Prescription Rules (Company Settings)

Prescription Rules and Settings are database switches/triggers/ID's etc... that apply to the prescriptions module within the EMR. These settings allow our application to work differently from one practice to the next.  This article will explain how to access and set these values.

Prescription Rules and Settings Setup Window

1. Login to the application as a user that has administrative privileges.
2. Navigate to the EMR portal.
   
   
3. Search for and open a test patient.
   
   
4. Click on the Medications/Prescriptions Chart Tab.
   
   
5. Right-Click to the right of the Rx Pad and select the Prescription Rules menu option.
   
   
6. Search for a rule/setting name or select a Group.
   
   
7. Modify the rule or setting as appropriate.
   
   
8. Press the Close button when you're done.
   

The 'RxFill Indicator' prescription setting sets the default Fill Status for new prescriptions in the EMR. The Fill Status is sent on new electronic prescriptions, and indicates to participating pharmacies which Rx Fill messages to send for the prescription.

Default Value:  All Fill Statuses

Options: 

• All Fill Statuses
• All Fill Statuses Except Transferred
• Dispensed and Partially Dispensed
• Not Dispensed and Transferred
• Partially Dispensed
• Not Dispensed
• Cancel All Fill Statuses

This setting determines how the medication search feature works on the OfficeEMR Mobile application. When enabled, a "wild card search" is performed. This means that when a search is performed, the system will find drugs with the word that you typed anywhere in the medication name.  If this setting is off, the medication search will only find drugs with the exact name you typed. We highly recommend keeping this setting on.

Default Value: On

Options: 

• On - Wild card search is used
• Off - Literal search is used.

For practices that provide their patients with access to MyMedicalLocker (aka the Patient Portal), you have the ability to turn on or turn off the ability for a patient to request a refill of a medication that you prescribed.  When the setting is on, patients are provided with this option.  These requests will flow directly into the My Tasks > Prescriptions > Refills queue for you to review and approve.  When the setting is off, patients are not given this option.

Default Value: On

Options: 

• On - Refill requests are enabled for a patient in MyMedicalLocker
• Off -  Refill requests are disabled for a patient in MyMedicalLocker

For practices that provide their patients with access to MyMedicalLocker (aka the Patient Portal), you have the ability to turn on or turn off the ability for a patient to request a refill of a medication that you prescribed. If you have this setting on, you can set a threshold that determines if a prescription is automatically denied or not based on how long it has been since the patient's last appointment.  If you set the value to '3', this means the patient should have had an appointment within the last 3 weeks. If not, the refill request is auto-denied. You can control the message that the patient sees when this error occurs in Setup > MyMedicalLocker > Announcements.

Default Value: 0

Options: 

• 0 - No appointment threshold is set
• Number - The number of weeks for a patient's most recent appointment

For practices that provide their patients with access to MyMedicalLocker (aka the Patient Portal), you have the ability to turn on or turn off the ability for a patient to request a refill of a medication that you prescribed. If you have this setting on, you can use this setting to recommend pharmacies that you commonly use.  This is especially helpful if you have your own in-house pharmacy that you would like to make available for a patient when requesting a refill. You can add one to many pharmacies here by supplying a list of NCPDP ID's of the desired pharmacies.  Pharmacy NCPDP ID's can be found here: Setup > Pharmacies.

Default Value: blank

Options: 

• blank - nothing recommended
• NCPDP ID list

For practices that use the prescription pad, you can modify how the 'Days Supply' language displays:

• 0 = Abbreviate - will display as "30 d supply"
• 1 = Full text - will display as "30 days supply"

Default Value: 0

Options: 

• O = Abbreviated (d)
• 1 - Not abbreviated (days)

For practices that utilize the My Tasks Prescription Refill queue, you can decide if a user must first enter a PIN before approving a refill or not. If the setting is turned on, a user will be required to enter their 4 digit PIN number each time a prescription refill is approved, denied, or changed. If the setting is off, users will not be required to enter their PIN.

Default Value: On

Options: 

• On - PIN required
• Off -  PIN not required

For practices that utilize the My Tasks Prescription Refill queue, you may find it beneficial to have all refill requests and change requests assigned to one specific user rather than having these requests assigned to a group of users.  To direct all refill requests and change requests to a specific user, input the user ID into the setting. Otherwise, if left blank, prescription refill requests and change requests will be assigned to the RxRefill user group.

Default Value: blank

Options: 

• Blank - requests assigned to RxRefills user group
• User ID - requests assigned to the supplied user

For a user that decides to refill a medication from the Prescription History window, you may find it helpful to have the status of the prescription that you are refilling changed from New to Current without you having to make the change yourself.  Generally, medications with a status of 'New' will show up in the Plan portion of your note while medications with a status of 'Current' show in the Subjective portion of your note. If you would like for the prescription status of refilled medications to remain unchanged, turn this setting off.

Default Value: On

Options: 

• On - Refilled medications will be changed from New to Current
• Off -  Refilled medications status will remain unchanged

For practices that send prescriptions electronically to pharmacies, some edge scenarios may require you to change if the 'RxCode' field value is sent in the electronic message.  In general, users should not update this setting unless they are absolutely sure of the impact.

Default Value: On

Options: 

• On - RxCode value sent
• Off -  RxCode value not sent

For practices that send prescriptions electronically to pharmacies, some edge case scenarios may require you to change the Minimum Action Days Setting. In general, users should not update this setting unless they are absolutely sure of the impact.

Default Value: 1

Options: 

• 0 = Off, no minimum action days
• Number =  the number of minimum action days

For practices that print out prescriptions,  some edge case scenarios may require you to change how the Prescriber Signature Line is generated on the print layout.

Default Value: 1

Options: 

• On = 
• Off = 

For practices that print out prescriptions using non-custom Rx Layouts, this setting will determine if the image stored in Provider Setup displays on that printed layout.  If on, the image will be displayed, otherwise, it will not.

Please note, most practices are not configured to use non-custom Rx Layouts.  Practices are usually set up with 'Custom' Rx Layouts which means that this setting does not apply.

Default Value: Off

Options: 

• On = Image displayed
• Off = Image not displated

For practices that print out prescriptions, the prescription may be printed through our legacy 'Report Viewer' window or via our new modern 'PDF Layout' window. It is recommended to have this setting on so that more modern technology is being used.

Default Value: On

Options: 

• On = PDF Layout used
• Off = Active Report Viewer used

For practices that send prescriptions electronically to pharmacies, some groups may need to modify which practice name is submitted on the electronic prescription. By default, the practice name stored in the Provider Setup screen for the prescribing provider will be sent.  However, you may alternatively choose to have the practice name stored in the Company Setup screen instead.

Default Value: Off

Options: 

• On - Company Profile is used to determine the practice name
• Off -  Provider Setup is used to determine the practice name

For practices that send prescriptions electronically to pharmacies, some groups may need to modify which address is submitted on the electronic prescription. By default, the address stored in the Provider Setup screen for the prescribing provider will be sent.  However, you may alternatively choose to have the address retrieved from the Company Setup screen.

Default Value: Off

Options: 

• On - Company Profile is used to determine the address
• Off -  Provider Setup is used to determine the address

For practices that send prescriptions electronically to pharmacies, some groups may need to modify which phone numbers are submitted on the electronic prescription. By default, the phone numbers stored in the Provider Setup screen for the prescribing provider will be sent.  However, you may alternatively choose to have the phone numbers retrieved from the Company Setup screen.

Default Value: Off

Options: 

• On - Company Profile is used to determine the phone numbers
• Off -  Provider Setup is used to determine the phone numbers

For practices that send prescriptions electronically to pharmacies, some groups may need to modify which email address is submitted on the electronic prescription. By default, the email address stored in the Provider Setup screen for the prescribing provider will be sent.  However, you may alternatively choose to have the email address retrieved from the Company Setup screen.

Default Value: Off

Options: 

• On - Company Profile is used to determine the email address
• Off -  Provider Setup is used to determine the email address

For practices that send prescriptions electronically or print a paper prescription, you may find it beneficial to increase or decrease the security protocols related to performing these actions.   The options are as follows:

• 0 - This is the least secure option. You will not be required to enter a PIN.
• 1 - This is more secure than the previous option. This will require the user to enter their PIN for the first prescription sent or printed after logging in. For every prescription thereafter, no PIN will be required.
• 2 - This is the most secure option.  This will require the user to enter their PIN for every prescription printed or sent.

Default Value: 2

Options: 

• 2 - All prescriptions require a pin
• 1 - Only the first prescription requires a pin
• 0 - No prescriptions require a pin

For practices that utilize the pharmacy search screen, you may choose to change how the pharmacy type is displayed.   The options are as follows:

• 0 - Don't display pharmacy product type
• 1 - Display pharmacy type abbreviation
• 2 - Display pharmacy type full name

Default Value: 0

Options: 

• 0 - Don't display pharmacy product type
• 1 - Display pharmacy type abbreviation
• 2 - Display pharmacy type full name

For practices that utilize the prescription screen, you may choose to change how the word 'Tiers' is displayed to conserve space.

• 0 - Display abbreviation for Tiers (t)
• 1 - Display full name (Tiers)

Default Value: 1

Options: 

• 0 - Display abbreviation for Tiers (t)
• 1 - Display full name (Tiers)

For practices that utilize the prescription screen, it is highly recommended that practices utilize the RxHub and the features that it enables.  RxHub is the connection that allows medication coverage information to be displayed as well as allows medication history data to be pulled from pharmacies. If this setting is off, these features are disabled. We strongly encourage you to leave this setting on.

Default Value: On

Options: 

• On - Use RxHub
• Off - RxHub is not used

For practices that electronically send medications to the pharmacy, in a few edge cases, it may be appropriate to send the following fields in the electronic message: DrugDBCode and DrugDBCodeQualifier.   Unless you truly understand the impact of this setting, it is recommended this remain unchanged.

Default Value: Off

Options: 

• On - Send additional fields
• Off  - Do not send additional fields.

For practices that utilize the prescription screen to view prescription coverage details, you may want to enable this setting so that a patient's secondary insurance plan name will display in the event that the primary insurance name is left blank.  Generally, practices do not need to change this setting.

Default Value: Off

Options: 

• On - Display primary insurance plan name even when blank
• Off - Display secondary insurance plan name when primary insurance plan name is blank

For practices that utilize the prescription screen to view prescription coverage details, you may want to enable this setting so that a patient's insurance plan ID displays next to the insurance plan name.  Generally, practices do not need to change this setting.

Default Value: Off

Options: 

• On - Display plan ID
• Off - Do not display plan ID

For practices that electronically send prescriptions to a pharmacy, you may want the application to interrogate the sig dosage field (i.e tab) to automatically set the Dispense Method (i.e. Tablets). When this setting is on, enhanced logic is used to automatically set this value. Otherwise, users are required to set the Dispense Method themselves.

Default Value: On

Options: 

• On - Set Dispense Method field based on Sig Dosage field
• Off - Do not set Dispense Method field

For practices that electronically send prescriptions to a pharmacy, you may want the application to interrogate the sig dosage field (i.e tab) to automatically set the Dispense Method (i.e. Tablets). When this setting is on, enhanced logic is used to automatically set this value. Otherwise, users are required to set the Dispense Method themselves.

Default Value: On

Options: 

• On - Set Dispense Method field based on Sig Dosage field
• Off - Do not set Dispense Method field

For practices that utilize the prescription screen to send or print prescriptions, it may be necessary to activate this setting so that these prescriptions automatically check local state rules related to Dispense As Written settings to ensure the correct message is displayed. It is recommended to leave this setting on.

Default Value: On.

Options: 

• On - Display plan ID
• Off - Do not display plan ID

For practices that utilize the prescription screen to electronically send prescriptions, the application has the ability to check the current operating status of each pharmacy you send a prescription to. The check ensures that the pharmacy is up and able to receive a prescription. If they are not, an appropriate error message with an explanation of why the pharmacy is offline will be returned.  Practices can turn this check off if needed, but is recommended to remain on.

Default Value: On

Options: 

• On - Check operating status
• Off - Do not check operating status

For practices that utilize the prescription screen to electronically send prescriptions, you may want to require users to have captured a patient's height and weight within the last 30 days before sending a prescription.  Doing so will ensure that the appropriate vital information is sent electronically with the prescription.  Otherwise, this requirement will only be enforced for patients 18 and younger.

Default Value: Off

Options: 

• On - All prescriptions require a recent height and weight on file
• Off - Prescriptions for patients 18 years and younger will require a recent height and weight to be on file

For practices that utilize the application to data related to a prescription fill status from the pharmacy, you may find it beneficial to only see a set number of Rx Fill Statuses. Use this setting to determine your preference.

The options include:

• All Fill Statuses
• All Fill Statuses Except Transferred
• Dispensed and partially dispensed
• Partially Dispensed and not dispensed
• Not Dispensed and Transferred
• Partially Dispensed
• Not Dispensed
• Cancel All Fill Statuses

Our recommendation is to leave this setting on 'All Fill Statuses' while you become used to the type of data that is supplied. Then, as you see fit, narrow your selection.

Default Value: All Fill Statuses

Options: 

• All Fill Statuses
• All Fill Statuses Except Transferred
• Dispensed and partially dispensed
• Partially Dispensed and not dispensed
• Not Dispensed and Transferred
• Partially Dispensed
• Not Dispensed
• Cancel All Fill Statuses