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Electronic Prescription Writing Solution

Posted on 2008-11-06
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Last Modified: 2013-12-17
Medicare is encouraging physicians to write prescriptions electronically.
http://medicare-medicaid.com/medicare/cash-for-electronic-prescriptions/
Many electronic medical record software packages offer electronic prescription writing but they are very expensive for small offices.
I would like to know if there is an inexpensive (less than $500 per year) software package that would meet this need.  I don't need deluxe features, just a way to write a standard prescription in an electronic format that I can transmit to pharmacy.  
Alternatively, is there anyone who knows the techical data regarding format and interface information so that I look into a homebrew solution, or higher a progammer.  
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Question by:rreiss60
10 Comments
 

Author Comment

by:rreiss60
ID: 22901412
I mean hire a programmer. Sheesh!
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Author Comment

by:rreiss60
ID: 22901754
I found the following in the Federal Register.  I guess the following list is the barebones requirements.

Use of Version 8.1 of the NCPDP SCRIPT standard for the communication of a
prescription or prescription-related information between prescribers and
dispensers, for the following functions, therefore constituted compliance with
the adopted e-prescribing standard:
" Get message transaction.
" Status response transaction.
" Error response transaction.
" New prescription transaction.
" Prescription change request
transaction.
" Prescription change response
transaction.
" Refill prescription request
transaction.
" Refill prescription response
transaction.
" Verification transaction.
" Password change transaction.
" Cancel prescription request
transaction.
" Cancel prescription response
transaction.
How difficult is something like this to do?
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LVL 39

Accepted Solution

by:
BillDL earned 1000 total points
ID: 22907408
I am not a programmer, so I can hardly offer a "solution" here, but I am always interested in things that are beyond my scope of knowledge ;-)

One thing I thought that you should be aware of, if you went down the route of hiring a programmer, is the following:

http://www.anshealth.com/faq.htm
http://www.anshealth.com/faq.htm#05 Why use the NCPDP Script Standard

>>>
"..... In the future, NCPDP plans to enhance the standard with messages that include lab values, diagnosis, patient drug profiles, DUR Alerts, and formulary inquires."
<<<

That could involve a complete re-compilation by a hired programmer, whereas a bespoke retail system would probably offer an update as and when the extra features became mandatory.

A Basic Guide to NCPDP Standards:
http://www.ncpdp.org/pdf/Basic_guide_to_standards.pdf

I found what looks like conversion software that COULD be of use and perhaps integrated into your standard Windows, MS Office, or other database software (site needs registration so I'm not sure what lies beyond):

http://ww2.pervasive.com/Integration/DemoCenter/Pages/TranslationNCPDPHIPAAHL7.aspx
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Author Comment

by:rreiss60
ID: 22913708
Excellent links.
Thank you.
I wonder if a computer science student might, either as part of a course/degree requirement or for a modest amount of money be willing to develop a software solution with me?
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Author Closing Comment

by:rreiss60
ID: 31514157
The solution pointed me in a helpful direction.
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LVL 39

Expert Comment

by:BillDL
ID: 22914648
Thank you, rreiss60, although perhaps closing the question may be a little premature.  I was hopeful that someone with some direct knowledge of this e-process may show up with suggestions based on hands-on experience.

Just some additional info to justify receiving points for something I know nothing about.  Maybe it will save you some time.

The NCPDP SCRIPT Standard now appears to be on version 10.4:

http://www.ncvhs.hhs.gov/080129p1e.pdf
http://www.ncvhs.hhs.gov/080522lt.pdf (May 2008)

Here's an interesting letter from the American Society of Health-System Pharmacists (ASHP) to the Drug Enforcement Administration (DEA) dated September 2008 and hosted on the site of the National Association of State Controlled Substances Authorities (NASCSA):
http://www.nascsa.org/News/ASHPdeaEprescribing10.08.pdf

This appears to be the docket to which the letter applied:
http://edocket.access.gpo.gov/2008/pdf/E8-14405.pdf
and proposes the inclusion of Controlled Substances in e-prescriptions.
The DEA ceased accepting public comments on 25th September 2008.

The NCPDP response to the above proposal:
http://www.ncpdp.org/members/pdf/DEA_NPRM_response.zip (2 x PDF files).

Hopefully America will consider and avoid some bad examples from the UK with respect to digital helth databases:
http://www.govhealthit.com/print/4_22/strategies/350632-1.html

The official pages on the National Council for Prescription Drug Program  -> e-Prescribing:
http://www.ncpdp.org/eprescribing.asp
http://www.ncpdp.org/pdf/Eprescribing_fact_sheet.pdf

Useful links and documents:

http://www.learnabouteprescriptions.com/

http://www.learnabouteprescriptions.com/what-is-eprescription.aspx
http://www.learnabouteprescriptions.com/pdf/e-prescribing%20FAQs%20B&W.pdf

Electronic Readiness Assessment:
http://www.getrxconnected.org/

The NCPDP Standards:

http://www.ncpdp.org/standards.asp

How Do I Obtain A Copy of A Standard?

NCPDP Standards are available to any interested party. (NCPDP documents are copyrighted and may not be copied or distributed without express written permission from NCPDP.)

As an NCPDP member:
The Council provides a COMPLEMENTARY copy (http://www.ncpdp.org/members/members_download.asp) of each standard with an individual PAID membership.

It costs $650 to become an individual member, and coincidentally that is how much a NON-MEMBER has to pay for the "complementary" set of NCPDP Standards supplied to a new member who forks out $650 to join!!

However, there is a paper about the BASIC Standards:
http://www.ncpdp.org/PDF/Basic_guide_to_standards.pdf

There is apparently a lot more to it than just having a database of patients and a form to generate and transfer a prescription electronically for that person.

It looks like a Computer Science student or new graduate may have to have the FULL standards at his or her disposal before even considering such a project.  That being the case, then you could be sneaky and try to lay your hands on somebody else's "standards" for a small consideration or as a "free" illegal download, or add $650 to the graduate's modest fee ;-)

http://www.ncpdp.org/standards.asp

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
"What Is The Difference Between The Standard Implementation Guide, Data Dictionary and External Code List (ECL)?
An NCPDP Standard Implementation Guide usually contains the data layout or format of transaction(s). It contains technical rules and guidance for the format. Additionally, it provides information about the transaction(s), including business rules, guidance for usage, matrices of usage, and examples.

An NCPDP Data Dictionary contains the field identifiers, format, values, descriptions, and reject codes for the data elements supported in the various NCPDP Standards. It is intended to go hand-in-hand with a standard and implementation guide.

An NCPDP External Code List (ECL) contains values, descriptions, and reject codes for a subset of the data elements supported in the current NCPDP Standards. It is intended to go hand-in-hand with the Data Dictionary and is a subset of that document."
<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

An overview of the External Code List Process (ECL):
http://www.ncpdp.org/pdf/ECL_process_overview.pdf

I found the odd *.ppt presentation that seemed to contain some good content, but they were a fwe years old.  Perhaps you may find a couple that could yield something helpful:

http://www.google.com/search?&q=NCPDP+script+powerpoint+presentation+2008+.ppt&btnG=Search

I hope the links are helpful to you, but I saw something flying right over the top of my head as I began reading some of the PDFs :-)

Regards
Bill
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Expert Comment

by:btisjeff
ID: 22924691
I'm not sure if there is a way to get in touch with the original poster.
He seems to be interested in finding a programmer to work with him
and I'd like to discuss this.  I am a programmer and would be interested
in collaborating on this project.

Jeff Bennett
Jeff  at   Bennet-Tec   dot com
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LVL 39

Expert Comment

by:BillDL
ID: 22940361
Perhaps Netminder (http://www.experts-exchange.com/M_698653.html) or one of the other site administrators may be able to send an email to rreiss60 informing him or her that you are interested in a way that would really be impossible to do within the Experts-Exchange environment.
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LVL 3

Expert Comment

by:grouper15
ID: 28435405
I can help you out in making such a software. Let me know if you are still interested
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Expert Comment

by:kearnsat
ID: 35818223
Allscripts ePrescribe.. I think it's $20 / month
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