Healthcare Business DEMYSTIFIED

de mys ti fy - to make less mysterious, clarify

What is E-Prescribe?

E-Prescribe is an electronic system designed to send your prescription directly from the doctor's computer to the computer at the pharmacy.  It is designed to increase efficiency and require less intervention by office staff.  Before E-Prescribe, your doctor would write your prescription on a paper form and hand it to you before  you left the office.  The doctor recorded what he or she prescribed to you in your chart.  If you needed a refill later on, office staff would pull your chart from the file room and give it to your physician so they could review what they had given you in the past.  The refill prescription could then be called or faxed into the preferred pharmacy for you to pick up.  If you had the prescription in hand, you would take it to your pharmacy and wait for it to be filled.  E-Prescribe automates this whole process and makes it more efficient. 

E-Prescribe is designed to help your doctor keep track of any changes in your prescription as the software is connected directly to the electronic health record (EHR) (see under Topic section "Why does my doctor use a computer in the exam room?").  Any new prescriptions, or changes to current prescriptions, are instantly recorded in the EHR.  This contributes to a higher level of accuracy in the recorded information and also allows your physician to instantly access the information without the need to have staff pull a chart.

E-Prescribe is a great idea and has a lot of potential to be a powerful tool for all healthcare workers.  It is important to understand both its potential and current shortcomings to better use it to your advantage as a patient.

I mentioned earlier that E-Prescribe was a direct line of communication between your doctor's computer and the pharmacy.  That isn't exactly true.  Once your doctor presses send on his or her computer, the prescription is sent to a clearinghouse to be processed and routed to your local pharmacy of choice.  In a perfect world you would think that after your doctor presses send, the prescription goes directly to your pharmacy where they immediately retrieve it from the computer and fill it.  You could then stop by on your way home and pick up your prescription.  The current truth is that the process can take a couple of hours.  Your prescription can spend an extended period of time in a queue at the clearinghouse waiting to be processed and sent on to your local pharmacy.  Once it arrives at the computer terminal at your local pharmacy, it has to be retrieved from the terminal and placed in a queue for filling.  Pharmacies are currently juggling  prescriptions coming in via several different modes of communication and it takes exhaustive energy to constantly check all of these avenues for any communications.  Some prescriptions are old-fashioned paper forms and they are being carried into the pharmacy by patients.  Others are called in by physicians or their office staffs.  The message is either taken live or recorded on an answering machine.  If it is an answering machine, someone needs to listen to the messages and take down the required information.  Other prescriptions are being faxed into the pharmacy and still others are coming in on the computer terminal.  A pharmacy staff person needs to be constantly checking all of these sources of communication in order to get all the prescriptions that are coming into the pharmacy.  As you can imagine, it is a difficult task for the staff person to constantly monitor all of these areas and still wait on customers.

Once you begin to understand the challenge that your local pharmacy staff is facing each day, you truly begin to marvel at their ability to juggle all of this information.  You can also begin to see that there are several places where your prescription can get hung up in the process.  At the clearinghouse, problems can arise and the prescription can be left unprocessed.  Many clearinghouses do not send a report back to the physician office that the prescription failed to move on to the pharmacy.  If the doctor or his staff goes into the clearinghouse and checks the status of the prescription, they will often be able to see that it was rejected but they will not know that unless they check.  It would be impossible for them to go in and check every prescription that was sent electronically to make sure it went through so if your local pharmacy did not get your prescription after a couple of hours, be sure to call your doctor's office to let them know that the prescription did not go through.  As far as they know, the prescription was successfully sent.  Partner with your pharmacy and doctor's office to make sure that the prescription did indeed make it to the pharmacy successfully.

(Further pharmacy tips can be found in Topics under the section "How can I lower my prescription costs?")