Getting started with NZePS

Transcription

1 Getting started with NZePS Overview of NZePS The NZ eprescription Service (NZePS) provides a secure messaging channel for prescribing and dispensing systems to exchange prescription information electronically. It enables a prescription to be generated by the prescriber, transmitted to the NZePS health information exchange broker (NZePS broker), and downloaded electronically at a community pharmacy. When the prescriber prints a barcoded prescription, a unique identifier for the prescription is created by NZePS. The PMS prints the identifier as a barcode on the prescription form. At the same time, an electronic version of the prescription is created and sent, encrypted, to the NZePS Broker. When the patient presents the prescription at a pharmacy, the barcode can be scanned (or manually entered if no scanner) to allow the identifier to be quickly entered into the Pharmacy Management System (PhMS) and for the PhMS to request the electronic version of the prescription from the NZePS Broker. 99% of all community pharmacies have access to the NZePS Broker, via Connected Health. From a medicines management perspective NZePS will enable safer, more effective and efficient management of medicines across primary care now and in the future across all health services. This is largely achieved because NZePS provides a closed loop for information to be transferred between prescriber and pharmacist i.e. enabling details of prescribed medicines to be sent to pharmacists and the status of the prescription (e.g. dispensed, cancelled, repeats remaining) to be visible to the prescriber. This can only be achieved if pharmacy scan the barcode. Getting started for a practice 1. Let your PHO know of the practice s interest in using NZePS. 2. Identify a prescriber champion' for the practice. 3. Communicate with your key local pharmacies to let them know the practice will soon access NZePS and start to generate barcoded prescriptions. Communication between the practice and local pharmacies is a key criterion for a smooth transition to NZePS. 4. Once the practice is activated for NZePS the practice manager/administrator sets up the 'prescriber champion' to use NZePS. 5. Test the clarity of the faxed barcode with your key pharmacy to make sure it can be scanned at the pharmacy. You may need to increase the resolution on the practice fax machine/printer. 6. Prescriber champion' starts to generate barcoded prescriptions. Initially this is for noncontrolled drug prescriptions only. 7. Once familiar with the system the prescriber champion can support the other prescribers in the practice. 8. When all prescribers are set up and are familiar with using NZePS for non-controlled drugs the practice can request Ministry of Health approval to issue Controlled Drug Version 0.1 Last Updated 30 Jan 2019 Page 1 of 12

2 eprescriptions (i.e. triplicate form not required). Refer to Controlled Drugs details in this document. 9. Ask your key pharmacies to let the practice manager know if there are issues downloading eprescriptions from NZePS after scanning the barcode. There may be a technical issue that the practice is not aware of e.g. server may not have restarted after an overnight upgrade. Getting started for a pharmacy 1. Community pharmacies require a barcode reader (scanner) in the dispensary. This is more efficient than manually entering the 18 character barcode details into the pharmacy management system. 2. If no scanner then manually entering the barcode details into the pharmacy system means the pharmacist is still able to download the barcoded prescription from NZePS. 3. If the barcode is not clear / unable to be scanned let the practice manager know. The resolution on the practice fax machine/printer may need to be increased. Q. What does the pharmacist do with the printed, signed, barcoded NZePS controlled drug prescription? A. The pharmacist is required to make a certified true copy of the original printed, signed, barcoded NZePS Controlled Drug prescription. The certified true copy (that must include all the dispensing dates and annotations made by the pharmacist) is filed in the batch and the pharmacy retains the original copy in the pharmacy for 4 years. One copy of the completed prescription filed according to the last date of dispensing is acceptable. If the Pharmacy Prescription copy has no annotation or dispensing dates this is not acceptable. Q. On the barcode how does the pharmacist differentiate between the letters l and O and the numbers 1 and zero (0)? A. the Patient Management systems do not use the letters I and O so always read as the numbers 1 and zero (0). Why it is important for pharmacy to scan barcoded eprescriptions 1. For patient, pharmacy and practice to realise the benefits of NZePS it is important that pharmacy scan all barcoded prescriptions they receive. 2. A Controlled Drug (CD) barcoded eprescription is only a legal prescription when scanned and downloaded from NZePS. 3. Any pharmacy can dispense a CD barcoded eprescription as long as it is signed, has a barcode, is downloaded from NZePS and all current CD rules and regulations apply. 4. The pharmacy is not required to be the 'policeman' as to whether a practice has Ministry of Health approval to issue CD barcoded eprescriptions. Version 0.1 Last Updated 30 Jan 2019 Page 2 of 12

3 5. A faxed barcoded eprescription for non-controlled drugs can be accepted as an original at the pharmacy when scanned and downloaded from NZePS. Administration costs are saved as the practice does not have to send the originals or the pharmacy does not have to chase them up. 6. When a pharmacy scans the barcode and downloads the barcoded eprescription from NZePS, the Status of the prescription within the Prescriber PMS changes from Active (meaning it is sitting in the NZePS broker) to Dispensed or Repeats Remaining. Prescribers want to be able to view this change in prescription Status particularly for patients where medicine adherence is an issue. 7. If a prescriber has added a Comment for the Pharmacist (a functionality in the Medtech and Indici systems) when prescribing a medicine for a patient an Envelope symbol will appear on the paper prescription above the barcode. For example when a prescriber has prescribed an unusual dose of a medicine and provided the reason 'why' for the pharmacist. The prescriber writes the comment to eliminate the pharmacy having to make a call for clarification. If the pharmacist does not scan the barcode the comment will not be seen and may result in an unnecessary call to the prescriber. Barcode The barcode and barcode number must be clearly legible on every paper prescription, so the pharmacy can use them to retrieve the electronic copy of the prescription from the NZePS broker. Example of barcode and barcode number: Envelope Symbol Should there be an Envelope symbol printed above the barcode on the paper copy of the prescription (as shown above) this indicates that either: a) the prescriber has written a Comment for the pharmacist that will be visible to the pharmacist once scanned OR b) the prescriber has requested to be notified within a selected number of days if the medication has not been dispensed (Medtech and Indici systems only). Technical issues The Ministry, or your software provider, may advise if there have been any unexpected instances where eprescriptions have not been able to be downloaded from NZePS at the pharmacy for any reason e.g. may be a technical issue at the practice or pharmacy end. The Ministry receives an NZePS daily report and the Ministry, or software provider, may be in touch if the practice or pharmacy has appeared on this daily report. Version 0.1 Last Updated 30 Jan 2019 Page 3 of 12

4 Support If you have any questions or issues please and include NZePS as a reference. If there is an issue please attach a screen shot if possible. If your problem is specific to your software provider please contact them. If your problem is hardware specific please contact your 3 rd party IT support provider. User Guides - prescriber and pharmacy software providers have developed NZePS User Guides. Please ask your software provider for this if you do not have one available. Faxed eprescriptions for non-controlled drugs 1. A faxed NZePS barcoded prescription for non-controlled drugs can be accepted as an original by a community pharmacy. 2. It must have a barcode, be signed by the prescriber and downloaded from NZePS at the pharmacy. 3. This means the practice no longer has to send the original to the pharmacy for faxed NZePS barcoded prescriptions for non-controlled drugs. 4. If it can't be downloaded from NZePS at the pharmacy, due to a technical issue, then the pharmacy will need to request the original from the practice. In the situation where the pharmacy requires the original prescription, a prescriber can use the Reprint function to generate a copy of the prescription, and the eprescription will have the same barcode number as the first prescription. 5. The Reprinted NZePS barcoded prescription can then be signed by the prescriber and sent to the pharmacy so they can claim. Note: For a faxed NZePS barcoded eprescription for Controlled Drugs the original is still required. Class B Controlled Drugs NOTE: All current rules and regulations apply for CD barcode eprescriptions regardless of format (i.e. electronic or triplicate form) e.g. no forward dating of prescriptions allowed. No hand written amendments are allowed on any barcoded eprescription (i.e. controlled drug or non-controlled drug barcode eprescription). Each prescriber that will generate NZePS controlled drug eprescriptions must do so only within a practice that has Ministry of Health approval to generate NZePS controlled drug eprescriptions. Version 0.1 Last Updated 30 Jan 2019 Page 4 of 12

5 Process for Ministry approval to generate controlled drug eprescriptions (Reference NZePS / Request Approval for CDs). Note: The practice must wait to receive MOH approval (by from the online helpdesk) before starting to generate NZePS Controlled Drug eprescriptions. By generating NZePS Controlled Drug eprescriptions the practice is consenting to agree to and meet the following Conditions and Requirements for NZePS Controlled Drug eprescriptions. Conditions to be met 1. The practice must communicate with their key pharmacies to seek their agreement to receive NZePS Controlled Drug prescriptions and to dispense via NZePS. 2. The prescriber must ensure the patient understands the NZePS Controlled Drug prescription must only be taken to one of the named pharmacies and be presented during normal working hours (for both the pharmacy and the practice). NOTE: The patient must retain the right to choose where they take their prescription to be filled. If a patient does not wish to take their Controlled Drug prescription to one of the named pharmacies then the prescriber will need to complete a triplicate form. 3. The prescriber must ensure the patient understands if, for any reason, the eprescription for Controlled Drugs is not able to be downloaded from NZePS then it is not a legal prescription and can t be dispensed. A triplicate form will then be required. If a triplicate form is required the prescriber must CANCEL the original eprescription before completing a triplicate form. Requirements for NZePS Controlled Drug eprescriptions 1. NZePS Controlled Drug items must be printed on a separate prescription form to noncontrolled drugs except where the ingredients are used in the making of syringes and clear instructions stipulate the medicines to be included in the syringe. 2. Multiple Controlled Drug items can be printed on the same prescription form. If there are too many Controlled Drug items to fit on one page then multiple pages will be printed. All pages will have the same barcode number and are treated as one prescription. 3. The barcode and barcode numbers must exist and be legible. Please check before giving the signed barcoded prescription to the patient. 4. If a patient presents with a request to reissue a NZePS Controlled Drug prescription (for whatever reason) then: To reprint a Prescription use the Reprint function as this will generate a prescription with the same barcode number as the original, ensuring it can only be dispensed once. Version 0.1 Last Updated 30 Jan 2019 Page 5 of 12

6 Do not issue a triplicate paper form or repeat new eprescription unless the eprescription for Controlled Drug in question is SUCCESSFULLY cancelled. a) For Medtech sites the NZePS medication Status must indicate Cancelled b) For MyPractice sites this is shown by the item(s) having been struck through in the notes c) For Indici sites Cancelled medications are shown in orange background and their status is also indicated as Cancelled. NOTE: If DO REPEAT function is used then the second Prescription will have a new barcode and will be treated as a new prescription (as in issuing repeats). Methadone eprescriptions The way the Medtech system is set up means that a Mitte (quantity) must be specified otherwise the number of days will be populating in the Quantity field in the pharmacy system. Put daily dose as the 'quantity' and specify number of repeats. e.g. on a script where the daily dose was 120mg (24mls) and the script was for 28 days supply, the quantity provided is 24mls and the number of repeats is 27. The specific instructions for the pharmacist are added in the directions. For Example: Methadone hydrochloride 5mg/mL oral liquid 120mg daily = (24mls daily) x 28days. Consume on premises Tues/Fridays. Takeaway Mon/Wed/Thurs and Tues/Fri if closed. Start 26/4/18 last dose 23/5/18 24mls (27 repeats) Any other instructions for early pickups/holidays etc would also be included in the directions. See Appendix 1 for example Methadone eprescription and screen shots from the Medtech, MyPractice, Indici, Toniq and RxOne systems Version 0.1 Last Updated 30 Jan 2019 Page 6 of 12

7 Appendices Methadone eprescription and vendor screen shots Example 1: MyPractice eprescription Version 0.1 Last Updated 30 Jan 2019 Page 7 of 12

8 NZePS Access Prerequisites Reference Guidelines for General Practices MyPractice Toniq Pharmacy System Version 1.0 Last Updated 30 Jan 2019 Page 8 of 12

9 NZePS Access Prerequisites Reference Guidelines for General Practices Example 2: Medtech eprescription Version 1.0 Last Updated 30 Jan 2019 Page 9 of 12

10 NZePS Access Prerequisites Reference Guidelines for General Practices Medtech Note: Do not enter a Period of Supply RxOne Pharmacy System Version 1.0 Last Updated 30 Jan 2019 Page 10 of 12

11 NZePS Access Prerequisites Reference Guidelines for General Practices Example 3 Indici eprescription Version 1.0 Last Updated 30 Jan 2019 Page 11 of 12

12 NZePS Access Prerequisites Reference Guidelines for General Practices Indici Version 1.0 Last Updated 30 Jan 2019 Page 12 of 12