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Ask a Peer - Learn about PrescribeIT® from other health care professionals

Learn about PrescribeIT®
from other health care professionals

Explore Their Answers

 

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?

bubble greenAndy 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.

Currently, PrescribeIT can be integrated in with the following EMRS:

  • PS Suite
  • Accuro
  • Juno
  • Oscar Pro
  • Med Access
  • Wolf
  • EMR Advantage
  • Indivica
  • Medfar Clinical Solutions
  • Intrahealth
  • MicroQuest
  • P&P Data Systems
  • Omnimed

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.

For more information please refer to this link.

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!

bubble greenAndy 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.

bubble greenAndy 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?

bubble greenAndy 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!

bubble greenAndy 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

bubble greenAndy 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?

bubble greenAndy 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.

bubble greenAndy 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?

bubble greenAndy 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.

Ready to integrate PrescribeIT® into your workflow? Get started today!

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