IHS e-Prescribing Tribal Best Practices Conference Salt Lake City, UT July 22-26, 2012

1. IHS e-PrescribingTribal Best Practices ConferenceSalt Lake City, UTJuly 22-26, 2012 Lori Moore, Pharm D. IHS e-Prescribing Federal Lead USET Pharmacy Consultant Office of Information Technology (OIT) Carla Stearle, Pharm D, BCPS USET Pharmacy Consultant Office of Information Technology (OIT)

2. Objectives • Receive an overview of the IHS e-Prescribing program including • Network infrastructure • Requirements to participate • Deployment process • Compare and Contrast the differences between the CMS Meaningful Use (MU) program and the CMS e-Prescribing Program (MIPPA) • Review statistical trends associated with e-Prescribing including National Statistics and IHS statistics

3. IHS RPMS/EHR E-Prescribing Functionality Today…. New Rx (Retail Pharmacy)

6. IHSe-Prescribing Network Cont…

9. e-Rx Phase 1 Sites

10. e-Rx Phase 2 Sites

11. e-Rx Implementation Requirements • Complete Readiness Form • Allows National e-Rx Team to track site progress with the required changes that must be in place including but not limited to: • Verify site has recent patches • Verify site has Nationally assigned Station Number • Provides number of providers using the system • Complete Drug File Optimization • Standard Drug File Names • Appropriate matching of drugs to NDF • Verify NCPDP codes populated • Verify dosages have been completed and optimized for all drug file entries • Ensure Orderable Items have been configured

12. e-Rx Implementation Requirements Cont… • Complete Agreements: • Business Associate Agreement (BAA) • Data Exchange Agreement (DEA) • End User Agreement (EUA) • Required for all Tribal and Urban sites wanting to participate on the e-Rx Network • Documents can be obtained by emailing your local Area CAC or the National e-Rx Team.

13. Deployment Planning Call

14. e-Prescribing Deployment Schedule

22. e-Rx HOTTopics MU e-Prescribing Measurement CMS e-Prescribing Program Established 2010 Incentives/Penalties Required Functionality Prescription Routing Established in 2008 Incentives/Penalties Required Functionality Prescription Routing Medication History Formulary Eligibility

23. CMS e-Prescribing Penalties • Must submit 10 claims with G8553 within the reporting period • Impacts Eligible providers billing Medicare B claim with E/M or psychiatric code

24. 2012 CMS e-Prescribing Program (MIPPA) Changes • Sites with RPMS Pharmacy package • Should be able to meet the new 2012 definitions for a Qualified eRx system as long as the providers are actively using EHR to order prescriptions that are electronically received/processed by the in-house pharmacy.  • Sites with NO onsite pharmacy • Will need to implement the new RPMS/EHR e-Prescribing functionality. • This new functionality will give them the ability to use the certified EHR to electronically transmit prescriptions from the local site to community pharmacy via the Surescripts network.  • At this time sites not using the new e-Rx functionality will not meet the definition of e-Prescribing since they are still writing/verbally communicating with the community pharmacies.  • Sites with an onsite pharmacy using a commercial pharmacy package • Will also need to implement the new RPMS/EHR e-Prescribing functionality to meet the requirements • The new functionality will allow them to use the certified EHR to transmit electronic prescriptions from the clinic side to the commercial pharmacy package using the Surescripts network.

25. e-Rx 2.0 Updates • e-Rx 2.0 • Anticipated release Spring/Summer of 2013 • Will require re-certification with Surescripts, LLC. before we can deploy • Aligns with Surescripts, LLC requirements & MU Stage 2 requirements • Anticipated development changes include (but not limited to): • New messaging version (Script 10.6) • New pharmacy directory version (Directories 4.4) • New Electronic Prescribing of Controlled Substances (EPCS) • New Refill Request/Response interface and improved workflow • New QA reports for e-Rx medications and active providers for local/central instances of Ensemble • Improved Transmission Failure Notification messages for providers

26. e-Rx Pharmacy Consultants OIT Mary Ann Niesen OIT Pharmacy Consultant Mike Allen OIT Pharmacy Consultant Carla Stearle OIT Pharmacy Consultant Lori Moore OIT Pharmacy Consultant USET Bob Adams (PEI) Sarah Michael (PEI) Preston Van Curen (PEI) Shelly Foster CRIHB Denise Vermilyea Alaska Carlene McIntyre

27. National e-Prescribing Team Lori Moore, Pharm D. USET/OIT National Pharmacy Consultant Federal Lead lori.moore@ihs.gov Carla Stearle, Pharm D., BCPS USET/OIT National Pharmacy Consultant carla.stearle@ihs.gov Gail Crane Deployment Project Manager (DNC Contractor) gail.crane@ihs.gov Sean Cook e-Rx Analyst (DNC Contractor) sean.cook@ihs.gov

28. Questions?

29. E-Prescribing & Surescripts Provider Identifier (SPI) Number

31. Drug Description Examples Note: The free text drug description string is 105 characters in length and should be populated with the “drug name”, “strength”, “strength qualifier” and the “dosage form” in the same exact format. E.g.: Amoxicillin 500 mg Oral Capsule

32. SIG/Notes Examples

33. Quantity Qualifier Examples

34. Types of Sites

35. Types of Sites Cont…

36. Types of Sites Cont…