Getting Started with ePrescribe v2
- Dylan Nigh
This article is designed to get you started with using ePrescribe features within MacPractice. ePrescribe is powered by NewCrop, and thus we will be using their interface to prescribe electronically.
This article covers the updated NewCrop interface. In order to use the V2 interface, you'll need to be on Build 14.5.6 and above of MacPractice.
When interacting with the ePrescribe Ability, we strongly recommend that you only work in one MacPractice window to ensure that there’s not the possibility that you accidentally prescribe a medication for the wrong patient!
Configuring Preferences and Setting Up Users
Overview of the ePrescribe Node
To access ePrescribe, you'll first navigate to the Rx Ability and select the ePrescribe node in the left hand sidebar, as demonstrated in this screenshot:
First Time Accessing ePrescribe
When a User that's configured and granted permissions accesses ePrescribe for the first time, they'll be presented with an agreement that must be reviewed. To proceed, you'll need to read this agreement and click the "I Agree" button at the very bottom of the Agreement.
Once you click "I Agree", you may see a initial window open up giving you a basic walkthrough of the NewCrop V2 interface, which does have some layout changes from NewCrop's previous interface. Peruse this at your leisure, then click "Close" when ready to proceed.
Navigating in ePrescribe
You'll first end up on the Compose Rx Tab by default. To navigate to another part of the ePrescribe interface, you can use the Navigation Bar, indicated in red in the screenshot below.
It's very important to note that if you have any questions regarding what a particular field or area does, you can click the "Help" link in the Navigation Bar, which will bring up a help sheet related to the area in question.
From left to right, the Navigation Bar contains links to:
Compose Rx: The default tab that you land on when accessing ePrescribe. This is where you can doublecheck what medications the currently selected patient has, search for medications to prescribe, and transmit them to a pharmacy. You'll probably spend most of your time in ePrescribe in this tab.
Med Entry: The Med Entry Tab provides a method to enter historical meds into the patient's record. This will sync up with the Clinical Ability in MacPractice.
Supplies: The Supplies tab
Pt Details (Patient Details)
Problems: This Tab pulls in Current Allergies, Historical Allergies, and Current and Historical Diagnoses pulled in from the patient's Clinical chart in MacPractice. These will be the allergies and diagnoses checked when prescribing medications when checking for drug conflicts.
Admin: The Admin Tab contains account configuration information, list maintenance for Favorites and other areas, EPCS administration, and also contains support documentation provided by NewCrop.
Help: This link will pull up a Help Page for whichever Tab you happen to be on. Helpful if you have a specific question on the Tab you're on.
ePA: This tab contains and manages electronic Prior Authorizations, provided by Cover My Meds.
Tasks: In the Tasks Tab, the User can review Pharmacy Review Requests, Pharmacy Change Requests, and any Unsent or Failed Prescriptions.
You can also review Renewal Requests in the ePrescribe node of the Rx ability by expanding the node and selecting "Renewal Requests".User: This Tab will be labeled with your MacPractice User. This has the two options to Request New Features from NewCrop, and to exit ePrescribe. This can be safely ignored.
When a patient is selected in MacPractice, their patient details, including the Name, DOB, Gender, Address, and Phone Number will pull into the NewCrop interface on the top left. Other Clinical data can pull into ePrescribe, such as the patient's Problem List, Medication, Allergies, and Vitals (height and weight for pediatric purposes).
This information, if entered into MacPractice's Clinical Ability, will be used to do Drug Interaction checks when selecting medications.
Composing Prescriptions
When you first land on NewCrop's interface, you will be on the Compose Rx Tab. The Compose Rx Tab is where the details of new prescriptions are created, reviewed, and transmitted. This will likely be the Tab you spend most of your time in. Let's cover how to prescribe medications.
For NewCrop’s direct resources, please review NewCrop’s article linked here:
https://support.newcroprx.com/hc/en-us/articles/360056804891-Create-a-New-Prescription-NewCrop-v2
You'll first want to select the patient in MacPractice using the Patient Selector.
Important note: Before prescribing, we strongly recommend that you ensure the patient's Clinical chart has allergy and existing medications entered in the appropriate widgets in the Clinical Ability in MacPractice. Doing this will ensure that any adverse drug interactions will be checked and a warning will pop up advising the user of the issue discovered.
The general workflow for creating a prescription in ePrescribe are these four sequential steps:
Use the Drug Search field to locate the medication you'd like to prescribe, or choose a Favorite medication to prescribe.
Set the Dosage information for the medication, if it isn't a Favorite.
Select the pharmacy to transmit the prescription to.
Transmit the prescription.
Step 1: Drug Search
Searching for a medication to prescribe is fairly simple. On the Compose Rx Tab, you'll see a Drug Search field immediately below the Patient information:
By typing a medication into the Drug Search field, options will populate with the best matches for your search.
You can use the drop down arrow on the left of each medication to see commonly prescribed dosages to start with. You can choose one by clicking the blue hyperlink of the medication that meets your requirements.
Selecting Favorite Prescriptions
Alternately, each prescribing user can set Favorites to be quickly selected without having to fill out the Dosage screen, the next step in the process. Favorites are user-specific, meaning each user has its own Favorites list.
You can choose an existing Favorite by first clicking the Favorites button. This will bring up your list of set Favorite medications for the user you’re signed in for.
Once you’ve pulled up your Favorites list, you can check any prescriptions that you’d like to Prescribe, and then click the Prescribe button:
After that, you’ll skip “Step 2: Set the Dosage” and proceed to Step 3.
You can set up a new Favorite by clicking the drop down arrow next to the Favorites button and selecting Add Favorite, or you can add it on the fly in the Dosage screen, which we’ll go over later in this article.
If the patient already has an Active Medication listed on the Compose Rx tab, you can easily re-prescribe that medication by checking the medication and clicking the Prescribe button.
Step 2: Set the Dosage
The next step is to fill out the Dosage information for the prescription in question. We'll cover the flow for "Open" medications, as for most users, this will be the most frequently used option. You can use the drop down at the top left to select between "Open", "Freeform", "Insulin" and "Vaccine" as required.
By default, the Dosage screen will default to provide a 30 Day Supply of the medication in question. You can choose to adjust this in the "Days Supply" selector shown in the above screenshot. This, combined with a selected Frequency, will auto-populate the Dispense field with the exact amount of medication required to fill this prescription. The Dispense field will not auto-populate unless both a Days Supply and a Frequency is set.
The flow is designed to go from left to right, selecting Quantity, the form of the medication, the route, frequency, and refills for the medication. Additional checkboxes are provided for PRN (Take as Needed) and DAW/DNS (Dispense as Written/Do not Substitute). You can add additional information in the "Additional Sig" field, and if you want to communicate something to the Pharmacist, you can use the "Pharmacist Message" field. Many of these fields correlate to similar fields when creating prescriptions in the Rx Ability.
You can use the Associated and Secondary Diagnoses drop down selectors to select a Diagnosis that was already added to the patient's Problem List in MacPractice to tie to this medication.
The Prescribe button allows you to immediately transmit this prescription. You can also opt to Queue the prescription to transmit them all in bulk later on down the line by clicking the drop down arrow and selecting Queue Rx.
Adding the medication as a Favorite
If this is a medication you intend on filling frequently, you can use the "Add To Favorites" checkbox underneath the Prescribe button to mark this medication as a favorite.
These are saved per prescribing user, and the next time you need to prescribe this exact combination on the Dosage screen, you could instead select the Favorite at the Drug Search step to bypass the Dosage screen entirely.
Effective Dates and Additional Scripts
If you simply want to set an Effective Date for the prescription without setting Additional Scripts, there is an Effective Date field at the bottom of the Dosage screen.
The Additional Scripts blue hyperlink allows you to schedule a 2nd and 3rd copy of this prescription to be filled by specific dates. You can choose a 30 or 90 day supply of the prescription and set the Effective Date for when this script can be filled.
Step 3: Select the Pharmacy and Transmit the Prescription
After you have completed the Dosage screen, you'll be taken to the Pharmacy Selection page. If your MacPractice serial includes the Comprehensive ePrescribe package, this page also displays the Interactions table, which checks the medications to be prescribed to ensure there aren't any harmful interactions with the patient's allergies, diagnoses, or other medications.
If you do not have the Comprehensive ePrescribe package and you're interested in having access to Drug Interaction checks, please reach out to our Sales Department for pricing information.
Below that, you'll see the Transmit Rx table, which will list all the prescriptions you intend to transmit today, along with the directions, dispense amount, and number of refills. You can click the Detail button for a given medication to see a sheet with the prescription details, the pharmacy that is currently selected to transmit to, written and effective dates, prescriber and patient information, and a breakdown of all the information selected in the Dosage screen.
After confirming all the details in the medications are correct and that there are no harmful drug interactions, you can select the Pharmacy.
If a Pharmacy was already previously selected for a patient, the ePrescribe interface will recall that previously selected Pharmacy and it will automatically be selected. You'll see the currently selected Pharmacy highlighted in blue:
If you haven't selected a pharmacy for this patient, or the patient chooses a different one, you can still use the Search button above the Pharmacy table to select a different Pharmacy.
Once you've selected your pharmacy and the correct one is highlighted in blue as shown above, you can click the Transmit button to transmit this prescription to the chosen Pharmacy. A receipt will be generated with the details of the prescription, as well as some discount coupons for the patient should they have need of them.
You can also choose to print a paper copy of the prescription, you can Print All (which would include the savings coupon), and you can also print a Patient Education Leaflet which gives information on the prescription you just prescribed for the patient's perusal.
Renewing Prescriptions
You can find NewCrop’s Knowledge Base resources on this topic at the following link:
https://support.newcroprx.com/hc/en-us/articles/360056349492-Renew-an-Active-Prescription-NewCrop-v2
To renew active prescriptions, you’ll first navigate to the Compose Rx tab, check any active prescriptions you wish to renew, and then click the “Prescribe” button:
NOTE: Alternatively, a script may be queued up to be sent as part of a batch using the Queue Rx option from the Prescribe button drop-down.
Adding, Managing, and Using Drug Sets
You can find NewCrop’s Knowledge Base resources on this topic at the following link:
https://support.newcroprx.com/hc/en-us/articles/360056947872-Add-Manage-Drug-Sets-NewCrop-v2
To add or manage Drug Sets, these are stored in the Admin Tab under “Drug Sets Maintenance”, listed under the List Maintenance header:
When you’ve navigated to Drug Sets Maintenance, you’ll see an “+ Add Set” button to add a new Drug Set.
Next, you’ll need to set a name for the Drug Set in the “Drug Set Name” field and click the “Add” button to create the Drug Set.
Once the Drug Set is named and added, it’ll then be listed in alphabetical order.
You can then begin to add and remove medications to this particular Drug Set by clicking the “Add” and “Remove” buttons below the name of the drug set.
Once you’ve clicked the Add button, you can use the field indicated below next to the Drug Search button to type in a medication to search for. Once results appear, you can click the ^ caret next to the drug name to expand it and see the different formulae for the medication in question. Click the blue link of a formulae to select it.
Once you’ve selected the medication, then you’ll need to set the quantity, form, route, frequency, dispense information, and refills much like a normal prescription. When you’ve set up everything to your specifications, click the “Add to Drug Set” button to add it to the Drug Set.
Repeat by adding as many medications as desired for this drug set.
Renaming or Deleting Drug Sets
Did you make a mistake when setting the initial name of a Drug Set? There’s an edit button to make changes, as indicated by the image below:
This will pop up the Drug Set Name field again, allowing you to edit the name. Click the “Rename” button when done to confirm the changes.
Deleting a Drug Set is about as simple. There’s a red button right next to the Edit button:
You’ll be prompted to confirm whether you want to delete the drug set.
Prescribing Drug Sets
You can find NewCrop’s Knowledge Base resources on this topic at the following link:
https://support.newcroprx.com/hc/en-us/articles/360056394092-Prescribe-a-Drug-Set-NewCrop-v2
Once you’ve created some Drug Sets, and you have a patient selected in MacPractice, you can then navigate to the Compose Rx tab and click on the Drug sets button below the Pharmacy selector:
This will bring up a list of your Drug Sets. You can select one, and you can expand that Drug Set to see all the different medications listed underneath that Drug Set. If you wish to exclude a particular one, you can use the checkboxes to enable or disable a particular drug in a drug set as needed, or just leave it alone to prescribe the full drug set.
Once you’ve selected your drug set, click the Prescribe button to proceed.
If applicable, the Interactions table may surface warning you of any issues with certain combinations of medications.
Finally, you’ll confirm the pharmacy is the correct one or select a different pharmacy, and when you’re satisfied, click the Transmit button to transmit the prescription to the indicated pharmacy.
NOTE: The pharmacy can be changed in the pharmacy table displayed below the Transmit button. If the desired pharmacy is not listed, you can select one from the Location Pharmacy list, using the Show Location Pharmacies checkbox, or click the Search button to search the full pharmacy database.
Adding, Managing, and Prescribing Compounds
In order to prescribe Compound medications, you’ll need to first add them.
The information presented in this article has largely been pulled from NewCrop’s Knowledge Base located here: https://support.newcroprx.com/hc/en-us/articles/360057817391-Add-Manage-Compounds-NewCrop-v2
If you’re coming in from ePrescribe’s V1 interface, unfortunately Compounds will have to be re-created in V2.
Adding and Editing Compounds
Compounds are stored in Compounds Maintenence, located in the Admin Tab under the “List Maintenance” header.
When you click this, you’ll see your previously created compounds, if any. You’ll see a “New Compound” button that, when clicked, will open the Compound Builder. Alternately, if you need to edit a compound, you can click the Edit button on the right hand side of a given Compound line.
Once the Compound Builder is open, you’ll need to next give a name to the new Compound. From there, you can click the “Add Ingredient” button to start adding in Active Ingredients.
For each Active Ingredient you add, you’ll need to choose the ingredient in question, assign the Strength (str), Strength Units (Str Units), the Quantity (Qty) and Quantity Units (Qty Units). If you make a mistake and wish to remove an ingredient, you can click the red “X” icon on the far right of a given ingredient line to remove it.
Finally, you’ll need to add in some information in the Default Sig field and the Default Pharmacist Message for this Compound. You’ll also need to note Dispense, Dispense Form, and Schedule information. Once you’ve set these, you can click the Save button to either save the new compound or lock in the changes to this compound when editing.
Deleting Compounds
To delete a Compound, you’ll still navigate to the Admin Tab and select Compounds Maintenance to bring up your Compounds list. On the Edit button, you’ll also see a drop down arrow. When clicked, this will reveal a “Delete” button:
You’ll be asked to confirm that you wish to delete the compound.
Prescribing Compounds
To prescribe a Compound, with a patient selected in MacPractice, in ePrescribe you’ll visit the Compose Rx Tab, and then click on the Compounds button below the Pharmacy selector:
This Compounds button will pull up your Compounds list, which contains any previously added Compounds.
If you need to add a Compound, you can click the drop down arrow right next to the Compounds button and select “Add Compound”.
From here, all you need to do is select the Compound in question that you wish to prescribe, and then click the “Prescribe” button.
This will take you to the Transmit area, where you can confirm the prescription and select a pharmacy.
EPCS Prescriptions
If the medication for your prescription is a Controlled Substance, and the selected Provider is registered for EPCS with Exostar, then you will see an additional section below the Pharmacy selection requesting a PIN. This PIN is set the first time you submit a Controlled Substance medication.
After the PIN, you'll also be required to provide a Passcode. This is either provided from an OTP hardware token, or the Twilio Authy App.
You can read more about EPCS Prescriptions here.
How do I...?
This section is for frequently asked questions on particular tasks or items.
How do I edit my Favorites List?
In the Admin Tab, you can access the Doctor's Favorites in the List Maintenance section:
Here, you can search for a drug to add to your Favorites via the Drug Search button and field, you can delete items by checking them and clicking the Delete button.
You can also use the Copy From/Copy To selectors to copy over the Favorites list from one Provider to another. Remember that each Provider will have their own Favorites list.
For more information, please review NewCrop’s Knowledge Base article on the subject here: https://support.newcroprx.com/hc/en-us/articles/360058260852-Add-Manage-Favorites-NewCrop-v2