Medication history provides you with a way to access your patient's medication history and quickly reconcile each medication with those on your patient's medication list. If you’re enabled for eRx (e-prescribing), each time you schedule an appointment with a patient, the EHR will automatically check for the patient’s prescription eligibility and medication history from Surescripts. Whether your patient has filed a claim to fill a prescription or paid out of pocket with you or any other provider, medication history can conveniently compile a list of the medications that a patient has filled from a number of different sources.
Why Medication History?
Making a patient's past prescriptions available to a prescribing provider in conjunction with knowing a patient's current prescriptions is critical in providing meaningful care and driving patient safety and improving outcomes. With this information available electronically, you’re able to quickly reconcile the medication list with your patient and ensure that your patient's medication list includes the most accurate medications.
How Does Medication History Work?
This feature is only available to providers with e-prescribing enabled.
Step 1: Check Patient's Consent Setting
By default, medication history will be retrieved for a patient’s prescription history only from the provider with whom they have a scheduled appointment. To retrieve the patient’s full medication history across providers, you’ll need to receive consent from the patient and update the patient's consent setting to Patient's entire prescription history; patient consent given.
Please ensure that the patient has the following information in their patient profile.
· First name
· Last name
· Date of birth
· Address + Zip
Medication history will not work if there is no address.
You can alter this setting in the Profile tab of a patient's chart. You may choose between the following options:
Patient's entire prescription history - patient consent given: Will
retrieve the patient's entire medication history (PBM claims and
Pharmacy fill) for all providers the patient has seen across all
practices within and outside of the Practice Fusion network. This
setting is required to retrieve the patient's Pharmacy Fill medication
history even for just the prescribing provider.
Patient's prescription history with provider: Will retrieve only the patient's PBM claims data for the scheduled provider only.
Do not retrieve prescription history: Will not make any medication
history requests for the patient for all providers in the practice.
Step 2: Schedule Appointment OR Add/Record a Medication which runs an eligibility check.
When you schedule an appointment in the Schedule section, the patient's prescription eligibility check is automatically performed in the background. The provider assigned to the appointment must be eRx enabled. The eligibility check determines which Pharmacy Benefits Managers (PBMs) the patient is a member of in order to retrieve the PBM claims data for the patient.
Please note: Creating an appointment in the Schedule section triggers the medication history request. The Prescription History option selected at the time the request is made determines the medication history that will be returned from Surescripts (ie: "All of the patient's prescription history"). If you'd like to alter the type of medication history Surescripts returns, you must select a different option in the drop-down menu. At that point, a new appointment would need to be created in order to retrieve an alternate type of history for your patient. Surescripts only allows one prescription history request per 72 hours.
Step 3: Medication History is sent to the Patient Rx History Report
When the patient's medication history is retrieved from Surescripts, it will be automatically available for the provider to reconcile. Open the Reports section from the left navigation bar and select the Patient Rx history report. Patient medication histories will be assigned to the provider used to make the eligibility check. You can also sort by patient, date received, and most recent tasks. Once you have adjusted your filter settings, click Run Report. While you can review all patient medication histories within the report, the Status column will indicate if it has been reconciled.
Note: We have recently relocated patient medication history from the Tasks section to the Reports section. All patient medication histories will be available in the Reports section and will no longer be generating tasks going forward.
Step 4: Reconcile Medication History
Select View to be presented with a list of the items retrieved from either the PBM or the pharmacy, which will allow you to ignore, or add medications to the patient’s chart. You can use the buttons to the right of each item, you can Ignore or Add each item one at a time, or do this in a batch by using the Ignore all and Add all buttons at the top right corner of the page. Items in black (not in green) are already recorded in the patient's chart.
More details are available for each medication. Clicking on any item will expand the row to display additional details about the medication (see below screenshot).
How does this affect my eRx?
The retrieval of medication history will not affect the eRx status of users. It is not a requirement for using eRx.
Will I need to be eRx enabled to get my patient's medication history?
If the provider is eRx enabled, then the retrieval of PBM claims data is possible given that the patient has had a successful eligibility check performed.
If the provider is not eRx enabled, then the patient's PBM history is not available and the pharmacy FILL information request will not be sent.
What is pharmacy FILL data?
Pharmacy FILL data is the prescription fill history for a patient. This data is collected from all pharmacies in the Surescripts network that have filled a prescription for a patient. This list of medications will include the list of medications retrieved through the PBM claims request.
How far back is the patient's medication history retrieved?
For PBM claims data, the patient's last two years of history is retrieved. For pharmacy FILL data, the last year of history is retrieved.
Will this add more duplicate medications to my patient's med list?
The retrieval of medication history will not automatically add medications to a patient’s Rx list. The provider will be able to manually add each of the records to the patient's chart, if they choose. The records will appear to have duplicated medications because each represents when the prescription was filled. It is possible to have the same medication prescribed multiple times for the patient.
I don't want it. How do I turn the feature off?
In order to turn the feature off, you will need to navigate to the patient's Profile tab and set the patient's consent setting to “Do not retrieve prescription history.” This action will turn off the retrieval of medication history for the patient for all providers in the practice. Please know- that medication history, by default is set to only pull in medication history with the provider.
How do I turn if off for all patients in my practice?
At this time, you will need to turn off medication history for each patient one at a time.
How do I turn off medication history for just me and leave it on for other members of my practice?
At this point in time, there is not a way to turn off medication history on the provider level.
Is the retrieval of medication history an invasion of patient privacy?
By default, we will only be pulling the medication history of the patient for prescriptions in which the prescribing provider assigned to the scheduled appointment has written for the patient. In order to retrieve the full medication history of the patient, you will need to receive consent from the patient and set the patient's consent setting to "Patient's entire prescription history - patient consent given". It is the provider’s responsibility to determine consent from the patient and conduct their practices ethically.
How can you pull the patient's medication history if they have not given consent?
The provider is within his/her right to request the fill information for prescriptions he/she has written. The prescribing provider knows which pharmacies the prescriptions have been sent to and it would be no different than the prescribing provider calling the pharmacy to determine whether or not the prescription was filled. It is the provider’s responsibility to gain consent from the patients to pull in their entire medication history.
Can anyone in my practice perform reconciliation?
Medication history is currently available to all edit levels. We are not currently preventing anyone from being able to view and reconcile the medication, just as all edit levels can view medication lists within charts. The preferred workflow would be conducted by the provider who is completing the encounter.
In a patients chart, under Reconciliation, what is the difference between the medications in black and the medications in green?
The medications in black are already added to a patient’s medication list, therefore there are no “ignore” or “add” buttons. The medications in green are medications retrieved from the patients medication history, and the provider has to choose whether they want to ignore the medication or add the medication to the patients Rx list.
Can I bulk delete the Prescription History in my tasks list?
We have recently relocated patient medication history from the Tasks section to the Reports section. All patient medication histories will be available in the Reports section and will no longer be generating tasks going forward.
However, when in the Tasks list, you can go to the Actions menu and delete existing Prescription History tasks. You will be prompted to confirm that you want these deleted. Once deleted these cannot be retrieved, and the action cannot be undone. Deleting these tasks is final.
The bulk deletion of tasks is a time-saving feature designed to help simplify and streamline your practice management. Based on provider feedback, medication tasks can become overwhelming if the physician is out of the office, on vacation, or not using their tasks list. Because of this, we have allowed both staff and physicians to manage the tasks list and bulk delete items when necessary. Please note this action cannot be undone, so it's important to be careful when using this feature.