Using ePrescribe in TherapyNotes

A clinician who has successfully enrolled in TherapyNotes ePrescribe will be able to manage new prescriptions and refill requests and look up pharmacy benefits, formulary information, and medication histories for patients via the Surescripts® network.

  1. Overview of the eRx tab
    1. Demographics Panel
    2. Add/Edit Drug Allergies
    3. Add/Edit Pharmacies
    4. Coverage Details Panel
    5. Medications Table
  2. Managing and Prescribing Medication
    1. Managing Medications
    2. Prescribing Medications

Overview of the eRx tab

Role Required: Clinician with Medication Management type AND successfully enrolled with ePrescribe

Click Patients > Patient Name > eRx tab

The eRx tab is only visible to users authorized to use the ePrescribe features, and only for patients assigned to the clinician. This tab is the main location for managing your patient medications. 

Demographics Panel

In the Demographics panel, you can confirm the patient demographic information that will be used as part of ePrescribe. Open the panel by clicking the arrow on the top right.  You can confirm the patient’s name, date of birth, age, address, and phone numbers. You can update any of these items by clicking the  Edit icon on the Info tab in the patient chart.  If the patient is under 18 years of age, use the Edit Height and Weight link to document these items, which are required as part of the prescribing process. If the patient's height and weight have already been entered and saved in the Vital Signs section of their note, this data will automatically populate in ePrescribe.

Add/Edit Drug Allergies

Use the  Add/Edit Drug Allergies button to document the presence or absence of drug allergies for your patient. If your patient does not have any known drug allergies, simply select the No Known Allergies checkbox and click the Save button.

To document a drug allergy, begin typing in the  Name field to find the medication your patient is allergic to, then choose the allergy Status and Reaction Type from the dropdown menus. In the Reaction field, you can document specific information about the patient’s reaction to the medication. You can also document when the allergy was first discovered in the Onset box, if desired. Click the Save button to add the allergy to the patient record. Repeat this process to document all drug allergies for your patient.

You can click the  Edit button within an existing drug allergy to update its information or click the “X” to delete the drug allergy altogether. When you have finished documenting drug allergies, click the Close link to close the Add/Edit Drug Allergy panel. All documented drug allergies will be displayed in the Demographics (patient information) panel.

Note: The system will perform drug-drug interaction and drug allergy checks. The system will NOT perform checks against drug ingredients or non-drug allergies. Carefully review your patient’s allergy history when prescribing any medication.

Add/Edit Pharmacies

Use the  Add/Edit Pharmacies button to manage your patient’s preferred pharmacies, both local and mail order. Use the name (first 3 letters), address, phone number and specialty fields to search for a pharmacy. The Specialty dropdown allows you to search for specific pharmacy characteristics, such as 24-hour, mail order, or specialty. The Search by Patient button uses the patient’s address to locate pharmacies automatically. You can also select the Map View checkbox at the top of the results to see a map and choose a radius within which to locate pharmacies. If you select multiple pharmacies for a patient, the "default" selection will appear on all new prescriptions. If no pharmacy is selected, you will be prompted to select one before you are permitted to send a prescription.

Be sure to select the  EPCS checkbox to ensure the pharmacy can accept and fill electronic prescriptions for controlled substances, if needed. Click the Search button to see a list of participating pharmacies, then select the appropriate one from the list. 

You can add multiple pharmacies for each patient. If you do so, you can use the checkbox to set one of the pharmacies as the default for the patient.

When you have selected the pharmacy/pharmacies you will send prescriptions to for the patient, click the  Close link to close the Manage Patient Pharmacies panel. The default pharmacy information will display in the Demographics panel.

Coverage Details Panel

Use the  Coverage Details panel to look up pharmacy benefits for your patient. This may include information about preferred pharmacies and other prescription benefits. 

The  Plan dropdown menu lists Surescripts® network plans in which the patient is enrolled. If multiple policies are on file, use this dropdown to switch between plans.

Clinicians can view coverage for retail, specialty pharmacy and mail-order prescriptions for the plan chosen in the  Eligibility section within the panel.

The  View Demographic Information link at the bottom of the panel allows clinicians to view demographic information associated with the patient's insurance on file to check for discrepancies.

Note: A warning about demographic data discrepancies will appear for some patients because this panel displays Surescripts® network plan information, which will look different than TherapyNotes payer data.

Medications Table

The  Medications Table displays your patient’s medications. The default view is Active Medications – these are medications your patient is actively taking. When a medication has been completed or otherwise discontinued, it will be on the Inactive Medications tab. You can use the Search bar within the Medications Table to search for a particular medication.

Both the Active and Inactive Medications tabs have  Simple and Detailed views, allowing you to review medications at a glance or see additional information, if desired. Each column in the Medications Table is sortable, allowing you to view the data alphabetically or chronologically, and to sort medications by Status. To sort, click the arrows next to the column heading.

The  Medication History tab allows you to view medications prescribed by both you and other providers and to see the patient’s prescription history from the Surescripts® network. From the history, you can import active medications by clicking the Add button. However, the medication will appear as a patient-reported medication, so you will not be able to refill it. 

Managing and Prescribing Medication

Managing Medications

Add Patient Reported. Patient-reported over-the-counter medications and medications prescribed by other providers can be added to your patient Medications Table through two views: Simple or Detailed, which appear after you click the Add Patient Reported button.

Simple view allows you to simply type the name of the medication and add it to the list. This option is helpful when the patient does not remember the exact name of the medication (“a little yellow pill”) or reports taking something not listed in the compendium, such as some supplements. Select the desired medication, then click Save.

Detailed view allows you to quickly add more specific information about the medication in a 3-step process:

  1. Search for the medication. Begin typing at least 3 characters to see a list of medications. Select the appropriate medication name and dosage form. If you cannot find the medication you are looking for, switch to the Simple view.
  2. Select the strength of the medication the patient needs.
  3. Complete the remaining information fields as needed. Each field is optional, so incomplete or unavailable information is acceptable. When finished, click the Save Medication button.

Medication History. You can use the Medication History tab to search the Surescripts® network for previously prescribed medications.

Once you have secured patient consent to obtain their medication history, select the patient consent checkbox and click the  Show Medication History button. It may take a few minutes to return results. You can navigate away from the Medication History tab and return later to view results, if desired, because the search will continue running in the background.

To add a prescription from the Medication History, click the  Actions button next to the desired medication and then click Add Prescription.

Tip: A verbal authorization or consent from the patient is all that is needed. HIPAA allows for information exchanges such as this as part of the coordination of care for patients.
Note: Be sure to review the medication history results with your patient to confirm their accuracy. Add any medications not returned in the search through the  Add Patient Reported button. This search will only return results for prescriptions processed via the Surescripts® network. Certain medications, such as OTC medications or others paid for out-of-pocket, may not appear in the list. A person icon will display under  Status for patient-reported medications. 

Prescribing Medications

Click the  Add Prescription button to begin the prescribing process. In the Add Prescription panel, begin typing the name of the medication you want to prescribe. After you enter at least 3 characters, a list will appear. Continue typing to refine the list options, then click on the list item that accurately reflects both the medication and dose form.

Next, click to choose the desired  Strength.

After adding the strength, a panel for  Real Time Pharmacy Benefits (RTPB) will appear where you can view the Plan Selected for This Medication, add Pharmacy Information, and view Formulary Status. By clicking the Refresh button next to Formulary Status, you can view Patient Specific Pricing Coverages, and for some medications, view Payer Alternative Medications or Therapeutic Alternative Medications.

Fill in the rest of the required fields. For the  Effective Date, you can click the Today button to automatically enter today’s date, or choose a date less than 6 months from the current date.

If more than one  Diagnosis is selected, you can choose Primary and Secondary diagnoses.

You can add  Pharmacy Notes by clicking Show Pharmacy Notes and typing notes into the field. You can also use the Insert Common Note dropdown to automatically fill the Pharmacy Notes box with common notes.

If indicated, you can click  No Substitutions and/or Urgent, or if desired, Save as Favorite. Save as Favorite will add the drug, including your instructions, to a list of medications you commonly prescribe across patients, allowing you to add it for a new patient simply by clicking it in your favorites list.

When finished, click  Save Prescription.

If you enter a brand name drug and a generic version is available, you will get a message asking if you want to Switch to Generic. If you choose this option, the change will be made and you will be taken back to the prescription to review it, and you will need to save it again. The same popup also gives you the option to choose Allow Substitutions or No Substitutions. You will also be taken back to the prescription to review and resave if you select either of these options. 

Prescribing controlled substances. If you prescribe a controlled substance (EPCS), you will need to provide your PIN and complete two-factor authentication (2FA) when you sign the prescription. (Note that once you have defined your PIN, you will be prompted to enter it for all prescriptions.) Select the Ready to Sign checkbox. Next, input your PIN and 2FA code from DUO Mobile . You may also choose to complete 2FA using the "Send DUO Push" option instead of entering a passcode. Click "Approve" in DUO; you will see a green banner with "Authenticated" if successful.

After you approve and send a prescription, it will appear under  Pending Medications. You can Select All or check off individual prescriptions as desired, then click Approve and Send to submit electronically, or Approve and Print to print a copy. You can also change the pharmacy for pending medications by clicking Change Pharmacy at the bottom of the panel, or click the gray Actions button to the right of each drug to edit, delete, or change the pharmacy for the selected drug.

Repeat this process to add as many prescriptions as needed for the patient.

Tip: Any  Alerts from "Pending" Medication will appear in a box at the top of the patient's eRx page. Drug interaction alerts are color-coded based on the severity of potential interaction. Click the interaction to view details in a popup window. There is an option to print the information from this popup. 

After a prescription is approved and sent, it will appear under  Active Medications in the Medications Table. You can view the prescription's current status in the Status column of the table. Statuses include Sending (arrow symbol), Sent (green check mark), Pharmacy Verified (green Rx symbol), and Printed (black and white Rx symbol).

You can reorder, remove or reprint prescriptions for active medications by clicking the gray  Actions button. If you choose to discontinue a medication, you can note why the prescription was ended.

Under the Medication column, you can click the drug name to view the monograph, or click to  View Pharmacy or View Prescriber.

Tip: An eRx icon for ePrescribe notifications will appear next to the User Icon at the top right of your screen, and there will also be a link to eRx notifications at the bottom right of your staff eRx page. eRx notification categories include New, Pending, Pharmacy Requests and/or Transmission Error, which will appear in red.

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