OpenEMR ePrescribe

From OpenEMR Project Wiki

Overview

There are currently two known options for e-prescribing in OpenEMR.

Newcrop, a subscription service, is well integrated into OpenEMR.

Weno Exchange a subscription service,is well integrated for narcotic/ECPS.

Formerly Allscripts was integrated but is now broken. (8-4-2022)

Allscripts

This section describes the integration of the Allscripts ePrescribe website with OpenEMR.

Website

  • Clicking the green button, with the question mark in the middle of it, navigates to the Help Section. This button is located at the bottom. The Help Section will give instructions regarding account acquisition and website use.
  • It is not necessary to pay for Deluxe Allscripts to use the Greasemonkey script. Choose Free Allscripts instead.
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Firefox and Greasemonkey

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Integration Script

  • The last step is the installation of the script, found here.
  • Click "Install this script".
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  • A Greasemonkey Installation dialog will appear. Click the "Install" button.
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  • Check the Add-ons Manager of Firefox to ensure that Allscripts IntegrationMM had been installed.


Using the Script

  • Go to the Patient Summary screen and click the "Allscripts" button at the top, to the right of the patient's age. If viewing with split screens, the Allscripts logon will appear in one of the two screens. If a check mark had been placed in the box between the patient's age and the "Allscripts" button, clicking the button will cause the Allscripts logon to appear in another tab.
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  • If the Untrusted Connection warning appears in a split screen and an exception cannot be added, open Allscripts in another tab.
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  • Click "I Understand the Risks" and add an exception.
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  • After logging on, the patient data will populate automatically if an account had been created previously. If a new account needs to be established, click the "Add Patient" button.

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  • In the Add New Patient screen, click the "Load from OpenEMR" button to import the data and click "Save".
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Non-Functioning

If both the split screen login and the "Load From OpenEMR" button are non-functional; the cause stems from the fact that the version of Firefox, when first installed, pre-dated version 31.0. Firefox underwent major changes with 31.0. Upgrading to the latest version will not permit the script to work properly, thus the following steps are necessary.

  • Uninstall Greasemonkey and the script.
  • Browser customizations should be preserved with Sync.
  • Uninstall Firefox and reinstall the latest version.
  • Reinstall Greasemonkey and the Allscripts IntegrationMM script.

Acknowledgment

The author of this clever and exceedingly useful script is Kevin Yeh, M.D., of IntegralEMR.

Modifications were contributed by Marcin Matuszkiewicz.


NewCrop

A partnership of ZH Healthcare and Medical Information Integration, LLC (mi-squared) called ZMG created the NewCrop interface for e-prescribing.

NewCrop vendors are authorized to service subscriptions to NewCrop's eRx services delivered through the interface integrated into OpenEMR. As of Dec 2020 only ZH Healthcare and MI-Squared are authorized vendors of NewCrop eRx with OpenEMR.

Subscribing to NewCrop is simply a matter of contracting for the desired services with the selected vendor, who then configures some OpenEMR globals settings with their NewCrop account connectors. Assuming that the patient demographics and the facility and user data are properly formed, the subscriber is ready to use NewCrop regular eRx immediately.

Electronic Prescription of Controlled Substances (EPCS), as offered by MI-Squared, is an optional separate add-on subscrioption- I'm not familiar with how ZH Healthcare manages their eRx subscriptions. Adding EPCS reqires a deeper level of 'IDentity Proofing' (IDP) to assure the applicant is not a criminally fabricated identity seeking access to EPCS.

Once the IDP is completed for EPCS the provider may e-prescribe controlled and non- controlled medications with the same workflow except for entering a 6 digit One Time Password (OTP) when their batch of orders contains a controlled substance. Again, this is a description of MI-Squared's eRx package.

Please note that the demo video that used to be on this page has been taken down. As of 2019, NewCrop demo videos presented by outfits other than NewCrop themselves are not authorized. Additionally, if they exist they may be long out of date.

Here is a link to NewCrop's own Help Videos on particular workflows. https://www.youtube.com/playlist?list=PLC2E55B597A88C7F9

The only video of an example of general usage that I know of is this one, which shows OpenEMR's walkthrough of the G3 Usability testing performed in 2015. As it happens that G3 testing used the NewCrop eRx service.

OpenEMR/ NewCrop eRx walkthrough for G3 Usability testing by MI-Squared MI2Bug40.png

Weno Exchange

WENO Exchange is the only ePrescribing intermediary that competes with Surescripts. Because you are going directly to the network, WENO is the lowest cost ePrescribing solution that supports the US, International, narcotic/ECPS, & Veterinarian ePrescribing. See prices for our stand-alone and 3 EHR connectivity options below.

  • WENO contributes part of the revenue earned from OpenEMR clients back to the OpenEMR community to keep it healthy.

STAND ALONE ePrescribing PRICES: Start ePrescribing in minutes, including narcotics (EPCS), by sign up for a free account at online.wenoexchange.com. Users without any ePrescribing role assigned are free. They also have a test prescribing role that is free and a great way to have a look at the screens. (select non veterinarian -no EPCS role to see the free test prescriber option). Users assigned to ePrescribing roles must have a $99/year or $180/year option where the difference is if the user will see advertisements or not.

EZ Integration prices: Free to sign up at online.wenoexchange.com, but pay $300 to go live after you turn in your test plan. This solution will allow your EHR to offer ePrescribing, including EPCS. The stand-alone prices for each user will apply after you go live. Your EHR will control the account with the ability to add as many locations/users as you need. The developer's page will show you how to send WENO info to iframe their ComposeRx screen (the prescriber does not need to supply patient or pharmacy info) - just complete the script. WENO will allow you to synch the charts throughout the day. This is a great solution if you need to ePrescribe yesterday. Find out more or sign up on the website wenoexchange.com - scroll down to see CONNECT YOUR SOFTWARE.

WENO Online API prices: EHRs that want more control of the ComposeRx screen but still need to offer EPCS to their ePrescribers, will find this API a great fit. You'll send WENO the prescription and then show the prescriber the page to sign it on a DEA audited application. Onboarding cost is $1550 ($800 one time sign on fee for support and $750/2 years for the drug database). The the stand-alone prices above will apply for the users. 

You'll have all you need to offer ePrescribing and control the ComposeRx screen.  Find out more or sign up on the website wenoexchange.com - scroll down to see CONNECT YOUR SOFTWARE.

WENO Switch API prices: If your EHR does not need to ePrescribe narcotics or if your EHR has its own DEA audit, or your country does not require this, then this is the API for you. WENO will show you how to send them prescription messages and they will route them to the designated pharmacy. Your EHR is in full control of the user's interface. This onboarding costs $800 one time sign on for support and $750/2 years for the drug database. After that its just 5 cents a transaction. No users fees. Find out more or sign up on the website wenoexchange.com - scroll down to see CONNECT YOUR SOFTWARE.


LIMITATIONS of ePrescribing with WENO (last updated May 18, 2022): WENO legally routes all ePrescriptions to all designated pharmacies, so all prescribers are in full compliance with all ePrescribing mandates; however, not all pharmacies in the US are compliant with the new mandates. After October of 2022 the federal government can fine pharmacies up to 1 million dollars for information blocking (which includes ePrescribing when ePrescribing is mandated). Until then, please take note of these limitations:

NY - should ePrescribe to WENO connected pharmacies only.

For now, Sch II narcotics must be either ePrescribed to a WENO connected pharmacy or written using the allowed exception that it will cause delays/problems for the patient.

WENO offers a free announcement service to notify pharmacies in any area if a prescriber is using WENO rather than Surescripts.

WENO has been ePrescribing since 2012 and offers all pharmacies a free web based ePrescribing service to retrieve the ePrescriptions they are sent until their own application can connect. This allows WENO to send ePrescriptions to all pharmacies in the world.

International ePrescribers should contact WENO before beginning to discuss drug data bases and other outliers.

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