Electronic Prescribing March 2010
	Finally. Not only was the certification process, required by Surescripts to allow direct writing of electronic scripts and renewals from within TheraManager, very protracted, but when completed, it took them 6 weeks to establish a production console for us! Everything is now in place. Alex has done an excellent job in developing the very complex code to send and synchronize scripts, and receive acknowledgments and renewals.
	This has been a very time consuming and expensive process for us but it does put us into a select group of top EMRs. We have accordingly changed our pricing strategy.. Anyone who wishes to use the TheraManager program interface will be required to pay the comprehensive annual subscription that includes all the features shown below, which may reduce your malpractice insurance, and give you Medicare credits. We are no longer offering the basic FDB index without the comprehensive benefits. If you have this option and you wish to use our interface, or at your next renewal, you will need to upgrade your subscription. If you are currently using the RXNorm free option, you will have to continue using the NewCropRX website to write your scripts electronically. Printing paper will continue to be available for all. The features that come with the comprehensive subscription are indeed comprehensive and valuable: Writing scripts and renewals using the TheraManager Prescription Screen and sending them (at least from your viewpoint) directly to the pharmacy, without having to wait for and use any web-screens. Automatic indication of waiting renewals requested by pharmacies and sending those renewals from the TheraManager Screen. The FDB database which populates the TheraManager Prescription Screen with available doses, forms, generic name and type of medication. This is updated monthly and is so much easier to use than RXNorm and avoids any future migration issues. Automatic creation of your own custom list of meds within TheraManager from the database. All scripts synchronized and stored in the TheraManager database as well as that of our partner for complete records for each patient. Interaction checks including drug-to-drug and drug-to-disease interactions, food and drug allergies.. Formularies based on the patients' insurance plans, which can save your patients money. Drug Monographs for your technical education. Patient Notes in multiple languages, to inform your patient and save you time explaining side-effects etc. Making a note in your EMR that you have printed this for the patent could save you from the major cause of lawsuits to psychiatrists. We plan to add this note automatically in the future. National List of Pharmacies updated daily for electronic transmission . Remote browser capability (Any computer or internet-connected PDA or smartphone) for responding to out-of-the-office medication requests using the NewCropRX website.
	To enable the new Screen interface for electronic prescriptions, you must first have the March 22 update, and if you are already registered with a comprehensive subscription, you will then be ready to go. If you are not so registered please call customer service for a new registration.
	You can write your script in the usual way either from the FDB Index or from your custom list if you have been using the FDB index already. If you have not been using the FDB Index, you will need to empty your custom list using the Cleanup Button on the Settings Tab and the custom list will be repopulated as you write new scripts. This is required because of the unique identifiers in the FDB Index required to transmit the med, dose and form.
	When your script is setup on the Prescription Screen a new Review Button will be enabled. This will open a Review Screen, required by Surescripts, before the final transmission. If the Pharmacy Button is red then for just the first time for each patient if you have not done this already, you will need to click that button and select the pharmacy by searching the list provided.
	Renewals (and failed transmissions) will blink on the lower status bar. Click the Renewal Button on the Prescriptions Screen to review the pending renewals. Click on each pending renewal to check for a match with prior scripts. The yellow color and text shows mismatch information. You may selct a reason fom the drop-down list and deny, renew or modify at your discretion, send a note to the pharmacist. On first using this you may initially see a bunch of unhandled out-of-date renewals. These should be handled as "Denied" with a reason from the drop-down box and a note to the pharmacy such as "Please ignore. Out-of-date Request". If you see messages about not recognizing, patient, the medication and/or pharmacy, this may be because the pharmacy was not responding directly to a prior electronic script. If the request none-the-less makes sense, we suggest "Request Denied. New Script to Follow" and create a new script.
	We encourage those few who elected to use the RXNorm database to change to the comprehensive subscription service.
	If you have problems please email customerservice@theramanager.com or call 908-508-8900. I