E-Prescribing Workflow: What Pharmacy Techs Need

What Is E-Prescribing?

E-prescribing (eRx) is the electronic transmission of prescription information from a prescriber's computer system directly to the pharmacy's management system. It has largely replaced handwritten and faxed prescriptions in modern pharmacy practice. For PTCB exam preparation, understanding the e-prescribing workflow and its benefits is essential knowledge.

How E-Prescribing Works

The e-prescribing process follows a defined workflow:

1. Prescriber creates the prescription: The prescriber enters the prescription in their EHR system, selecting the medication, dose, route, frequency, quantity, and refills
2. Routing through Surescripts: The prescription is transmitted through the Surescripts network, the primary electronic prescribing network in the US, connecting over 1.5 million prescribers with virtually all US pharmacies
3. Pharmacy receives the prescription: The prescription appears in the pharmacy management system's electronic queue
4. Technician processes the prescription: The pharmacy technician reviews the electronic prescription, enters it into the workflow, and begins the filling process
5. Pharmacist verification: The pharmacist performs a clinical review and final check before the medication is dispensed

EPCS: Electronic Prescribing for Controlled Substances

The DEA permits and increasingly requires electronic prescribing for controlled substances (EPCS). EPCS has additional security requirements beyond standard e-prescribing:

• Two-factor authentication: Prescribers must use two of the following: something they know (password), something they have (token or phone), or something they are (biometric)
• Identity proofing: Prescribers must complete an identity verification process before using EPCS
• Audit trails: Systems must maintain complete records of all controlled substance prescriptions
• Third-party certification: EPCS software must be certified by a DEA-approved auditor

Many states now mandate EPCS for some or all controlled substance prescriptions. Pharmacy technicians should be familiar with their state's requirements.

Benefits of E-Prescribing

• Reduced medication errors: Eliminates handwriting interpretation issues
• Faster processing: Prescriptions arrive at the pharmacy before the patient does
• Improved formulary compliance: Prescribers can check formulary status at the point of prescribing
• Better drug interaction checking: Real-time alerts for interactions and allergies
• Complete medication history: Prescribers can view the patient's medication history through Surescripts

Common E-Prescribing Issues

Pharmacy technicians should be prepared to handle common eRx issues:

• Incomplete prescriptions: Missing information that requires a call to the prescriber
• Duplicate prescriptions: The same prescription sent to multiple pharmacies
• Incorrect pharmacy: Prescriptions routed to the wrong pharmacy location
• System downtime: Backup procedures for when electronic systems are unavailable
• Clarification requests: Using the eRx system to send clarification requests back to the prescriber

Technician Responsibilities in E-Prescribing

Pharmacy technicians play a key role in the e-prescribing workflow by monitoring incoming electronic queues, verifying patient information matches the pharmacy record, identifying and flagging incomplete or suspicious prescriptions, and processing refill requests through the electronic system.

Master pharmacy technology concepts for the PTCB exam at PTCBprep. Start with our free practice questions.