Use The Rx Fill History with e-Prescribing in Medisoft Clinical or Lytec MD

The Rx Fill History tab under the Rx/Medications section of the patient’s chart is a valuable tool that is designed to help physicians reconcile medication in order to prevent adverse drug interactions or overdose.

Note: The Rx Fill History tab is only available to providers enrolled in ePrescribing.

The Rx Fill History tab displays pharmacy fill events downloaded to your system from the patient’s Pharmacy Benefits Manager. This feature allows you to see details of what medications your patient is actually obtaining from pharmacies, whether they were prescribed by you or another physician.

You can obtain or refresh the fill history by clicking the Update Fill Hx button, which will initiate a live download of data from the patient’s Pharmacy Benefits Manager. (This feature is limited to what the Pharmacy Benefits Manager provides. It may not contain a complete list of all medications for any particular patient, and it may not be available for all patients.)

Once data has been downloaded you can view detailed information about a prescription by selecting the prescription from the list and clicking the Show Detail button. The Medication Fill History Detail screen will appear with detailed information about the prescription.

You can use the Fill History to update the Current Medications list by clicking the Add to Current Meds button.

Considerations Regarding Patient Privacy& Practice Liability:

It is up to the practice to make sure they are gaining patient consent before accessing a patient’s medication history through their e-prescribing/EMR software system. Surescripts does not provide any sort of form/template for gaining patient consent. As a network, Surescripts does not mandate how a prescriber obtains consent-whether this is done orally or in writing (although the prescriber must act in accordance with the applicable law where they are practicing).

Sample wording for a signed consent:

“I understand that performing a medication reconciliation in order to prevent adverse drug interactions and overdose is a critical component to my care. By signing this form I authorize my provider to query and review my medication fill history including drug, dose, form, strength, prescribing provider, and pharmacy.”

Optional Security Settings:

Access Levels can be used to limit access to the Rx Fill History features to only those users that should have access. Your system administrator grants or denies access to these features by going to Maintenance/Setup/Access Levels, selecting the access level and hitting the Edit button.

On the Records tab the “Rx Fill History Request” should only be checked for users that should have the ability to request the fill history information. And “Rx Fill History” should be checked for users that should have access to view the Rx Fill History tab of the Medications Screen.

By default the system is setup with the assumption that either a written or oral consent has been obtained, however there is a feature that can be enabled to require users to record in the patient record that consent has been obtained. This would prevent the download of fill history data for any patients that had no indication that consent had been obtained.

To set this feature up the Administrator must edit the ppart.ini file (Found in the ppart directory on the server), changing the current setting of “RxFillHxCheckConsent=OFF” to “RxFillHxCheckConsent=ON”

The next step is to create a new question under the patient demographics screen. The “Other Data” tab in the patient’s chart is a place where you can create custom fields to record information on a patient that is not otherwise tracked in the chart. We will setup a question on this tab to indicate whether or not the patient has given consent to obtain Rx Fill History.

Select Maintenance/Configuration/Define Other Data/Patient

When the Patient Define Other Data Select screen appears, click on the New button.

Enter Rx Fill Hx OK? in the Label field, select Text from the Type drop-down list, and select 1 Character from the Length drop-down list. Enter a Description and hit OK.

The Rx Fill Hx OK? field will now appear on the Other Data tab of the Patient screen.

You will need to establish a workflow where patients (or, for minor patients, their guardian) are informed that their pharmacy benefits provider provides information about the medications they have had filled at retail and mail-order pharmacies, and asked for their consent to request that data for medications prescribed by all providers, providers at your site, or not at all. You can enter the following values in the Rx Fill Hx OK? field based on the patient’s response:

– Enter “Y” if the patient gives consent for all providers.

– Enter “P” if the patient gives consent for providers at your site.

– Enter “N” if the patient does not give consent.

Note: The response must be entered in as a single character and must be in uppercase for the feature to work.