1. HIT Standards Committee Standards Summer Camp, ePrescribing of Discharge Meds Power Team (DMPT) Update and Recommendations Jamie Ferguson, Kaiser Permanente Scott Robertson, PharmD, Kaiser Permanente 20 July 2011

2. 2 Status & Progress Teleconferences –6/24, 7/5, next 7/27 Discharge Medication Use Case –Concepts, Scope, Requirements –Draft documentation of use case in circulation Preliminary Identification of Standards –ePrescribing and related workflow Recommendations –Align with existing regulatory requirements and initiatives –Use standards that are in-place, available and needed

3. 3 ePrescribing of Discharge Medications Use Case Defining Use Case by Workflow vs Scope –eRx standards exist but do not address full use case –Many workflow actions are not impacted by technical standards –Should stress where current workflow can be improved by application of messaging standards (direct and indirect) Internal versus External pharmacy transactions –Employ different eRx standards (HL7 vs NCPDP SCRIPT) –External facilities, other than pharmacies, may be involved Additional eRx functionality –Prescriber overrides for decision support prompts –Prescription change, cancel

4. 4 Recommendations: 1 of 2 1.Align Standards For Discharge eRx With CMS Standards For Medicare Part D –NCPDP SCRIPT for eRx to external/retail pharmacies Includes eRx to long-term care associated pharmacies –HL7 for eRx to internal/hospital pharmacies –Limitations for Controlled Substances eRx –Align timeline and functionality for updates and changes 2.Align Standards For Medication History Used in Discharge eRx With Meaningful Use And EHR Certification Standards –Ability to use comprehensive Medication History obtained from longitudinal summary documents in certified EHRs (CCD, CCR) –Standards for patient-reported medications a possible future capability

5. 5 Recommendations: 2 of 2 3.Align Standards For Discharge Prescription Medications Eligibility and Benefits With HIPAA Administrative Simplification –X12 270/271 when used during the prescription writing process 4.No Formulary Standard Is Recommended –NCPDP exists but not tested or implemented to prescribers –No current standard represents all types of formulary data –Team believes each EHR should not be required to contain the multiple formularies of all relevant drug benefit payers –Use case for standardizing transmission of formulary data is not clear and mostly unrelated to discharge eRx