR and a Pharmacies PMS. Both the prescriber and the pharmacy must be enabled with PrescribeIT in order to send and receive e-prescriptions. PrescribeIT if not available for practices with paper-based workflows.
Med discontinuations do not send automatically to the pharmacy. Do you have a suggestion for good work-flow to do this? Is there a way to message the pharmacy without initiating a prescription in PS Suite/Med Dialogue?
Dr. Soreya Dhanji
Family Physician
This is a great question as it's so important to be on the same page with our clinical team regarding patient medication changes. This improves safety and reduces medication errors for the patient. In order to keep the pharmacy updated on medication changes or discontinuations, you can initiate a Clinical Communication to send to the pharmacist. A simple message stating that the medication is discontinued would be the documentation that the pharmacy requires to discontinue the prescription in their pharmacy medication system. It's very similar to writing an order in a hospital setting informing the other clinical team members a medication has been stopped. Thank you for your question!
I do not want the pharmacies to send me messages or requests for medications through the e-prescribe system. Is there a way to send a message to all the pharmacies to tell them about my preference or do I have to call each pharmacy directly to inform them about my preference.
Dr. Soreya Dhanji
Family Physician
Thank you for your question! PrescribeIT is designed to be a two-way communication system between physicians and pharmacies regarding specific patients. The open lines of communication between the prescriber and pharmacy help to reduce error, increase communication efficiency, decrease redundant faxes, and clarify medication instructions pertaining to individual patients. As the pharmacy communications are regarding specific patients, there isn't a way to broadcast a general message to all pharmacies.
I am not sure the stack of eRx waiting on a Monday after a long weekend is worth continuing with eRx. Patients expect their Rx to be done on command as they sense it is a retail consumer process like any other. Any suggestions before I disconnect?
Dr. Soreya Dhanji
Family Physician
With PrescribeIT, the goal is to have e-prescriptions seamlessly integrated into your EMR so they can be addressed during your day-to-day workflow and provide flexibility as to when to address the prescription requests. Urgent renewals can be addressed remotely at any time, while non-urgent renewals can be addressed as part of day-to-day work (similar to the previous fax-based environment). Physicians can work with their EMR provider to ensure they have remote EMR access when appropriate to meet their patient’s needs (labs, notes, prescriptions, etc).
Prescription requests sent electronically allow patients the reassurance their request has been received by their physician. However, as e-prescribing becomes more widely adopted, it's important that both the pharmacist and physician work together to educate our patients that e-prescriptions do not equate to being an "instant" process.
My pharmacy currently uses PrescribeIT, but a local medical clinic is hesitant to get it as they are concerned about the costs for their clinic. I understand that it is currently subsidized, but I have only found information about potentially future costs for pharmacies on your website. I have not seen any information about potential future costs for the prescribers. Is there a cost for the prescribers or will there be costs for the prescribers in the future?
Dr. Soreya Dhanji
Family Physician
Thank you for raising a very important question! There is no fee for physicians or any prescribers to use PrescribeIT. Currently, there is no fee to pharmacies today for the service due to funding from Health Canada. In the future, a nominal transaction fee will be applied to pharmacies for new and renewal transactions. With more transactions, the less the cost will be for all pharmacies. The transaction fees for pharmacies will only be implemented after extensive stakeholder communication. PrescribeIT's goal is to drive down the cost of the service over time.
Hello! Do you know if PrescribeIT will eventually be available in Quebec? Or is that not in the plans because Quebec is developing its own system?
Christine Fitchett
Nurse Practitioner
Yes! Infoway is working with the MSSS (le Ministère de la Santé et des Services Sociaux) to bring the service to Quebec under the name Prescription-Quebec. https://bit.ly/3y6yqqS
How do I initiate a message to a pharmacist in the community in PSS when there's not a medication request in chart?
Dr. Soreya Dhanji
Family Physician
Thank you for your question. PrescribeIT is an e-prescribing service that works with a pharmacist's pharmacy management system and the physician's electronic medical record. If you would like to encourage your physician or pharmacist to subscribe to PrescribeIT, please direct them to this link.
Great question! Whether it’s to follow up with the pharmacist about a patient or ask a general medication availability question, 2-way communication with pharmacists is an important piece of patient safety. It also allows for efficient communication between both parties without having to rely on fax on being on hold on the phone. The message is stored as documentation within the chart.
To send a message to a pharmacist using PrescribeIT, the pharmacy must be PrescribeIT enabled. This information can be found in the Provider Registry tab in the address book. Hint: these pharmacies display an eRx icon in the third column of the address book.
To send a message to the pharmacy that is not regarding a specific prescription:
- Go into the patient’s chart and start a regular message by pressing ‘Ctrl + M.’ Then address the message to the preferred pharmacy.
- Select the urgency of the message in the ‘Due Date’ box. If you want it to be flagged to the pharmacy as urgent, please select ‘As Soon As Possible.’
- Write your communication in the message box and press ‘Send Message.’
To send a message to the pharmacy regarding a patient’s medication:
- Double click on the medication and choose ‘Clinical Communication to Pharmacy’ which opens a message box.
- Ensure the message is going to the preferred pharmacy in the ‘To’ box.
- Select the urgency of the message in the ‘Due Date’ box. If you want it to be flagged to the pharmacy as urgent, please select ‘As Soon As Possible.’
- Write your communication in the message box and press ‘Send Message.’
Let me know if you have any more questions!
I am a physician in Thunder Bay, Ontario (Northwestern Ontario). Most pharmacies here are signed up for the PrescribeIT system, which enables me to send them prescriptions electronically. However, few pharmacies will send messages to me electronically, for example, to ask for prescription refills. Some of the smaller pharmacies or independent pharmacies will do this. Notably, Shoppers Drug Mart does not message me electronically. Some of their pharmacist tell me that Shoppers head office has not yet activated this part of their system to allow for communication electronically from pharmacist to physician.
Is this true? If so, when will Shoppers Drug Mart fully participate with and use Prescribe IT?
Also notably, Walmart pharmacy does not use the system at all!
Andy Donald
Pharmacist
Hi, thanks for reaching out. It does appear that Shoppers Drug Mart is slowly rolling out PrescribeIT functionality in stages. They currently can respond to physician initiated PrescribeIT communications (like sending an email prescription to the pharmacy), however, they do not currently allow pharmacies to initiate the refill request. Hopefully, Shoppers agrees to utilize the full functionality of PrescribeIT soon! As far as Walmart, they just launched their first location on the PrescribeIT platform in Toronto at the start of June 2022. Walmart is ramping up the deployment of other locations in the coming weeks and all of their stores will have full PrescribeIT functionality.
I would like to know how to join PrescribeIT but I can't find the procedure. Can you help me? I am a patient. Thank you.
Dr. Soreya Dhanji
Family Physician
Thank you for your question. PrescribeIT is an e-prescribing service that works with a pharmacist's pharmacy management system and the physician's electronic medical record. If you would like to encourage your physician or pharmacist to subscribe to PrescribeIT, please direct them to this link.
Is PrescribeIT going to work with acute care facilities for discharge prescriptions?
Andy Donald
Pharmacist
At the moment, PrescribeIT is only available in the community setting for both prescribers and pharmacies. The hope is to eventually have this as an option for hospitals in the near future, as the platform continues to grow and expand. There is actually a pilot for hospital use currently being done in the Ottawa region.
We have PS Suite as our EMR. Our local pharmacy was unable to send the renewal request to our office because of the spelling of the patient's first name.
Is there a way as an Admin to view PrescribeIT messages or renewal requests from pharmacies that did not get matched up with a patient of the clinic within our EMR?
Dr. Soreya Dhanji
Family Physician
In general, a pharmacist can send any patient renewal request or message to any clinic. The matching of patient names occurs on the side of the EMR, in this case within PS Suite, and not on the pharmacy PrescribeIT side.
Once the renewal or message has been sent from the pharmacist, then the EMR tries to find a patient match. If a match is not found, PS Suite identifies the renewal request or message for the unmatched patient with a “??” in front of the patient’s name. When the request is then opened, a link that says “identify” appears next to the patient’s name which can be clicked (either by the intended prescriber or admin) to help select the correct patient from the EMR.
Hopefully, this answers your question from the clinic side of PrescribeIT. If there are further questions, please reach out to your technical support as there may be other factors at play for your specific case.
I'm a pharmacy technician and I want to know where we can find training online on how to use the system. We have a hard time figuring out how to use it. Is there a tutorial available?
Andy Donald
Pharmacist
There are a few resources you could consult for training online. The first one being provided directly by the PrescribeIT team so that would be a great place to start. There are some eHealth learning modules for students offered by the Association of Faculties of Pharmacy of Canada as well.
Can the program be integrated in Accuro to have physician assistants help with refill authorizations?
Dr. Soreya Dhanji
Family Physician
Thank you for the great question! As physicians, delegating certain tasks can be an important part of our practice. At this time, delegated prescribing is not supported. PrescribeIT specifications are developed based on the EMR's ability to support licensed prescribers. However, the PrescribeIT and Accuro specifications are still in development and expected to be deployed later this year so I am unable to provide a more detailed response at this time.
I'd like to send a message directly to the pharmacy to ask a question about a client's prescriptions. Usually I'd fax them a letter through my EMR. Can I send a message using PrescribeIT? Please explain how.
Christine Fitchett
Nurse Practitioner
Great question! I have to say, this is one of my favourite features of PrescribeIT: being able to directly message the pharmacy. Prescribers and pharmacies communicate through secure messaging, the same way messages are sent currently through your electronic medical record. The other nice feature is that the communication records remain available for later reference within the medical record. I find this way of communication is quick, simple and improves interactions between the provider and pharmacy.
Do you know what EMRs PrescribeIT is integrated into? Can it work with any EMR?
Dr. Soreya Dhanji
Family Physician
EMR integration of PrescribeIT is an essential factor to ensure efficient workflow and prescription documentation. There aren’t any extra login requirements to use PrescribeIT within the EMR so it integrates seamlessly within each medical record system. With this integration, the prescriber can send electronic prescriptions and pharmacy clinical communications within the regular EMR workflow.
PrescribeIT is integrated into the following EMRs: EMR Advantage, Microquest, Oscar Pro, P&P data, Telus Health
The following EMR vendors are in the process of conformance: Accuro, Indivica, Juno, Medfar, Mustimuh Information systems and Omnimed.
Visit https://www.prescribeit.ca/about-us/working-together to keep up to date with conformed EMR.
If an EMR is not on the list, the user can contact PrescribeIT to request more information on how it can be incorporated.
What is the cost for the pharmacy to use this program?
Christine Fitchett
Nurse Practitioner
Great Question!
Currently, there is no fee to pharmacies for the service. This has been made possible from the funding provided by Health Canada for the development of the technology and cost of the start-up operations. This non-repayable seed capital also offsets the cost of the service over time.
I am a coop student working at the Canadian Institute for Health Information (CIHI) with the pharmaceuticals team. I am working on a small project to try and find out where the data for prescription filled out with private insurance might get collected to (other than individual insurance company). I was wondering if PrescribeIT might be one place where this data is collected. If you have any insight into this, it would be greatly appreciated if you could let me know. Thank you!
Andy Donald
Pharmacist
All individual insurance company information would be held by the insurers themselves and not accessible. Personal health information is very tightly regulated and protected in Canada (PHIPA/PIPEDA). PrescribeIT is simply a communication tool between physicians and pharmacies in Canada that helps to minimize errors and improve convenience and collaboration. Data on health cannot be viewed or stored on PrescribeIT. Provincial plans (ODB) do house health information that with the proper authorization and protection can be viewed to improve patient care (ClinicalConnect or ConnectingOntario). However, unfortunately no such system has been organized for insurance provider networks as of yet. I hope this helps.
I assume this [PrescribeIT] is optional for each pharmacy? I did not see Shoppers Drug Mart listed where the other pharmacies were located. Is SDM a participating pharmacy? Thanks so much. I like it.
Andy Donald
Pharmacist
It appears that Loblaws and all it affiliated pharmacies (including Shoppers Drug Mart) are currently signed up for PrescribeIT in both Ontario and New Brunswick. I am not aware of the launch dates for their company in other provinces, but I am sure they will be added shortly as well. Currently at least 2/3 of pharmacies in Canada now use PrescribeIT and growing fast. Any pharmacy and chain can apply to use this great communication tool. Read news release here.
In readying our clinic to adopt PrescribeIT, I know I will have questions from prescribers on the following point: "Pharmacists can electronically request prescription renewals from the prescriber and, if approved, clinic staff respond with an e-renewal."
Could you please provide an example of how prescription renewals are handled in-clinic by clinic staff other than the prescriber? What needs to be put in place? Thank you!
Christine Fitchett
Nurse Practitioner
I can’t provide an example where prescriptions are handled in clinic by staff on PrescribeIT — as they are sent directly from the pharmacist to the provider. It is so convenient and fast to renew! The old style of course is where the pharmacy would fax us the script, the admin support would scan in the request to the chart and then the Provider would have to review and renew.
One of the benefits of PrescribeIT® is that it takes some of the administrative burden related to prescriptions renewals off that of the frontend clinic staff. There are different clinic workflows at every clinic; we implemented PrescribeIT® and then supported the clinic change management based on the new process.
How to contact a doctor back for Rx clarification?
Andy Donald
Pharmacist
To contact a doctor for an Rx clarification, you can send a clinical communication directly from your pharmacy system to the doctor's inbox. This can be done in the context of a prescription or as a general clarification. Please refer to your PMS user guide on how to send clinical communications.
Is it possible to send a secure message from one registered prescriber to another at a different clinic, eg. MD to MD, similar to how a message can be sent to a pharmacist? Wondering about communicating with specialists and other prescribers.
Dr. Daniel Pepe
Family Physician – Past Peer
Thank you so much for your question! At this point, PrescribeIT does not support the ability to send a message to another provider on the platform. We are able to send messages through PrescribeIT to pharmacies as that supports the e-prescription flow.
When a message is sent back to the doctor regarding a prescription question (through the mail icon) is there a way to track that message/ conversation so that it may be printed for records and intervention billings? Thank you for your time!
Andy Donald
Pharmacist
In the workflow for Kroll, under EPrescribe Notifications, you can find all your messages if you select “Sent” from the dropdown menu. Currently, the communications cannot be printed directly from the EPrescribe Notifications. You can also find the message within the patient profile itself, under EPrescribe Messages and again, in the dropdown select “Sent” to find the ones you have sent for that patient.
Can you let me know what is the current statistics data that shows percentage decrease in medical errors after e-prescribing implementation? By how many percentage points were errors reduced compared to previous years? Thank you
Andy Donald
Pharmacist
According to a study cited in a paper on e-Prescribing:*
“Prescribing error rates decreased from 42.5 per 100 prescriptions to 6.6 per 100 prescriptions in one year after e-prescribing. Illegibility errors were very high at baseline and were completely eliminated by e-prescribing (87.6 per 100 prescriptions at baseline for e-prescribing adopters, 0 at one year).”
*Electronic Prescribing Improves Medication Safety in Community-Based Office Practices, Kaushal et. al.. J Gen Intern Med 2010 Jun; 25(6): 530–536
What type of replies can we expect from the pharmacy? I am aware it will indicate when an Rx has been dispensed, but will it communicate to the prescriber other things?
Andy Donald
Pharmacist
Yes, besides dispensing, PrescribeIT will also tell you if an Rx has been cancelled and serves as a great platform for secure direct messaging between pharmacists and prescribers. There is also a great formulary integration* that allows prescribers to ensure a drug is covered by the patient’s plan before they prescribe it.
*In jurisdictions where it is available
How can I be notified when a new prescription is sent to the pharmacy? Either an audio or visual notification would be great. I'm using Kroll v10.
Andy Donald
Pharmacist
I am not sure about audio notifications. However, the new prescriptions immediately go into your workflow (in the ToDo queue) at the moment, so you can visually see it right away. With increasing technology, a notification ping would be great. However, I believe that would need to be an improvement that is organized and implemented from the Kroll (Telus) side of things.
Wondering when we can expect to see Shoppers go live with PrescribeIT?
Dr. Daniel Pepe
Family Physician – Past Peer
This is such exciting news, but Shoppers Drug Mart is now starting to go live across Canada including Alberta & New Brunswick with other provinces to join in soon!
Learn more here.
Is there any way to view the complete list of PrescribeIT enabled pharmacies in my area? I'm using PS (Telus) and in Toronto and Telus limits the search results to 100 so I'm not able to see all pharmacies in my area.
Dr. Daniel Pepe
Family Physician – Past Peer
Thanks so much for this question!
I have asked this very question myself and Canada Health Infoway has informed me that a PrescribeIT locator map with the data you are hoping for will be live in February on PrescribeIT.ca and we will be sure to share it once we have it!
Does PrescribeIT integrate in Nexyss/Pharmaclik RX? When a prescriber sends in a prescription if the patient has had it before does it attach itself to a previous prescription or does it enter it as a new prescription each time?
Andy Donald
Pharmacist
Yes, PrescribeIT does integrate with both Nexyss and Pharmaclik RX. In fact, here is a link to other vendors that PrescribeIT is currently integrated with.
Regarding the prescription linkage, the pharmacy has the ability to link a new prescription to a previous prescription if it is appropriate. This functionality may vary depending on your pharmacy system.
Is there a way to temporarily stop pharmacy prescription requests via PrescribeIT for vacation periods?
I have a locum who needs to receive such requests via fax while I am on holidays
Dr. Daniel Pepe
Family Physician – Past Peer
Thank you for this important message. Pharmacy prescription requests via PrescribeIT do not need to be stopped while away on vacation. A locum can still process the requests in the EMR on your behalf, and then send the responses to the pharmacy via fax. If the locum is PrescribeIT enabled, they would be able to process and send the requests via the service. In both cases, the locum would just need access to where you normally receive PrescribeIT messages (i.e., EMR inbox).
If available in your EMR, using the “away” or “vacation” setting will ensure the locum receives your PrescribeIT notifications while you are away.
I'm a pharmacist, and some time ago, the physicians at our local clinic asked us NOT to enable Prescribe IT on our system because they were unhappy with the volume of irrelevant messages that it pushed to their desktop
I don't see the physician's end of the process, so I can't say if this is true or not, I support the use of integrated EMR and pharmacy systems so I want to use a system such as Prescribe IT but not if it antagonizes our physicians by adding to their workload.
Has this been your experience with Prescribe IT?
Dr. Daniel Pepe
Family Physician – Past Peer
Thank you for your question!
I can tell you that my current experience is only that I receive messages in my inbox when there is a prescription renewal request. Outside of that the only time I receive messages are if a medication is unavailable or if I have not completed a prescription or included a limited use code. In each of these cases, PrescribeIT is substantially more efficient than fax-based communications.
Ultimately, I think a short trial period between yourself and physician colleagues would be the best as it would allow you to actually experience the workflow. From my experience, this product saves time and effort!
I could not find any information on OCP website about validity of PrescribeIT RX. It is legally acceptable by pharmacy in Ontario?
Andy Donald
Pharmacist
Yes, PrescribeIT has been approved by OCP as a means to receive prescriptions in Ontario. The prescriptions are securely transmitted by the prescriber directly to the pharmacy in a manner that is PIPEDA and PHIPA compliant. Essentially, this new prescription transmission with doctors unique identifiers can replace faxing of prescriptions in a manner that helps reduce workload while also reducing the chance of transcribing errors.
Read the section on Guidance to Members Regarding Prescriptions Using Unique Identifiers here.
How do you rebill a script using PrescribeIT without losing the attachment of the script itself?
Andy Donald
Pharmacist
If this is a question for Kroll pharmacy users: I believe you would do it the same way you would rebill other scripts with an image. If you cancel and rebill the prescription it should keep the image of the script. You just have to make sure to not outright cancel the prescription.
In Alberta we have a triplicate program to regulate and monitor narcotics prescriptions. PrescribeIT has introduced some complications with this process and there's a potential risk of one prescription being used twice at different pharmacies. Have you had any issues with narcotics abuse/over-prescribing with PrescribeIT?
Dr. Daniel Pepe
Family Physician – Past Peer
One of the challenges in Ontario and other provinces is that if we want to send a prescription directly to a pharmacy at present, we rely on fax. A challenge I have encountered is that this often means - failed faxes, multiple faxes back and forth for clarifications when a dose is increased/ decreased and challenges when patients are due for an early release or should not have medications released early.
I’ve found quite frankly that patients who have prescriptions filled by PrescribeIT are much safer than our current framework for the following reasons:
- All drug data is transmitted electronically and not just an image as in a traditional fax
- I’ve never had a PrescribeIT transmitted script used twice. And frankly, this is impossible. PrescribeIT transmitted scripts are sent once, to a single pharmacy and are always received.
- We also receive dispense notifications of when a script was filled, this option has not been available to us before. It provides enhanced safety as I can be certain when a prescription is dispensed — the information I’ve never had before.
In Alberta, prescription requests usually go through MOAs (medical office assistants) BEFORE they cross the desk of a physician (well over half are declined before the doctor even sees them). With PrescribeIT, the workflow bypasses the MOA and goes straight to the physician. Has this increased workflow toward the physician been a problem at your office?
Dr. Daniel Pepe
Family Physician – Past Peer
With regards to the prescriptions going through the MOA this is very common and the default workflow in nearly all offices in Ontario. This has not been an issue for us at all for a few reasons:
- MOA’s no longer receive, scan/ file, label and message physicians for prescriptions
- Renewals are processed simply using an “approve” or “approve all” button by the physician which saves time in having to select individual medications
- Lastly, the cost of faxing has been reduced as I now receive 40-50 less fax pages per month (a small but a noticeable improvement which will increase when adoption increases).
Please consult this document to learn more about PrescribeIT for TPP Alberta.
How can we fund a sustainable business model for pharmacists to help deprescribe. Can the funding for MED reviews go beyond matching drug lists and actually reward programs like Andy's that will integrate into circle of care for seniors at risk due to polypharmacy?
Andy Donald
Pharmacist
It is exciting that new technologies such as ClinicalConnect and ConnectingOntario, along with PrescribeIT, are helping to eliminate health care siloing in the community setting. This is making more comprehensive reviews and personalization of medications possible, a necessity in helping to combat polypharmacy and medication overuse that is problematic in our publicly funded health care system. Unfortunately, there does not seem to exist any funding for deprescribing or medication optimization funding yet from the government as it is still a very cutting edge and new concept. It will likely take a lot research and statistics to encourage the government to fund such a game changing program within our health care system. Unfortunately, this becomes a chicken or the egg story as it is not viable for many pharmacies to launch such initiatives if there is not adequate reimbursement for your efforts.
Are all the pharmacies in Ontario registered or connected with PrescribeIT? If you have used it, is it better than what is available now? How much does it cost to register for it?
Christine Fitchett
Nurse Practitioner
I have been using PrescribeIT for over a year and can say that it has made my practice workflow seamless. Our previous use of auto-faxing was always causing headaches. PrescribeIT allows me to manage and track my own prescriptions and communicate directly with the pharmacist.
PrescribeIT currently has launched in select communities in Ontario, Alberta, New Brunswick, Saskatchewan and Newfoundland and continues to roll out across the country. There are no fees to prescribers.
Is Oscar based EMRs on the radar for PrescribeIT integration?
Andy Donald
Pharmacist
Oscar PRO are now fully functional with PrescribeIT. From what I understand often the main hurdle in getting software onboard with PrescribeIT is to ensure there are sufficient privacy and safety protocols to conform to regulations. The Well Health and Kai Innovations instances of Oscar PRO have done this, with a full rollout expected soon.
And, as my colleague Dr. Pepe points out, be it for Oscar EMR or other platforms the single most important thing users can do is emphasize the importance of the integration of technology like PrescribeIT in their EMR.
One hesitation I have to implementation is holiday coverage. I may have a Locum cover & need temporary old-style faxing resumed. Is this possible?
Dr. Daniel Pepe
Family Physician – Past Peer
For the first few months of using PrescribeIT I had my colleague cover my practice by faxing prescription requests even though I am utilizing PrescribeIT. I wouldn’t consider this a barrier but would love to clarify this if you have more questions!
Does the requesting pharmacy have to be a PrescribeIT client in order for the program to work on the physician's end?
Christine Fitchett
Nurse Practitioner
In your EMR, you will have the option to select when writing your prescription “draft, post only, print, fax or e-Sign and Send.”* If the Pharmacy you select is a part of PrescribeIT — the e-Sign and Send will be highlighted. If the Pharmacy is not yet a part of PrescribeIT, you can select one of the other options.
PrescribeIT® integrates seamlessly into electronic medical records (EMR) and pharmacy management systems (PMS), enabling prescribers to digitally transmit prescriptions to pharmacies. Transmission is secure, private, and directed to the patient’s pharmacy of choice.
*Please note the exact wording might differ across various EMRs.
Is pharmacy paying any fee to sign up for PrescribeIT? Any monthly or annual fees involved?
Andy Donald
Pharmacist
At the moment there are no fees charged to pharmacies for the foreseeable future. Currently, the program is fully funded by Health Canada. Eventually the plan is to have this program sustain its costs through slight fees to be charged to pharmacies for both new or renewal e-prescriptions. The fees will be charged on a per use basis and we will have lots of warning as to when these fees will start.
If I decide to add PrescribeIT to my EMR (Indivicare) do my colleagues have to as well or can I choose to use it myself only? Would there be any problems with my colleagues using the fax feature of our EMR? Also, is there a charge for using this tool?
Dr. Daniel Pepe
Family Physician – Past Peer
Thanks so much!
When I started to use PrescribeIT in my office I was the first to add the service. Other physicians were not signed up for PrescribeIT in my office at the time and did not need to use it. Needless to say, quickly after I adopted PrescribeIT there was a wave of other physicians in my office who followed. There are no issues with your colleagues using the fax in your EMR. We continue to use fax and PrescribeIT alongside each other as many services still require a fax.
There is no charge! Let me know if you have more questions. Over the weekend I had two consecutive days where all prescriptions were sent through e-prescribing and it took about 50% less time than it currently does for me using a traditional fax.
If there is an 'oops,’ where a medication is prescribed in error, is there a 'recall' function?
Christine Fitchett
Nurse Practitioner
Great Question! There is not a recall button, but Prescribers are able to cancel an existing prescription and issue a new prescription. However, PrescribeIT does not support a function to alter or modify a prescription after it has been sent.
A wonderful component of PrescribeIT is its clinical communications feature which allows prescribers and pharmacies to exchange secure messages through their electronic medical records and pharmacy management systems to discuss medication related issues or questions.
Is PrescribeIT helpful when you're prescribing from home or away from the office?
Dr. Daniel Pepe
Family Physician – Past Peer
Yes, it is incredibly helpful especially when you are away from the office. PrescribeIT ensures that the prescription arrives without question when you are at home or away from the office and don’t have time to deal with failed faxes. It’s also incredibly helpful when we receive requests from pharmacists as we don’t need to read what the fax says and then prescribe the medication. We are simply given the option to approve the script and send it off. When I am processing my own prescriptions I usually tackle the PrescribeIT renewals first as they are the fastest to do!
How has PrescribeIT integrated within your existing workflow? How does it compare to traditional paper/fax prescriptions?
Andy Donald
Pharmacist
PrescribeIT integrates doctors’ e-prescriptions directly into Kroll, our pharmacy software. The prescriptions sent from physicians pop directly into our workflow. It has definitely helped improve our workflow as it reduces scanning and entering times required for inputting prescriptions, while also reducing the risk of transcribing errors. The prescriptions pop into your workflow exactly the way the doctor entered it, instead of having to be first interpreted by a pharmacy team member. The ability to use secure messaging between the pharmacy and prescribers increases the efficiency of the process as well.
Can you prescribe narcotics through PrescribeIT? Can you still fax or print prescriptions if needed?
Christine Fitchett
Nurse Practitioner
Of course! PrescribeIT allows prescribers to electronically prescribe medications including narcotics, compounds and devices such as lancets and blood glucose test strips.
If a patient’s preferred pharmacy location is not yet connected to PrescribeIT, prescribers may continue to use their previous method of prescribing (i.e. print or fax)
Does PrescribeIT use a different technology than fax? Is it free or are fees involved in using?
Dr. Daniel Pepe
Family Physician – Past Peer
With regards to the technology used, PrescribeIT is different from a regular fax which is sent from the primary care provider to the pharmacy as an image which is then re-entered at the pharmacy. With PrescribeIT we are sending actual prescription data to the pharmacy reducing the risk of medication errors but removing a traditional data entry step that pharmacists would need to carry out. The other nice thing is that the data which is sent does not end up in a stack of paper where it may be visible to individuals who are not prescribers or the pharmacists. As such there is an added layer of security. Lastly, Health Canada has provided seed funding to launch PrescribeIT which will subsidize the cost of the technology for several years.
Does PrescribeIT transmit any of the patient's supporting information (such as a diagnosis)?
Andy Donald
Pharmacist
Like regular faxed or paper prescriptions, the initial e-prescription transmitted to the pharmacy from doctors does not include a diagnosis unless the doctor includes it. However, the clinical communications feature in PrescribIT allows you to securely message the doctor directly through your pharmacy software to their EMR. It's great as you can skip the line and delays associated with faxing requests and speak directly with the physician. This definitely is easier and has improved turnaround time on getting responses.