E-PRESCRIPTION is more advantageous than paper prescription.

1. E-PRESCRIPTION
Good Bye To The Doctors’
Scribbles
Prepared by
Suganthi.S
M.Pharm I-Year
Pharmacy Practice

2.  The prescription is a written order by the doctor to the pharmacist to
make and dispense the medicines for a patient.
 Prescriptions are personal and unique for a patient which should
not be shared with other patients with similar conditions.
 The prescription has details of prescriber, patient and signature of
the prescriber.
PRESCRIPTION

3.  The superscription symbol Rx in a
prescription is a Latin abbreviation of
the word Recipe meaning "you take".
The body of the prescription contains
abbreviated diagnostic details of
patient's condition, name of
medication and dosage instructions.
 Prescriptions are given the status of
legal document and are to be
preserved by the dispenser and also
stamp the dispensed prescription as
dispensed in order to avoid re-
dispensing
Standard prescription specimen

4.  The doctors in olden days were writing prescriptions in a sign
language so that the patients should not get familiar with
medicines name and treatment details just to avoid self
medication.
 The communication between doctor and pharmacist was a
guarded secret whereas pharmacist was able to understand what
doctor had written in the prescription. The doctors were using self
created abbreviations and sign language as per their style and
wish which used to cause chaos if the patient took the prescription
to a new place or different pharmacy.
DRAWBACKS OF PRESCRIPTION

5. What’s wrong
with paper
prescriptions?

6. There are serious implications arising
due to illegible prescriptions
 In accuracy in writing
 Incomplete writing or insufficient information
 Use of non-standard abbreviation
 Unintended omission
 Failure to stop a day timely
 Dose error
 Dosage form error

7. 7,000 Deaths
occur each year in the
United States due to paper
prescription-based adverse
drug events, including:
• handwriting illegibility
• incorrect dosing
• missed drug-drug or drug-
allergy reactions

8.  Computerized physician order entry (CPOE) is the process of a
medical professional entering medication orders or other physician
instructions electronically instead of on paper charts. A primary benefit of
CPOE is that it can help reduce errors related to poor handwriting or
transcription of medication orders.
 CPOE systems are often used in tandem with e-prescribing systems,
which alert physicians and clinicians to a particular patient's drug allergies
and current medications. CPOE systems were formerly frequently sold as
standalone systems.
CPOE

9.  E - Prescriptions are prescriptions
filled in computers by the physicians
or physician assistants under the
supervision of the physicians and
transferred to a
pharmacy electronically with all details
of patient, prescription medicines,
special instructions along with doses.It
was a secured information exchange
system.
E-
PRESCRIPTION

10.  For example, the RMP writes an e-prescription which automatically gets
transferred to the pharmacy and the prescription is read and understood
before making a dispensing package. The patient when arrives at the
pharmacy, he/she can get his/her medicines with counselling as pharmacist
had time to think before the patient arrives to pick the medicines.

11. THE BASIC COMPONENTS
 Prescriber
 Transaction hub
 Pharmacy with implemented electronic prescribing software
 Pharmacy Benefit Manager (PBM)
MODEL

12.  Process Description:
1.The physician’s patient list or patient schedule (for next day) is
provided to the selected e-Prescribing vendor to be used for
verification of eligibility, formulary and drug history. This patient data
is stored as secure data during the execution of an electronic
prescription.
2.The vendor uses the data provided by the physician to request the
eligibility, formulary and drug history for a patient from the patient’s
payer or Pharmacy Benefit Manager.
3.The PBM checks for a matching member in their system and
provides the appropriate data back to the e-Prescribing vendor for
use during the patients visit.

13. 4. The physician now has all of the information needed to confidently
write a prescription at the point of care utilizing the e-Prescribing
package that connects real time to the vendors secure data centre.
5. The prescription is sent via Fax to the appropriate pharmacy where it
is filled and ready to be picked up by the patient. The physician also
has the option to print the prescription in the office for the patient to
take to the pharmacy of their choice.
6. Once the prescription is filled, the pharmacy submits a claim to the
PBM for payment. This claim will then be part of the drug history
provided to the physician the next time the patient is seen.

14. Pharmacy (retail or mail)
E-RX
Vendor
Histo on
mati
ication for
yIn
Med
ular
t
Form
tLis
Patien
Printed
Prescription
Practice
Physician Management
System
PBM
Eligibility,
Formulary
History based on
requests
submitted by
vendor
Printed
Prescription
Electronically Submitted
Scripts (EDI or Fax)
Pharmacy (retail or mail)
Physician
E-RX
Vendor
E-RX
Vendor
Practice
Manageme
nt System
Pharmacy Claims to PBM
for payment
PBM
e-Prescribing Process
Flow & Conceptual Data
Flow Diagram
1
2
Eligibility Requests based
on
patient lists from Physicians
Data being transferred:
• First Name
• LastName
• Date of Birth
• Member ID
• Member Plan Information
3 & Medication
4
5
6

15. A "qualified” e-prescribing system must be capable of performing all of
the functions
 Patient identification
 Generating a complete active medication list, possibly incorporating
electronic data received from an insurance provider
 Printing prescriptions
 Electronically transmitting prescriptions to a transaction hub
FUNCTIONS

16.  Access to patient historical data
 Prescribe or add new medication and select the pharmacy where
the prescription will be filled.
 Conducting all safety checks using an integrated decision support
system, known as a Drug Utilization Review. Safety checks
include: automated prompts that offer information on the drug
being prescribed, potential inappropriate dose or route of
administration, drug-drug interactions, allergy concerns, or
warnings of caution

17. e-prescriptions are better than the
conventional prescriptions
 The e-prescription is safe, secure and system based where there
is little chance for human based errors of dispensing.
 As the prescription is transferred electronically, it can reach
pharmacy much early which gives enough margin time for the
pharmacist to plan dispensing. There are no issues of illegible
prescriptions and the errors associated with conventional
prescriptions..

18.  Improving patient safety and quality of care
 Reducing time spent on phone calls and call-backs to
pharmacies
 Reducing time spent faxing prescriptions to pharmacies
 Automating the prescription renewal request and authorization
process
 Instant notification of allergies, drug interactions, duplicate
therapies and other clinical alerts
 Increasing patient convenience and medication compliance
 Allowing greater prescriber mobility
 Improving drug surveillance/recall ability
BENEFITS OF E-
PRESCRIPTION

19.  Reduces the number of lost prescriptions
 With e-prescribing, physicians can track how many
controlled substance prescriptions a patient has
received

20.  In India some private hospitals started using electronic prescription.
But a major step was taken by government of West Bengal in August
2014 when they started the process of issuing e-prescriptions
instead of hand-written instructions in top government hospitals. The
biggest advantage of the system is that a patient has all his medical
data stored in the server of state health department which can be
referred to in future. In the private sector number companies have
initiated to build software to support Electronic Prescription in India.
ERXPAD.COM is one among the pioneer player offer cloud based
electronic prescription software ( erx) in India.

21. THANK YOU