E-prescription criteria for EHR attestation

Attestation requirements

DENOMINATOR/NUMERATOR/ THRESHOLD/EXCLUSION

* DENOMINATOR: Number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the EHR reporting period; or Number of prescriptions written for d rugs requiring a prescription in order to be dispensed during the EHR reporting period,

NUMERATOR: The number of prescriptions in the denominator generated, queried for a drug formulary and transmitted electronically using CEHRT,

THRESHOLD: The resulting percentage must be more than 50 percent in order for an EP to meet this measure,

 EXCLUSIONS: Any EP who:

(1) Writes fewer than 100 permissible prescriptions during the EHR reporting period; or
(2) Does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP's practice Location at the start of his/her EHR reporting period.

Additional Information

. The provider is permitted, but not required, to Limit the measure of this objective to those patients whose records are maintained using certified EHR technology (CEHRT), Authorizations for items such as durable medical equipment, or other items and services that may require EP authorization before the patient could receive them, are not included in the definition of prescriptions. These are excluded from the numerator and the denominator of the measure ,

* Instances where patients specifically request a paper prescription may not be excluded from the denominator of this measure, The denominator includes all prescriptions written by the EP during the EHR reporting period.

 As electronic prescribing of controlled substances is now possible, providers can choose to include aII prescriptions or only permissible prescriptions as long as the decision applies to all
patients and for the entire EHR reporting period, The determination of whether a prescription is a ''permissible prescription'' for purposes of this measure should be made based on the guidelines for prescribing Schedule II-V controlled substances in effect on or before January 13,
2010 ,

* An EP needs to use CEHRT as the sole means of creating the prescription, and when transmitting to an external pharmacy that is independent of the EP's organization such transmission must use standards adopted for EHR technology certification,

* EPs should include in the numerator and denominator both types of electronic transmissions (those within and outside the organization) for the measure of this objective,

*  For purposes of counting prescriptions ''generated and transmitted electronically,'' we consider
the generation and transmission of prescriptions to occur concurrently if the prescriber and dispenser are the same person and/or are accessing the same record in an integrated EHR to creating an order in a system tiat is electronically transmitted to an internal pharmacy,

* Providers can use intermediary networks that convert information from the certified EHR into a computer-based fax in order to meet this measure as Long as the EP generates an electronic prescription and transmits it electronically using the standards of CEHRT to the intermediary network, and this results in the prescription being filled without the need for the provider to communicate the prescription in an alternative manner.

* Prescriptions transmitted electronically within an organization (the same legal entity) do not need to use the NCPDP standards, However, an EP's EHR must meet all applicable certification criteria and be certified as having tie capability of meeting the external transmission
requirements of 170,304(b), In addition, the EHR that is used to transmit prescriptions within tie organization would need to be CEHRT,