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1 /GE / Confidential and Proprietary Information

©2009 General Electric Company – All rights reserved.

General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the product described at any time without notice or obligation. This does not constitute a representation or warranty or documentation regarding the product or service featured. Contact your GE Representative for the most current information.

GE, GE Monogram and Centricity are trademarks of General Electric Company.

General Electric Company, by and through its GE Healthcare division


Confidentiality and Proprietary Rights and Limitations and Conditions of Use

This document is the confidential property of GE Healthcare, a division of General Electric Company (“GE Healthcare”) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein.

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GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies

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Copyright 2009 General Electric Company. All rights reserved.

Disclaimers

Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health.

General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown.

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Notes:


Administration>System>User/Location Setup>Security>Main>Chart>ACCESS Electronic Prescribing: This will need to be given to any user who will be considered a prescriber or delegate.

Administration>System>User/Location Setup>Security>Main>Setup>CHANGE Electronic Prescribing Settings: This should only be given to anyone who can change the settings in Administration. NOTE: This must be granted to someone in order to enable electronic prescription.


To enable ePrescribing, you will need to go to Administration>Charts>Electronic Prescriptions.

eSM clinic webservice URL: This URL is dynamically set during the eSM configuration.Enable ePrescription: Check this box to enables ePrescribing for eligiblepatients and pharmacies.Enable Medication History: Check this box to turn on Medication History. If enabled, the Med Hx button is enabled for patients eligible to use ePrescribing. This option will only be available if ePrescribing is enabled. (see option above)Allow electronic prescribing and faxing for medications in controlled substance schedule 2: This option is only available if ePrescribing is enabled and you have selected to allow electronic prescribing and faxing for medications in controlled substance schedules 3 through 5. Allow electronic prescribing and faxing for medications in controlled substance schedules 3 through 5: This option is only available if ePrescribing is enabled.NOTE: If you don’t select to allow medications in scheduled 2-5 to be sent via electronic or faxing method, then the user will get a warning message when they try to send a medication in any of these schedules. Proxy User: This drop down will list all of the prescribers that have been set up for advanced eprescribing. In the event a patient does not have a responsible provider, the prescriber’s name selected here will go out on the eligibility request. eRx Manager: Select the user who has been designated in the eSM Console as the ePrescribing Manager. This user will receive flags pertaining to eligibility, medication history, new prescriptions, refills, etc.Scan for ePrescribing events every x seconds: This will determine how often the DTS will scan for ePrescribing events, such as eligibility and med history.


The NPI and DEA # fields are required to be populated on the user table in order for them to be set up as an ePrescriber. If a user does not have a these and needs access to ePrescribing, then they can only be set up as a delegate.

NOTE: A resident prescriber who does not have a DEA number can be assigned a supervisor with a DEA number and still be enabled for ePrescribing.


To import prescribers from Centricity EMR:

1. From the Prescribers page, ensure that you are on the ePrescribers tab and

click Import From EMR.

2. A message appears indicating the number of prescribers that were imported from Centricity EMR.

Each time you import prescribers from Centricity EMR, the eSM database is

updated to correspond to the newly imported prescriber list. If you make changes

in Centricity EMR, those changes will be reflected in the eSM prescribers list. If

you revoke ePrescribing privileges from a prescriber in Centricity EMR, the

prescriber will be removed from the eSM prescriber list. Users marked as

Obsolete in Centricity EMR are also removed.

Register Prescribers with Surescripts

• Prescribers must be registered with Surescripts before they can ePrescribe. A successfully registered prescriber is given a unique Surescripts Prescriber Identification (SPI) number.

• Only prescribers who have the ACCESS Electronic Prescribing privilege, NPI and DEA # in Centricity EMR and have been imported will appear on the ePrescribers tab.

NOTE: Before you register prescribers, verify that your eSM list of prescriber

suffixes is up to date. For more information, see the field description for Prescriber

Suffixes in "EMR Settings" in the eSM 3.0 Admin Guide


Surescripts assigns a unique SPI number to each prescriber, indicating that the prescriber is successfully registered. You can view the SPI number by clicking the prescriber's View Details icon.

To complete the registration process, a new ePrescriber (or a prescriber who is reactivating after a break from ePrescribing) must send five new electronic prescriptions. Afterward, the pharmacies begin sending refill requests electronically.

Enable New Prescription and Refill Service

After you have registered prescribers with Surescripts, you can enable ePrescribing services (New Rx and Accept Refill) for each prescriber. Registering prescribers automatically sets their service level to New Rx, enabling them to send new prescriptions.

To enable the Accept Refill service:

1. From the Prescribers page, verify that you are on the ePrescribers tab.

2. Select the Accept Refill check box for a particular prescriber.

3. Click Save Modifications.

Under most circumstances you will authorize prescribers for New Rx or for both New Rx and Accept Refill. If a prescriber leaves your clinic, you can disable the New Rx service for the prescriber and enable Accept Refill. You could then continue to refill prescriptions for a short term after the prescriber's departure


Delegates are authorized to manage ePrescribing on behalf of a prescriber.

You can assign a delegate to a prescriber from either the ePrescribers tab or the Delegates tab. If you use the ePrescribers tab, you can assign one delegate to one prescriber. If you use the Delegates tab, you are able to assign one delegate to one or more prescribers. One delegate can be assigned to multiple prescribers, but each prescriber can have only one delegate.


To assign a delegate to one or more prescribers using the Delegates tab:

1 From the Prescribers page, click the Delegates tab and locate a delegate. To shorten the list, enter the delegate's name and click Apply Filters, or select the location of care.

2 Click Add in the delegate's row. The Modify Prescriber Selection window appears.

3 Select the check box to the left of the prescriber's name. If you select more than one prescriber, the same delegate will be assigned to each of them.

4 Click Save Modifications and close the Modify Prescriber Selection window.

On the Delegates tab, the prescribers are displayed in the Prescriber column to the right of the delegate's name. On the ePrescribers tab, the delegate's name is added to the Delegate column, to the right of the prescriber's name.

NOTE: To remove a delegate using the Delegates tab, click Modify, deselect the delegate, and click Save Modifications.

To assign a delegate to a prescriber using the ePrescribers tab:

1 From the Prescribers page, ensure that you are on the ePrescribers tab and click Add in the Delegate column to the right of the prescriber's name. The Modify Delegate Selection window appears.

2 Select a delegate from the list. You can choose only one delegate.

3 Click Save Modifications and close the window. The delegate's name is added to the Delegate column, to the right of the prescriber's name.

NOTE: To remove a delegate using the ePrescribers tab, click Remove next to the


Notes:


Eligibility checking can be done on-demand by a user or automatically by

the system. An eligibility request will not be sent if a successful eligibility

response was received within 24 hours.

There are 5 fields that RxHub will search on when receiving an eligibility

request from the EMR:

1. Last name

2. First name

3. Zip Code

4. Birth Date

5. Gender

NOTE: Remind users about checking for missing data when scheduling the

appointment or registering the patient.


Pharmacy benefit eligibility is requested automatically for patients who have appointments on the next day’s schedule. Eligibility is also requested automatically when a Chart Update is started to support walk-ins and other non-scheduled encounters. However, there may be times when you need to check eligibility on-demand.

To check eligibility on-demand, go to the patient’s reg and click on the Insurance tab. At the bottom of the Insurance tab, click on the “View Patient’s eRx Drug Plans” button. This will open the View Pharmacy Benefit Eligibility window.


If eligibility has never been requested for the patient, the Eligibility Status will be Unknown and the Status Message will state “Eligibility benefits have never been requested”. Click the Request Eligibility to submit the request on-demand.


Eligibility information needs to be less than 24 hours old at the time of appointment. If the patient’s last eligibility check is >24 hours, then the Eligibility Status is Unknown and the Status Message states “Last eligibility data is more than 24 hours old”.

In this case, either someone could start the eligibility request in the patient’s registration or it will automatically be requested when the chart update is started.


Once a request has been sent, the status changes to Pending. This window will

not automatically refresh. It should take approximately 1-2 minutes to return the

eligibility data.

In order to get an eligibility response:

1. The LinkLogic Data Transfer Station (DTS) must be running in the background so it will automatically import eligibility information into EMR when it is received from RxHub.

2. The Kryptiq eScriptMessenger agent (eSM Clinic) must be running in the background so it will receive requests from EMR client workstations and send them to eSM Central Kryptiq data center to be forwarded onto RxHub. eSM will collect responses and put them into DTS inbox.

3. The Centricity Data Transfer Station (DTS) must also be running in the background so it will import eligibility (and med history responses) as they are received by eSM.


The following is displayed in the View Pharmacy Benefit Eligibility window when information is returned:

Drug Plan: Some patients may be eligible for more than one drug plan. The * will display to the left of the current plan selected for prescribing. You can toggle to other active drug plans when you are prescribing.

Plan Status: Active or Inactive

Benefits: Mail-Order, Retail, both or neither.

EMR uses the following preference to determine the default drug plan when a patient is eligible for more than one: Patient eligible for both mail order and retail, eligible for only mail order but not eligible for retail, and lastly eligible for retail but not eligible for mail order.

NOTE: Address 1 or 2 must be populated in Patient Registration in order for an eligibility response to be returned.


You may receive the following errors after requesting the eligibility information:

•Eligibility information is available but no formulary information is available.

•Request did not contain the necessary information.


RxHub pharmacies may have registration (demographics) information that differs from what is stored in CPS. To compare the patient demographics, click on the Compare Patient Info button on the View Pharmacy Benefit Eligibility. The Compare Patient Information window will display the CPS patient registration information on the left and the patient information from the Drug Plan on the right. If RxHub eligibility response indicates that the RxHub demographics information is different than what is stored in EMR, then it is the patient's responsibility to contact their pharmacy benefit manager(s) to get the information corrected.


Medication History can be obtained from the Update Medications window. To gather this information, click on the Med Hx button on the right side of the Update Medications window. This will open the Medication History window.


The Status of the last history request, Last requested by and Last received on will display in the top left corner.

The Requesting Provider drop down will default to the user who is logged into the system. If you are a completing the request for a provider, drop down and select the provider’s name. The Consent Status must be granted by the patient or guarantor in order for the Request Med Hx button to be activated. If you select the Consent Status-Revoked by patient/guarantor then you will not be able to proceed with the request for med history. The Date Range is optional, but can be entered if the provider only wants to receive information from a certain time period. If the date range fields are left blank, then it could return up to 2 years worth of data.


When the Status of the last history request is In Progress the screen will not refresh dynamically. You will need to refresh the window by for instance, closing the window and re-opening. You can click the Refresh Grid button to have the CPS client application query the database to find out whether or not med hx response is available yet. Individual med history requests are sent to SureScripts and to each RxHub PBM for which the patient has active eligibility. It can take 3 to 5 minutes before all of the med history responses are available for viewing in the chart.

Recommendation: If you will be requesting Mediaction Hx for a patient, it is best to do this at the beginning of the visit, so the information will be returned by the time the provider is in the room.


Once the status is complete, it will display the information in the Medication Hx from prescribing network area. Some of the PBMs (payers connected to RxHub) will not return fulfilling pharmacy information. Most PBMs do not send back the prescription instructions or the Sig line.


To see the PBM returned drug history data including the filled date, prescribing provider, fulfilling pharmacy and data source, you will need to scroll to the right of the Medication Hx from prescribing network results.

NOTE: Most of the pharmacies connected through SureScripts will send "date written" instead of or in addition to "filled date". RxHub PBMs do not send "date written" and send only "filled date".

The bottom portion of the Medication History window will display the current medications that are on the patient’s chart.

NOTE: If the patient’s zip code is not in the valid format or exceeds the correct number of digits, you will get the below error message when requesting the patient’s medication history:

PrescriberNetworkError: 1: the value does not match the regular expression “(\d{5})|(\d{9})”.


On the left hand side of the window, you can review the patient’s current eligibility status. There are 3 status options: The patient has pharmacy benefits; The eligibility data for this patient may be out of date, the patient may not belong to any plans, or there was an error during the eligibility request; or The eligibility request for this patient may still be in progress. Hover over the Eligibility statusto view summary information. Click the Eligibility status to open the View Pharmacy Benefit Eligibility window. NOTE: If the eligibility check has not been requested, you can do so by clicking on the Eligibility Status button and then clicking on Request Eligibility.

After you have reviewed the eligibility status, use the custom list or reference list to search for a medication.


The Type column will now display Rx Brand, Rx Generic, OTC Brand, OTC Generic or blank in the search results table. A blank will appear in the type column if the medication has no strength associated. NOTE: You would only want to add a medication with no strength, if you are adding only a historical medication. You cannot electronically prescribe a non-strength medication where type is blank.

Highlight the appropriate medication and click OK.


Depending on the patient’s formulary and the medication selected, you will seeone of the following to the left of the medication name in the Formulary box:1. red light (off formulary)2. yellow light (on formulary but not preferred)3. green light (preferred)4. red circle with slash (not reimbursable)5. red U (formulary status unknown-not published or not specified by PBM). Note: If a medication is preferred but has at least one coverage factor, then themedication will display with the yellow light. This will trigger the prescriber to viewthe coverage factor(s).

ePrescribing Formulary Coverage Factor Abbreviations:AL-Age LimitGL-Gender LimitQL-Quantity LimitRS-Summary Level Resource LinkRD-Drug Specific Resource LinkMN-Medical NecessityPA-Prior AuthorizationSM-Step MedicationDE-Drug Exclusion


To review information about a formulary's creator, contact, and pre-authorization requirements, click on the Status button in the formulary box of the New Medications window. You can also see whether a selected medication is on or off formulary, its relative cost, and whether the medication has alternatives. For ePrescribing, the co-pay and coverage is also displayed.


A patient may have multiple formularies. To select another formulary for prescribing, click on the Eligibility status on the left hand side which will open the View Pharmacy Benefit Eligibility window. The drug plan with the asterisk indicates it is the current plan that is selected for prescribing. To toggle to another drug plan, highlight on the drug plan you want to switch to and then click the Select for Prescribing action button. This will change the formulary that is being used for the update.

NOTE: If a prescriber wants to change for the current medication they are prescribing only, click on the Select Formulary button on the New Medications window. From the Select Formulary button, a prescriber may also select a formulary from Info Scan or another formulary source.


If a medication has alternatives, you can select a therapeutic alternative medication that is on formulary. If multiple alternatives are available, selectChoose Alternative drop down and select one of the other alternative medications. You may see 2 different lists, one for payer suggested alternatives and one for therapeutic alternatives. If provided, payer suggested alternatives are specific drugs specified as being preferred over the currently selected medication. Therapeutic alternatives are based upon the therapeutic classifications from the MediSpan drug reference data. Formulary status and abbreviated copay information is displayed for each alternative.

NOTE: If the medication selected is off the formulary, the Choose Alternative list will automatically display.


To change to an alternative medication, double click on the medication.


Once you have selected a medication, you will need to populate at minimum the 3 required fields: Instructions, Quantity and Refills

Character limits/requirements on New Medication (if prescribing method is electronic):

Instructions-140 character limit. Special characters such as (/ ( ) { }) cannot be listed. Do not enter any carriage returns.

Quantity-Cannot be blank or 0 and must start with a number.

Refills-Must be numerical or PRN

Dx/Instr to Pharm- A new free-text field for the prescription. It can be used to indicate the diagnosis for the medication or other instructions to the pharmacy. Maximum length is 200 characters.


If you have forgotten to populate any of the required fields, you will receive a warning message listing every required field that was missed. You will not be able to continue with saving and sending the medication until these fields have been populated.


If a pharmacy is not listed in the pharmacy field of the New Medication window or you need to change the pharmacy, click on the Select button which will open the Select Pharmacy window. If a user is looking for a pharmacy that is enabled for ePrescribing, they can select either Retail Online or Mail Order Online from the Pharmacy Type drop down. This will show all of the retail and mail order pharmacy results separately. If the user wants to see all of the pharmacies (retail and mail order combined) that are enabled for ePrescribing, select Electronic from the Prescribing Method drop down. All of the ePrescribing enabled pharmacies will display with an asterisk (*) at the end of the pharmacy list name.

Pharmacy Type

Retail Online- Retail pharmacies enabled for ePrescribing

Retail Offline- Retail pharmacies not enabled for ePrescribing

Mail Order Online- Mail Order pharmacies enabled for ePrescribing

Mail Order Offline- Mail Order pharmacies no enabled for ePrescribing

NOTE: You may need to expand the List Name column in order to see the asterisks (*) at the end of the pharmacy name.


Once you have completed the new medication(s), the Update Medications will now display the medication description, instructions, start date, formulary, last refill date (pending will display until the prescription has been signed), and BMN.

To send/print the prescription, click on the Send/Print Rx button.

ePrescribing Formulary Coverage Factor Abbreviations:

AL-Age Limit

GL-Gender Limit

QL-Quantity Limit

RS-Summary Level Resource Link

RD-Drug Specific Resource Link

MN-Medical Necessity

PA-Prior Authorization

SM-Step Medication

DE-Drug Exclusion


Once the prescription has been sent the details will then display in the Last Refills column.


To get formulary details on a medication from the update medications window, highlight the medication and then click the Formulary button. This will open a separate formulary details window.


Once you have closed the update medications window, you will notice the text translation for the prescription indicates it was sent electronically. It will display the Entered and Authorized by user, Signed by user, Method used and the recipient pharmacy information.

NOTE: The text translation shown above will only be present if the update includes the Refills form or MEL_ADD_MED. If the update has no data symbols associated with it, there will be no text translation. However, you can still see the data by scrolling over the Rx in the Medications Tab > Prescriptions / Refills field. Or, by accessing the Clinical List Changes dialog.


Pending prescriptions to be printed, faxed or sent electronically will be completed automatically when the document is signed.


You can also send prescriptions electronically when using the Prescriptions form. Check off the medication that you would like to refill and then update the Quantity, # Refills, BMN, Pt Info and Dx/Instr to Pharm (single line item on second row).


The formulary status and question mark now display to the left of the medication name. You can click on the question mark to display the Formulary Status details for that prescription.


If you try to send a medication for a controlled substance schedule 2-5 drug, you will get a warning message that either the refill is more than 0 or the prescribing method is Fax or Electronic. If you want to continue with this prescription, then you must change the prescribing method to a written prescription.

NOTE: If you have set your system to allow schedule 2-5 drugs to go electronic, then you will not receive this warning message and you will be able to send it electronically. However, the prescription request will fail and return a flag to the user.


You can set your system to send both successful and failed acknowledgement flag to the user’s desktop. ePrescribing failed acknowledgements will be sent with an Urgent priority.


MEL_ADD_MEDICATION can be used to a create quick text. Encounter forms will use the MEL_ADD_MEDICATION data symbol invisibly in the background without the user's knowledge. Quick text simulates or duplicates the same behavior for what would happen if we actually had an encounter form that used this data symbol to add an unsigned pending medication and prescription to the patient's chart update.

NOTE: In order for this feature to work the patient must have an electronic pharmacy on their contacts list and when they enter the quick text they must put a space on the end (ex “.addmed “).


If you used the MEL_ADD_MEDICATION feature in the chart update, when you

click on the End Update, you will notice that the document or clinical lists cannot

be signed until the formulary status of pending eRx is reviewed. To review the

formulary status, click on the Review Pending eRx button.

There are 2 instances where the user may not see the Review Pending eRx

button on the End Update window.

1) Patients not registered on eRx network: In this case an error would be received for the Eligibility request.

2) Patient with valid eRx plan but details are outdated or yet not available in EMR:

a) Request was made and no response received either because network is down or DTS was not working

b) The response is 24 hrs old and no new request has been posted yet


The update medications window will open and the user can review the status. If the medication is out of the patient’s formulary, the user may want to highlight on the medication and click the Change button and the proceed with making changes or choosing an alternative medication. If no changes need to be made, then click on the Send/Print Rx button.

Once the prescription has been reviewed and/or sent, then user can continue with ending the update.


Notes:


When a pharmacy sends a renewal request to the provider, it will go to the provider’s desktop as an unsigned document. To work the renewal request, the provider will highlight the Rx Refill document and then click on the Append action button. NOTE: If the provider has been assigned a delegate, then the refill request document will go to the delegate’s desktop

Once you implement Refill Requests, you will start getting the request after the provider has sent 5 electronic prescription request. This will include any prescriptions that were sent prior to enabling Refill Requests.

Caution: You will be expected to respond to at least 50% of refill requests within 48hrs time per month. If you do not meet this, you could not receive refill request for 14 days as a penalty.

NOTE: If an automatic match cannot be made for the patient identified in a pharmacy's renewal request, there will be a new item in the Pending Errors list in the LinkLogic module (go to LinkLogic > Errors). The LinkLogic manager can resolve this error by re-importing the renewal request and selected the appropriate patient using the data-to-patient matching screen. The ePrescribing Administrator could also do this if they are granted the LinkLogic CHANGE errors privilege.


The Append to Document window will open. For ALL refill requests from the pharmacy, the user will have to create a full feature append, by selecting the Click here to do a Full Update action button.


Next the user will select the *eSM Rx Refill encounter type and click OK. NOTE:If the delegate received this document and is starting the Append document for the prescriber, the delegate must change the provider name to the appropriate registered prescriber before clicking OK.

Before the update opens, you will get a sign document popup stating that you are trying to append an unsigned document. The document will be signed before continuing with the append, so click OK to continue.


Once the update has opened, the eScriptMessenger-Rx Refills form will

automatically open. The information that is displaying on the left hand side is the

request coming from the pharmacy.

On the right hand side of the screen, you have 3 response options:

1. Approved

2. Denied

3. Denied new to follow


The approval response only has 2 editable fields which include Total refills and Note to Pharmacist. This will approve the refill as it came over from the pharmacy.

Approved Fields:

From Med List: This should automatically match, unless the pharmacy NDC is different from the NDC in Medispan. If it does not automatically match, then you will have a drop down to select the medication. Caution-Make sure the medication matches to the one listed on the left. If you want to change the medication, then you should use the denied new to follow method.

Instructions: This is a view only field and cannot be edited.

BMN: This is a view only field and cannot be edited.

Total Refills: You can edit the number of refills you want to approve.

Note to Pharmacist: Allows you to type a note up to 70 characters to send to the pharmacist.

Once you have reviewed/completed the fields, click on the Save Refill to Chartbutton. This is a required step in order to send the approval response back to the pharmacy.


When you click on the denied radio button there are predefined denial reasons that you may select from. If you choose Other you may type in your denial reason up to 70 characters in length.


The denied new to follow response will be used if you want to change medications, instructions, or quantity from what was received from the pharmacy. To make the change click on the Add/Change Medication action button. This will open the update medications window where you can continue with the prescription process.


A new Medicare eRx Incentive form has been designed to help generate the appropriate code for an update. It is recommended that you add the Medicare eRX Incentive form to either your favorites or encounter type.


A G-code will not be submitted if a qualifying visit has not been added to the update.


Once an office visit has been added to the update the appropriate G-code can be added.

*Please reference the CMS website to ensure you are using the most current G Code.

NOTE: Please ensure that your Practice Management System has been configured to allow zero fee charges to be submitted on claims.


The button will prevent you from trying to submit more than one G-code. If you need to use a different G-code than what is already listed, you will need to remove the first G-code from the Orders module and then click on the button again.


The following will provide an overview of the eSM Console. For full details about the eSM Console, refer to the eSM Administrator's Guide from Kryptiq.


Kryptiq's web-based eSM Console enables you to configure and manage eSM, and to monitor and resolve ePrescribing issues.

Configuration and management tasks include:

• Matching eSM and Surescripts pharmacies.

• Managing ePrescribers.

• Performing system tests.

• Setting up test patients.

• Configuring eSM.

• Creating and managing eSM user accounts.

• Backing up eSM.

Monitoring and problem-solving tasks include:

• Tracking messages.

• Processing failed refills.

• Troubleshooting.

To access the eSM Console, use Microsoft Internet Explorer 6.x (with SP2) or 7.x:

1. From the server or workstation where eSM is installed, browse to: http://localhost/esmconsole/

NOTE: To connect to the eSM server or workstation from another computer, browse to http://<server name>/esmconsole/.

2. Type your user name and password. Passwords are case-sensitive. Kryptiq Customer Support creates an initial administrator account. All other accounts are created by the eSM administrator.

‹#› /GE / Confidential and Proprietary Information

3. Click Log In.


Only users who will be maintaining the ePrescribing system, will need to have access to the eSM Console. The Home page provides links to the other pages available in the console.

eSM Console includes the following pages:

• Pharmacies – Match pharmacies in Centricity EMR to pharmacies in Surescripts.

• Prescribers – Register prescribers with Surescripts, enable ePrescribing services (New Rx and Accept Refill) for a prescriber, and assign delegates.

• Tracking – Monitor prescriptions, refill requests, and transactions related to eligibility and medication history.

• Failed Refills – Manage failed refill requests sent to your clinic from pharmacies.

• Testing – Test system connections and set up test patients.

• Settings – Configure system settings.

• Users – Manage eSM Console users.


Use the Pharmacies page to match the pharmacies in Centricity EMR to those in Surescripts, to remove matches, and to add Surescripts pharmacies to Centricity EMR. The Pharmacies page has four tabs: EMR, Auto Matching, Manual Matching and Pharmacy List .

Before implementing Advanced ePrescribing, you will need to run the eSM Pharmacy Report (provided by Kryptiq). Review the report and:

• Remove duplicate entries.

• Update phone and fax numbers (including area codes).

• Ensure that each pharmacy is uniquely named.

Use the EMR tab to import your Centricity EMR pharmacy list into eSM for matching with the list of electronically-enabled Surescripts pharmacies. You can also use this tab to remove a match, effectively disabling ePrescribing for a particular pharmacy.

For more information about a particular pharmacy, click the View Pharmacy Details icon.

To import Centricity EMR pharmacies into eSM:

1. From the Pharmacies page, ensure that you are on the EMR tab and click Import From EMR.

2. A message appears at the top of the pharmacy list indicating how many pharmacies have been imported and how many pharmacies have been updated.

3. An asterisk appears next to those pharmacies that are already matched to pharmacies listed on Surescripts.

NOTE: Kryptiq recommends that you import pharmacies on a regular basis. When you click the Import From EMR button to update and maintain your pharmacy list, you are prompted to remove pharmacies in the eSM Console that are no longer listed in the EMR. This helps you synchronize your pharmacy lists.


Use the Auto Matching tab to search for matches between the pharmacies in Centricity EMR and those in Surescripts, based on phone number or fax number. You can then verify that the pharmacies are the same business and match them.

Use the Match on drop-down list to match pharmacies by phone number or fax number.

To match pharmacies by phone or fax number:

1. From the Pharmacies page, click the Auto Matching tab. Each unmatched EMR Pharmacy is listed with potential Surescripts pharmacy matches. Use the Match on drop-down list to find potential matches based on phone number or fax number.

2. For each EMR Pharmacy, select one pharmacy from the listed SureScripts-RxHub pharmacies.

NOTE: You can match multiple pharmacies at the same time.

3. Click Match Pharmacies. A message appears indicating that the pharmacies you selected are successfully matched. The matched pharmacy is removed from the Auto Matching tab.

NOTE: If you discover that an incorrect match has been made, you can remove a matched pharmacy and disable ePrescribing for that pharmacy.


Use the Manual Matching tab to match pharmacies that could not be matched by phone or fax number. The unmatched Centricity EMR pharmacies appear at the top of the tab. Electronically-enabled pharmacies from Surescripts appear at the bottom.

To match pharmacies manually:

1. From the Pharmacies page, click the Manual Matching tab.

2. Select a pharmacy from the EMR Pharmacies list. Unmatched EMR pharmacies are listed three at a time. Use filtering to find a particular pharmacy (see "About Filtering and Sorting" in the eSM 3.0 Admin Guide). Click Next or Prev (previous) to browse the list of unmatched pharmacies.

3. Find the pharmacy that you want to match on the ePrescribing Pharmacies list and select it. Unmatched ePrescribing pharmacies are listed five at a time. Use filtering to find a particular pharmacy (see "About Filtering and Sorting" in the eSM 3.0 Admin Guide). Click the page numbers at the bottom of the ePrescribing Pharmacies list to browse unmatched pharmacies.

4. Click Match Pharmacies. A message appears, indicating that the pharmacies you selected were successfully matched.

NOTE: To quickly copy the query information from the EMR Pharmacies list search fields to the ePrescribing Pharmacies list search fields, click the Copy Filters icon.


Use the Pharmacy List tab to export pharmacies from Surescripts to your Centricity EMR pharmacy list. You can also use this tab to remove a match, effectively disabling ePrescribing for a particular pharmacy.

For more information about a particular pharmacy, click the View Pharmacy Details icon. NOTE: Pharmacy service levels: 0 = Disabled for ePrescribing. 1 = Accepts new prescriptions only. 3 = Accepts both new prescriptions and refill requests.

To export pharmacies to Centricity EMR:

1. On the Pharmacies page, click the Pharmacy List tab.

2. Select the check box next to each pharmacy that you want to export.

3. Click Export To EMR. The pharmacies are added to the EMR tab. They are also added to your Centricity EMR pharmacy list, and their default Prescribing Method is set to Electronic.

Remove a Matched Pharmacy and disable ePrescribing:

1. On the EMR tab or the Pharmacy List tab, select the pharmacy that you want to remove, and then click Remove Match.

NOTE: This restores the pharmacy's Prescribing Method to the previous default in Centricity EMR.


To import prescribers from Centricity EMR:

1. From the Prescribers page, ensure that you are on the ePrescribers tab and

click Import From EMR.

2. A message appears indicating the number of prescribers that were imported from Centricity EMR.

Each time you import prescribers from Centricity EMR, the eSM database is

updated to correspond to the newly imported prescriber list. If you make changes

in Centricity EMR, those changes will be reflected in the eSM prescribers list. If

you revoke ePrescribing privileges from a prescriber in Centricity EMR, the

prescriber will be removed from the eSM prescriber list. Users marked as

Obsolete in Centricity EMR are also removed.

Register Prescribers with Surescripts

• Prescribers must be registered with Surescripts before they can ePrescribe. A successfully registered prescriber is given a unique Surescripts Prescriber Identification (SPI) number.

• Only prescribers who have the ACCESS Electronic Prescribing privilege, NPI and DEA # in Centricity EMR and have been imported will appear on the ePrescribers tab.

NOTE: Before you register prescribers, verify that your eSM list of prescriber

suffixes is up to date. For more information, see the field description for Prescriber

Suffixes in "EMR Settings" in the eSM 3.0 Admin Guide


Surescripts assigns a unique SPI number to each prescriber, indicating that the prescriber is successfully registered. You can view the SPI number by clicking the prescriber's View Details icon.

To complete the registration process, a new ePrescriber (or a prescriber who is reactivating after a break from ePrescribing) must send five new electronic prescriptions. Afterward, the pharmacies begin sending refill requests electronically.

Enable New Prescription and Refill Service

After you have registered prescribers with Surescripts, you can enable ePrescribing services (New Rx and Accept Refill) for each prescriber. Registering prescribers automatically sets their service level to New Rx, enabling them to send new prescriptions.

To enable the Accept Refill service:

1. From the Prescribers page, verify that you are on the ePrescribers tab.

2. Select the Accept Refill check box for a particular prescriber.

3. Click Save Modifications.

Under most circumstances you will authorize prescribers for New Rx or for both New Rx and Accept Refill. If a prescriber leaves your clinic, you can disable the New Rx service for the prescriber and enable Accept Refill. You could then continue to refill prescriptions for a short term after the prescriber's departure


Delegates are authorized to manage ePrescribing on behalf of a prescriber.

You can assign a delegate to a prescriber from either the ePrescribers tab or the Delegates tab. If you use the ePrescribers tab, you can assign one delegate to one prescriber. If you use the Delegates tab, you are able to assign one delegate to one or more prescribers. One delegate can be assigned to multiple prescribers, but each prescriber can have only one delegate.


To assign a delegate to one or more prescribers using the Delegates tab:

1 From the Prescribers page, click the Delegates tab and locate a delegate. To shorten the list, enter the delegate's name and click Apply Filters, or select the location of care.

2 Click Add in the delegate's row. The Modify Prescriber Selection window appears.

3 Select the check box to the left of the prescriber's name. If you select more than one prescriber, the same delegate will be assigned to each of them.

4 Click Save Modifications and close the Modify Prescriber Selection window.

On the Delegates tab, the prescribers are displayed in the Prescriber column to the right of the delegate's name. On the ePrescribers tab, the delegate's name is added to the Delegate column, to the right of the prescriber's name.

NOTE: To remove a delegate using the Delegates tab, click Modify, deselect the delegate, and click Save Modifications.

To assign a delegate to a prescriber using the ePrescribers tab:

1 From the Prescribers page, ensure that you are on the ePrescribers tab and click Add in the Delegate column to the right of the prescriber's name. The Modify Delegate Selection window appears.

2 Select a delegate from the list. You can choose only one delegate.

3 Click Save Modifications and close the window. The delegate's name is added to the Delegate column, to the right of the prescriber's name.

NOTE: To remove a delegate using the ePrescribers tab, click Remove next to the


Use the New Rx tab to monitor new ePrescriptions and refill ePrescriptions that are initiated from the CPS Chart. You can access transaction details and verify transaction status.

Retail pharmacy transactions (SureScripts NewRx) are separated from mail-order transactions (RxHub NewRx).


Use the Refill Requests tab to monitor refill request transactions. Refill requests appear as documents the CPS Chart. You can access transaction details and verify transaction status.

Retail pharmacy transactions (SureScripts Refill Requests) are separated from mail-order transactions (RxHub Refill Requests)


Use the Refill Responses tab to monitor prescriber responses (approvals and denials) to pharmacy-initiated refill requests. You can access transaction details and verify transaction status.

Retail pharmacy transactions (SureScripts Responses) are separated from mail-order transactions (RxHub Responses).


Use the Error Messages tab to monitor failed prescriptions that were not sent to pharmacies. You can access message details and review error descriptions.


Use the Eligibility tab to monitor eligibility request and response messages. You can access transaction details and verify transaction status.


Uses the MedHistory-SS tab to monitor SureScripts medication history request and response messages. You can access transaction details and verify transaction status.


Use the MedHistory-RxH tab to monitor RxHub medication history request and response messages. You can access transaction details and verify transaction status.


Use the Message Queue tab to resend or cancel transactions that you create when connectivity to eSM Central is lost or disrupted.

In the event that connectivity is lost, eSM queues messages that cannot be sent to eSM Central. The Message Queue tab displays a description of each transaction in the queue.

When connectivity is restored, click Re-Send to process the transaction. If you do not want to re-send the transaction, click Delete.


Use the Failed Refills page to review refill request error messages and correct errors. The messages also appear as failures in the Centricity DTS.

Retail pharmacy transactions (SureScripts Failed Refill Request) are separated from mail-order transactions (RxHub Failed Refill Request).


You can run tests that verify communication between eSM and CPS, and between eSM and the Surescripts network. Generally these tests are performed immediately after installation.

Choose one or more of the following tests: • Test EMR Connection verifies that the eSM Console is connected to the Centricity EMR database. • Test Clinic Connection verifies that eSM is communicating with the database that matches pharmacies and manages prescriber information. • Validate EMR Refill Setup verifies that the eSM import kit and clinical kit are properly installed for Centricity EMR. In addition, it generates a test refill request. • Test SureScripts NewRx sends a test prescription to eSM Central and verifies that the new prescription process is working properly on the SureScripts network.• Test RxHub NewRx sends a test prescription to eSM Central and verifies that the new prescription process is working properly on the RxHub network. NOTE: You must match at least one pharmacy and register at least one prescriber before running Test RxHub NewRx or Test SureScripts NewRx. If you do not set up a pharmacy and a prescriber before running these tests (or choosing Select All), the tests will fail.

To run a system test:1. From the Testing page, ensure that you are on the System Tests tab. 2. Either choose the Select All check box to run all of the tests, or select one or more of the individual tests. 3. Click Run Selected Tests. If the tests are successful, success messages appear in the Results area.


Use test patients in the eSM Console when testing ePrescribing and when training eSM administrators.

To add test patients: 1 From the Testing page, click the Test Patients tab. This tab contains a list of patients imported from Centricity EMR. 2 Type the patient name in the Name field and click Search. 3 Click the Add test patient icon next to each patient that you want to use. The patient is added to the Test Patients list. TIP: Add all of the test patients that your clinic uses to the Test Patients list to avoid accidentally sending test prescriptions to your pharmacies.

Remove Test Patients:You cannot create a real prescription for a test patient until you remove the patient from the Test Patients list. To remove a patient from the list, click the red X next to the patient's name in the Test Patients list.

Send a Test Prescription:Providers who are new to ePrescribing may can send a test prescription before filling an actual prescription. 1 Add a test patient using the eSM Console. 2 In Centricity EMR, open the patient chart for the test patient, enter a new prescription, select an electronically enabled pharmacy, end and sign the update. 3 From the eSM Console Tracking page, click the New Rx tab. In the Clinic Status column, the words Message prepared appear, and track... appears in the Central Status column. 4 Wait a few moments to ensure that Central acknowledged appears in the Clinic Status column, and SureScripts acknowledged or RxHub acknowledge appears in the Central Status column. These messages verify that the prescription has been successfully sent. You can click the link in either of these columns to display details.


To configure eSM system settings:

1. From the eSM Console, click the Settings page.

2. Enter your settings.

3. Click Update Settings to save the changes, or click Cancel.

4. Restart eScriptMessenger Services (click Start > All Programs > Kryptiq Corporation > eScriptMessenger > Restart eScriptMessenger Services).

NOTE: You must restart eScriptMessenger Services for the new settings to take effect.

Default Area Code – If a phone or fax number contains only seven digits, eSM automatically adds this area code to satisfy the ten-digit requirement. This area code is also added to any prescriber, patient, or pharmacy phone number that contains fewer than ten digits.

EMR Flag On Success – If this check box is selected, a flag is sent to the designated user's EMR desktop for each successful prescription or renewal transaction. If this check box is not selected, a flag is sent only if an error occurs. Use the EMR Flags sent to user that setting to designate the person to receive these flags.

Include DEA Number In NewRx – Some states require that new prescriptions include a DEA number. Enter a list of two-letter abbreviations for those states in which you want the DEA number to be added when a new prescription is generated. Use a space to separate one state abbreviation from the next, as in this example: AZ MO WI

NOTE: DEA numbers and NPI numbers are copied to the eSM Clinic database when you import prescribers from Centricity EMR. If you plan to include DEA numbers or NPI numbers in your prescriptions, you should not remove them from Centricity EMR. If you do so, subsequent prescriber imports will overwrite the prescriber data, and the numbers will be lost.

Include State License Number In NewRx – Some states require that new prescriptions include a state license number. Enter a list of two-letter abbreviations for those states in which you want the state license number to be added when a new prescription is generated. Use a space to separate


one state abbreviation from the next, as in this example: AZ MO WI


EMR Flags sent to user that – Select the person to notify if an error occurs during prescription processing. If the EMR Flag on Success check box is selected, this person also receives notification of successful transmissions. The following options are available: • Select authorized the update to notify the user who is selected in the Authorized By field of the Prescriptions window in Centricity EMR. If you are using delegates, select this option to ensure that notification goes to the assigned delegate. The authorizing prescriber must be registered with Surescripts. See "Register Prescribers with Surescripts" in the eSM 3.0 Admin Guide. • Select started the update to notify the user who initiated the update that includes the prescription. • Select signed the update to notify the user who signed the update that includes the prescription.

ePrescribing Manager – Use this field to select the EMR user responsible for resolving failed refill requests. See "Resolve Failed Refill Requests" in the eSM 3.0 Admin Guide. The default value of this field is None. If None is selected, failed refill requests are sent to the prescriber. After you select an ePrescribing manager and update the settings, you cannot return to a state in which there is no ePrescribing manager. However, you can select a different ePrescribing manager.

To select or change the ePrescribing manager: 1 From the Settings page, click Select. 2 Select the ePrescribing manager from the list of Centricity EMR users.3 Click Save Modifications and then close the Select ePrescribing Manager window. 4 On the Settings page, click Update Settings. 5 Restart the eScriptMessenger Services (click Start > All Programs > Kryptiq Corporation > eScriptMessenger > Restart eScriptMessenger Services). The ePrescribing manager you selected becomes active.

Prescriber Suffixes – eSM removes the title suffixes from the last names that come from Centricity EMR and formats them so that they can be interpreted by Surescripts. This is done to ensure consistent name matching at the pharmacies. It is very important that you add additional suffixes to the list to reflect your clinic's naming conventions. NOTE: Surescripts restricts suffixes to a total of ten characters. If a prescriber's combined suffixes are more than ten characters, registration will fail. See "Register Prescribers with Surescripts" in the eSM 3.0 Admin Guide


CAUTION Do not change any of Account Service Settings without consulting Kryptiq Customer Support. The default settings are shown here.

Agent Polling Frequency – The rate (in seconds) at which eSM checks Centricity EMR for new prescriptions and new refill responses.

Subscriber Polling Frequency – The rate (in seconds) at which eSM: • Checks eSM Central for refill requests from Surescripts. • Sends refill requests to Centricity EMR. • Checks the status of all messages sent to eSM Central. • Checks for eligibility and medication history transactions. These transactions can be monitored on the Tracking page. See "Manage ePrescribing" in the eSM 3.0 Admin Guide

Pharmacy Polling Frequency – The rate (in hours) at which pharmacies added to Surescripts are available for matching with pharmacies in Centricity EMR.

Days to Keep Scripts – The number of days that eSM retains transaction messages before they are permanently removed. Kryptiq recommends 90 days.

Time to Purge Scripts – The time of day that transaction messages (as determined by the Days to Keep Scripts setting) are purged. Choose a time when your clinic will not be utilizing the eSM database.

eScriptMessenger Central SettingsCentral Service URL – The Internet address for eSM Central. You should never change this setting or your prescription transactions will fail. Formulary Service URL – The Internet address for eSM formulary service. You should never change this setting or your formulary requests will fail. Proxy Settings – If your network requires that you use a proxy server to access the Internet, click the Proxy button, select Use Proxy Server, and enter the proxy settings. Consult your network administrator for the correct settings. Central Service Timeout – The length of time (in seconds) that a request made to eSM Central waits before the request “times out.” CAUTION Do not change this setting without consulting Kryptiq Customer Support.


Central Service URL – The Internet address for eSM Central. You should never change this setting or your prescription transactions will fail.

Formulary Service URL – The Internet address for eSM formulary service. You should never change this setting or your formulary requests will fail.

Proxy Settings – If your network requires that you use a proxy server to access the Internet, click the Proxy button, select Use Proxy Server, and enter the proxy settings. Consult your network administrator for the correct settings.

Central Service Timeout – The length of time (in seconds) that a request made to eSM Central waits before the request “times out.”

CAUTION Do not change this setting without consulting Kryptiq Customer Support.


Resolve Failed Refill Requests

When a refill request sent from a pharmacy fails, a flag is sent to the desktop of the ePrescribing manager (see the ePrescribing Manager setting described in the 3.0 eSM Admin Guide.

Refill requests might fail because:

• A patient in the DTS can not be matched with a patient in Centricity EMR (No Matching Patient flag).

• A pharmacy is not electronically enabled in Centricity EMR (No Matching Pharmacy flag).

NOTE: Only use the Failed Refills page to deny refills to nonpatients or invalid providers, and to resubmit refills for unmatched pharmacies.

Resolve a "No Matching Patient" Flag in LinkLogic

When an electronic refill request is sent for a patient that does not match the demographics imported in DTS, a No Matching Patient flag is sent to the ePrescribing manager's desktop.

Use LinkLogic to match the patient and resubmit the refill request. When you have responded to the No Matching Patient flag in LinkLogic, the refill request automatically disappears from the Failed Refills page.

NOTE: Do not attempt to match the patient in the eSM Console by clicking the Match Patient button on the Failed Refills page.

These errors should be resolved in LinkLogic for the following reasons:

1. Resolving in these in the eSM Admin Console does not remove them from Error in Link Logic. Matching them in the console and in the DTS will result in duplicate documents appearing the chart.

2. The matching algorithm in eSM is not as good as the DTS and cannot correctly match patients with duplicate charts. If these are matched in the console, they will be submitted to the DTS and will appear again on the Failed Refills tab.

3. Failed refill requests cannot be matched more than once from the eSM Admin Console. If a patient is matched in the console and it not processed by the DTS it will appear on the Failed Refills tab again. If an Administrator attempts to match the refill again an error will be returned.

NOTE: The Failed Refills tab should only be used to Deny refill requests and resubmit refills for unmatched pharmacies. The Deny should be used when a refill is received for a patient or provider that is not at that practice. The refill should be resubmitted once the pharmacy has been matched or exported for electronic prescribing.

Resolve a "No Matching Patient" Flag by Denying It

If you can not resolve the No Matching Patient flag in LinkLogic, you can deny the refill request using the eSM Console.

To deny a failed refill request:

1. On the Failed Refills page, find the failed refill message using filtering. See "About Filtering and Sorting" in the eSM 3.0 Admin Guide.

TIP Find the message ID in the Centricity EMR flag. Copy the message ID to the Message ID text box and click Apply Filters. You can also filter by prescriber, pharmacy, or date.

2. Click Deny.

3. Click OK to confirm the denial. A message is sent to the pharmacy stating that the


request is from someone who is not a patient at your clinic.


Resolve a "No Matching Pharmacy" Flag When an electronic refill request is sent by a pharmacy that is not matched to a

pharmacy in Centricity EMR, a No Matching Pharmacy flag is sent to the ePrescribing manager's desktop.

To resolve a No Matching Pharmacy issue: 1. In Centricity EMR, note the request ID, prescriber, pharmacy, and date located

in the Details area of the flag. 2. On the Failed Refills page of the eSM Console, find the failed refill message

using filtering. See "About Filtering and Sorting" in the eSM 3.0 Admin Guide. TIP Find the message ID in the Centricity EMR flag. Copy the message ID to the

Message ID text box and click Apply Filters. You can also filter by prescriber, pharmacy, or date.

3. Click the Message ID to verify the name, address, and contact information for the pharmacy that was not matched.

4. After noting the pharmacy information, close the Message Information window by clicking the X in the upper-right corner.

5. Click the Pharmacies page. 6. Click the Auto Matching tab to see if the pharmacy is on the Auto Match list.

See "Match Pharmacies by Phone or Fax Number" in the eSM 3.0 Admin Guide.

If the pharmacy is not on the Auto Matching list, click the Manual Matching tab and try to match the pharmacy manually. See "Match Pharmacies Manually" in the eSM 3.0 Admin Guide.

• If the pharmacy cannot be matched automatically or manually, click the Pharmacy List tab. Find the pharmacy, select it, and then click Export to EMR. The pharmacy is now available in Centricity EMR and is electronically enabled. See "Export Pharmacies to Centricity EMR" in the eSM 3.0 Admin Guide.

7. Click the Failed Refills page. 8. Find the failed refill message, and click Re-Submit to generate a new HL7

message.

You can verify that the refill request has been successfully resubmitted. See"Verify a Refill Request Resubmission" in the eSM 3.0 Admin Guide.

Verify a Refill Request Resubmission To verify that a refill request has been successfully resubmitted: 1. From the Tracking page, click the Refill Requests tab. 2. Find the message using filtering. See "About Filtering and Sorting" in the eSM

3.0 Admin Guide. TIP Find the message ID in the Centricity EMR flag. Copy the message ID to the

Message ID text box and click Apply Filters. The refill request has been successfully resubmitted if the HL7 Re-Generated

status message appears in the Clinic Status column.


Enabled Accept Refills but still receiving refill requests via fax

1. Verify that the Accept Refills box has been checked on the Prescribers tab

2. Check to see if the prescriber(s) have sent 5 NewRx electronically in the eSM Admin Console

Note: After 5 electronic NewRx have been sent the providers(s) will begin receiving refill requests electronically slowly over a 2-4 week period.

3. Check to see if the fax refills are for schedule 3-5 medications. Some pharmacies will not send electronic refill requests for schedule 3-5 medications. Prescribers will never receive electronic refill requests for schedule 2 medications.

4. Verify the pharmacy information on the pharmacy tab of the eSM Console. Pharmacies with a service level of 1 cannot send electronic refill requests.

Unable to generate a SPI Number for a provider

1. Verify the provider has a valid NPI and DEA # on the user table in the EMR

2. Verify the provider’s home LOC has the following fields populated: Address 1, Phone and Fax

3. Verify the provider’s home LOC Phone and Fax #s do not contain extensions or extra details/options

4. Verify the provider’s suffix (MD,FAC, NP, etc.) is in the suffix list on the Settings tab of the eSM Console

How to use an alternate fax # for a provider

1. Open the eSM Console

2. Go to the Prescribers Tab

3. Click on the fax icon to the right of the fax number. This will allow you to change the fax number for a specific provider if it is different from the LOC fax number.


Error Description Error Flag Sent to EMR User

Who Will See the Error

No Matching Patient for Refill Request RefillRequest with warning: No matching patient found for the incoming refill request.

Flag sent to ePrescribing Manager. Error message appears on Failed Refills page of eSM Console.

No Matching Pharmacy for Refill Request

eScript with warning: No matching pharmacy found for the incoming refill request.

Flag sent to ePrescribing Manager. Error message appears on Failed Refills page of eSM Console.

No SPI Error on REFRES Failed RefillResponse: Prescriber does not have an SPI.

Flag sent to prescriber or delegate. Error message appears on Error Messagestab of eSM Console.

Error Sending to eSM Central Failed NewRx: Problem in sending NewRx Message to Central.

Flag sent to prescriber or delegate.

Failed Formulary Failed FormularyCheckStatus: ESM central FormularyCheckStauts service call return error.

Flag sent to ePrescribing Manager.

Missing Instructions for New Rx Failed NewRx: Empty Tag; Error: Directions tag in MedicationPrescribed tag of NewRx tag is empty.

Prescriber or delegate gets EMR pop-up window. Flag will not be sent to prescriber or delegate.

Invalid Medication Quantity Value tag in Quantity tag of MedicationPrescribed tag is empty.

Flag sent to prescriber or delegate.

Invalid Refill Quantity Failed NewRx: Invalid Refill Quantity Value; The refill quantity field contains an invalid value, <invalidvalue>'. This field only accepts numbers or the text 'PRN'.

Prescriber or delegate gets EMR pop-up window. Flag will not be sent to prescriber or delegate.

Approving Refill Request for Scheduled Drug

No Flag – EMR pop-up window.

Prescriber or delegate gets EMR pop-up when attempting to approve scheduled drug refill request.

Eligibility Error No Flag – Eligibility status appears as Unknown and may give error reason when viewed in EMR.

Prescriber or delegate sees eligibility error when attempting to prescribe a medication from the EMR


1. Who will clean up the pharmacies, if needed? Remove Duplicates, Update phone and fax numbers (including area code) and Ensure that each pharmacy is uniquely named.

2. Who will you designate as the ePrescribing Administrator? This individual would manage the pharmacy clean up and matching; setup and maintain the prescriber and delegate settings, etc. Also, this individual will receive eSM related flags.

3. Will you enable all providers simultaneously or in phases? Caution-Once the pharmacies in your database have been matched then it will override the previous settings and will have a default method of Electronic. This could cause more room for error for those prescribers who may not be enabled for electronic prescribing.

4. Will you enable New Rx and Accept Refills at the same time? Determine if you will enable all features at once or do a phased approach.


5. Will you need to assign a supervisor to any prescriber? The supervisor’s name will also go out on the prescription. This may need to be necessary for residents or NPs.

6. Will delegates be assigned to prescribers? If so who will be assigned to each prescriber? Delegates are individuals such as nurses or MAs who may be assigned to a provider to receive flags and refill requests.

7. Will you enable success acknowledgement flags? It is recommended that you turn this feature on in the beginning of your implementation. Once you feel comfortable that most of your prescriptions are successfully going electronic, you can turn this option off in the eSM Console.

8. What test patients will you be using? Since you cannot have a test database, you may want to have several test patients assigned in the eSM Console so that you can test your practice’s workflows and train the end users.

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