Resource Center

EHR User Guide

Prescriptions

Introduction

CharmHealth EHR's dynamic Rx workflow is certified by both Drummond Group and SureScripts for excellence. The intuitive single-view Rx window streamlines your prescribing process with,

  1. Up-to-date Drug Information - A comprehensive database by First Databank ensures you have access to the latest drug details when prescribing.
  2. Reliable Dispensing - Our trusted partner, SureScripts engages with PBMs to provide secure and detailed patient eligibility data for transmitting prescriptions, ensuring a smooth dispensing process.
  3. Secured e-Prescription - CharmHealth has partnered with Experian and Exostar to facilitate a secure Prescriber identity-proofing process to enable e-prescription services.

Note - The eRx and EPCS workflow is available only to the US region. Non-US Practices can utilize the rest of the workflow.

Prerequisites

Prescribers can fulfill the required prerequisites based on their prescription method:

  • EPCS (Electronic Prescription of Controlled Substances) - This solution helps to e-prescribe Controlled substance drugs, as well as non-controlled drugs. Please visit our EPCS link to know more details. Providers with both NPI and DEA numbers can subscribe to this add-on.
  • eRx - This solution is used to e-Prescribe only Non-Controlled Substance drugs. Our video tutorial explains the steps in enabling the eRx solution for prescribers. You can either opt for EPCS or eRX prescriptions. Practice Admin can enable eRx for the Prescribers from the 'Settings > Rx > eRx' section. NPI number is mandatory to enable eRx for the Prescribers.
  • e-Fax Rx - The respective state authorities regulate the prescription and transmission of drugs through e-Fax.

Role Privileges

The Practice Admin or Office Manager should enable the following role privileges for Prescribers:

  1. Go to the 'Settings > Facility > Roles' section.
    Facility Roles Option
  2. Create a role or edit an existing role.
  3. Enable the 'Enter SOAP notes, Prescribe Medications, and Order Labs/Images' checkbox under 'Encounter' and the 'Add, Edit, and Delete' checkbox under 'Medications'.
  4. Click on the 'Save' or 'Update' button, respectively.

Add Prescriptions

Watch our video tutorial on how to e-prescribe controlled substances.
Watch our video tutorial on how to e-prescribe non-controlled substances.

Prescribers can follow the steps below to add prescriptions:

  1. Start an Encounter
  2. Navigate to the 'Recommendations' section, and click on the 'Add Rx' link.
    PDMP Option

    Note: With the PDMP add-on enabled, Prescribers can access important information on the patient's controlled substance prescription history and NARX scores before prescribing medication. It helps in identifying high-risk patients who would benefit from early intervention.

  3. The Add Prescriptions window displays information about the Patient, Prescriber, and Real-Time Eligibility, along with the options for Select Pharmacy and Search & Add Rx.
    Add Prescriptions
    If the Prescriber has more than one DEA number, choose one accordingly. Then, select an eligibility plan if there are multiple plans available.

    Note - If there is a discrepancy between the patient demographics in CharmHealth EHR and the Health Eligibility Plan, the plan name will display a red 'Man' icon. Clicking on the icon displays the Patient Benefit Plan details.

  4. Next, click on the 'Select Pharmacy' button.
    Select Pharmacy

    If you will be prescribing controlled substances, choose 'Yes' for the 'Are you e-Prescribing Controlled Substances?' option.

    Fill in the necessary filters like Name, City, Zip Code, Fax/Phone No, Address, and State to narrow down the search.

    Click the 'Search' button to view the list of available pharmacies. In the dynamic view window, click on the desired pharmacy to select it.

    Once selected, you can verify whether the pharmacy Supports EPCS, Set as Preferred, or Change Pharmacy.

    Note - You can easily select a Preferred Pharmacy with just a click for any upcoming prescriptions once you have added it.

  5. If you want to receive a prescription-filled notification from the pharmacy, select 'Rx Fill Indicator' from the drop-down to receive a status update on the prescription.
    Rx Fill Indicator
  6. Now, enter at least four characters of the drug and click 'Enter' in the 'Search & Add Rx' field.
    Search and Add Rx

    The system will fetch and display the drugs matching your search from the standard drug database, including information like route, brand or generic name, and strength. Refine your search using the Route, Dose Form, and Strength filters.

    Note: If the required drug name is not available in the database, you can create custom drugs.

  7. Select the appropriate drug from the auto-suggested list. For example, we have chosen 'OXYCONTIN 40 MG 12-HOUR TABLET' from the drug database.
  8. On adding the Legend drug, the right-hand side of the Add Prescriptions page displays the Real Time Eligibility Information, Plan & Alternatives, including Formulary, Copay, Coverage, and Pricing Details sections based on the Patient Plan Eligibility for the chosen drug.
    Add Prescriptions
    Add Prescriptions

    The 'Alternatives' tab displays Therapeutic and Payer alternatives with higher preference levels for the added drug.

    The suggested drugs can either be Therapeutic or Payer alternatives with higher preference levels.

    Compare the Plan & Alternatives and choose the most appropriate drug for your Patient, if needed.

  9. The 'Interaction' field provides information on adverse effects that may occur when combining the prescription drug with the patient's active medications, allergies, and food.

    In the Intake form view, enable Dispense as Written and fill the fields like SIG Build, Direction, Dispense, Days of Supply fields, Internal Comments, Note to Pharmacy, and more as needed.

    Click the 'Edit' button if you wish to enter free text for directions.
    Add Prescriptions
    Add Prescriptions
  10. If you have subscribed to the Real Time Prescription Benefit (RTPB) add-on, the Pricing Details tab displays the up-to-date pharmacy or plan benefit details, price information, and affordable alternatives based on the Pharmacy, dosage, and days of supply details.
    RTPB Pricing Details
  11. Then, proceed to enable the checkboxes:
    • Ready to Sign - If you are prescribing CS drugs or would like to complete the prescription later, enable this checkbox.
    • Prohibit Refill Request - Enable this option if you prefer that the Pharmacy not send refill requests after dispensing.
    • Initiate EPA - If the Prior Auth Required flag is set on the real-time eligibility response, the EPA checkbox gets enabled by default. Adding the drug to the system initiates an EPA request to the PBM.

      Note - Electronic Prior Authorization helps you streamline your workflow by making the most efficient medication-related prior authorization process by default. Click on this link to learn more about the EPA add-on

    • With Priority - Enable this option if you want to initiate the PA process immediately.
    Add Prescriptions
  12. Click the 'Save' button to add the drug to the chart note. Proceed to search and add other drugs or sign and transmit the prescription.
    Sign and Rransmit Prescriptions
    Alternatively, you can add drugs from the Templates or Past Rx sections.

Sign and Transmit Prescriptions

Prescribers with the required role privileges can Sign, Sign & eRx, or issue Paper Rx for the prescribed drugs.

Before signing and transmitting, mark drugs as Ready to Sign if you are e-prescribing controlled substances.

The Red Indicator icon against each of these actions displays the pending action count.

The "Transmitted" tag displays the number of prescribed drugs transmitted versus the amount transmitted.
Sign and Rransmit Prescriptions

Sign

The Prescribers can sign the prescription and allow their agents to transmit them on their behalf later using the following steps:

  1. Click on the 'Sign' link.
  2. Choose the drugs you want to Sign.
    Sign the Prescription
  3. Click on the 'Sign' button.

Sign & eRx

  1. Clicking on the 'Sign & eRx' link allows you to sign and electronically transmit the chosen drugs to the Pharmacy.

    Note - You should have e-Rx enabled for transmitting non-controlled substances or EPCS enabled for transmitting controlled and non-controlled substances.

  2. Choose the drugs you want to sign and transmit.
  3. Click the 'Sign & Send' button to directly transmit non-controlled substances. For transmitting controlled substances, complete the two-factor authentication steps below:
    • Enter your CharmHealth EHR login password.
    • Choose either the Exostar Hard Token or Soft Token (One Auth) from the drop-down list and enter the corresponding OTP.
    • Then, click on the 'Sign & Send' button.

    Sign and eRx
    Once you have signed and transmitted a Prescription, the status will change to eRx sent. Revisiting the page will show the Prescription transmitted view.
    Signed and Transmitted

    Note - Once you transmit electronically, the prescriptions cannot be transmitted by any other mode.

Paper Rx

Click on the 'Paper Rx' link to view and print a Paper Rx. In the US, you can print Paper Rx in the format recommended by your state.
Rx Print Format
Paper Rx

Note - Once you transmit through Paper Rx, the prescriptions cannot be transmitted by any other mode.

Fax Rx

You can fax the prescriptions from the 'Encounter > Rx > Fax Rx' section.
Fax Rx Option

Select the prescription and preferred Pharmacy. Click on the 'Send' button to fax the Prescription.
Fax Rx

Note - Once you transmit through Fax Rx, the prescriptions cannot be transmitted by any other mode. Visit our resource center to learn more about our Fax add-on.

Add Custom Compounded Drugs

Watch our video tutorial on how to add custom drugs.

For writing a custom compounded drug, follow the steps below:

  1. Click on the 'Add a Custom Drug' to create a custom drug.
  2. Choose the 'Drug Type' as 'Compounded'.
    Add a Custom Drug
    Note - You can also add supplies and drugs you are unable to find in our standard drug DB search list.
    • Supplies - NDC value and DEA schedule are not required to e-prescribe.
    • Drugs - Add free-text drugs only if you are not able to locate the ingredient in our standard Drug DB search.
  3. Typing the first five letters of the ingredient suggests the matching ingredients from our standard drug database. Selecting an ingredient from the list will fetch NDC and DEA scheduled levels from the Standard drug DB.
  4. Fill in the values for strengths, dose form, and quantity. Add the ingredients as needed.

    Note - The most restrained drug's NDC and DEA value applies to the entire prescription.

  5. In the Intake view on the left side, enter dispense details, days-of-supply, refills, note-to-pharmacy, and other fields as needed.
  6. Click on the 'Save' button.
  7. Once done, you can sign and transmit based on the schedule level.

Previously added custom drugs will be available as a part of the drug search. You can filter Custom Drugs by checking the 'Is Custom' checkbox in the Search and Add Rx view.
Search and Add Rx Custom

Add Prescriptions from Templates

Watch our video tutorial on how to add Rx Templates.

To add drugs using Prescription Templates, follow these steps:

  1. Start an Encounter and navigate to the 'Recommendations' section.
  2. Click on the 'Templates' link.
    Add Prescription from Templates
  3. Click on the Practice or My Templates drop-down to view the list of templates.
    Add Prescription from Templates List
  4. Choosing a Template lists all the drugs that are a part of it.
  5. Click on the '+' icon to add a drug.
    Add a Drug from Templates
  6. You can view real-time Formulary, Copay, Coverage details, and alternatives for each drug. It helps Prescribers choose the most relevant drug quickly for enhanced patient care.
  7. Review and modify the intake details if needed.
  8. Proceed to Add more drugs or Save.

Add Prescriptions from Past Rx

Watch our video tutorial on how to add Past Rx.

Follow the steps below for repeating prescriptions from previous encounters with the Patient:

  1. Start an Encounter and navigate to the 'Recommendations' section.
  2. Click on the 'Past Rx' link.
    Past Rx
  3. Choose 'From Patient Dashboard' or 'Encounter' from the drop-down to view the list of associated active drugs.
    Past Rx List
  4. Click on the '+' icon.
    • Choose the 'Repeat' option to repeat the previous Rx as it is.
    • Choose the 'Modify' option to modify the strength of the drug.

    Add Drug from Past Rx
  5. You can view the real-time Formulary, Copay, Coverage details, and alternatives. It helps Prescribers choose the most relevant drug for enhanced patient care.
    Plan and Alternatives
  6. Review and modify the intake details if needed.
  7. Proceed to Add more drugs or Save.

Cancel Rx

You can initiate a Cancel Rx for transmitted prescriptions from the following sections:

  • Encounter - Go to the 'Encounter > Recommendations > Prescriptions' section and click the 'Cancel Rx' button.
    Cancel Rx Option
  • Erx - Go to the 'Prescriptions > e-Rx Sent' section. Click on the 'More Options' icon (3 dots) available against each drug and choose the 'Cancel Rx' option.
    Cancel Rx Prescriptions
  • Patient Dashboard - Go to the 'Patient Dashboard > Medications' section. Click on the 'More Options' icon (3 dots) against each drug name. Choose the 'Cancel Rx' option.
    Cancel Rx Medications

Then, a pop-up box with the Rx details will appear; review and click the 'Cancel Rx' button.
eRx Message Details

Once canceled, the prescription status will change to eRx - Cancelled.
eRx Cancelled

Clicking on each canceled Rx displays a pop-up box containing the cancel confirmation message from Surescripts.
Cancelled Rx Details

Modify Rx Strength

To modify the prescribed drug strength, navigate to the 'Patient Dashboard', click the 'More Options' icon (three dots) next to the drug, and select 'Modify'.
Modify Rx Option

Now, pick the necessary drug strength from the Modify Prescriptions window and click the 'Save' button.
Modify Prescriptions

Once done, the previous drug will go inactive once modified.

Delete Rx

Prescribers can delete unsigned Rx from the 'Patient Dashboard'. Click on the 'Trash Bin' icon to delete the Rx.
Void Option Medications

Signed prescriptions cannot be deleted. Alternatively, you can choose the 'Void' option to prevent it from being transmitted.

Prescriptions Tab

The 'Prescriptions' tab facilitates the Agent workflow. It displays all prescriptions added to each patient throughout the Practice alongside the Provider, Date, and Status details. The 'Date', 'Rx Status', 'Provider', 'Patient', and 'Facility List' drop-down filters allow narrowing your search further.
Rx Status

Once the Agent has added the prescription, the Prescriber can click the 'More Options' icon (3 dots) against each Patient to review and Sign the prescriptions.
Review and Sign the Prescriptions

Similarly, the Agent can Transmit non-controlled prescriptions signed by the Prescriber from here.

Pharmacy Requests

Prescribers can review and process Pharmacy Refill or RxChange requests from the Prescriptions > Pharmacy Request section.
Pharmacy Requests

Refill Requests

Prescribers can click the 'Process' button against each request and choose to Approve, Deny, or Replace the Rx in the 'Action' field.

To approve the Pharmacy request, follow the steps below:

Modify the number of refills if needed, and proceed to sign and transmit the refill request.
Process Refill Request

Note - Processing CS refill requests requires two-factor authentication.

Replace Refill Request

This option allows you to replace the drug during the refill process. Clicking 'Replace' directs you to the Replace Prescriptions window.
Replace Refill Request

Rx Change Requests

The Pharmacy can raise Rx Change requests to dispense Generic Substitutes, Therapeutic Alternatives, or for Prior Auth. Prescribers can click the 'Process' button to approve or deny the request.
Rx Change Requests

Note - Processing CS refill requests requires two-factor authentication.

Rx-Fill Notification

Rx-Fill status update received from the Pharmacy will be displayed in the Prescriptions > Rx-Fill Notification section. You can click on each Rx to view the Prescription Fill Info.
Rx Fill Notification
Prescription Fill Info

eRx Sent

The Prescriptions > eRx Sent tab displays the entire list of prescriptions transmitted electronically from the Practice. You can filter the list using the Type, Date, Provider, Patient, and Facility List drop-down menus.
eRx Sent

Quick Rx

Quick prescriptions can be written for a patient without an encounter by following the below steps:

  1. Go to the Patient dashboard > Medications section.
  2. Click on the '+Prescriptions' button.
    Add Prescriptions Option
  3. Clicking on the Add Rx, Templates, or Past Rx links redirects you to the Add Prescription view. The Patient Allergies and recent prescription sections are available here for your reference.
    Quick Rx
    Quick Rx
    You can continue to add, sign, and transmit the prescription as usual.