When evaluating a Pediatric E.H.R. system, evaluating the connections and technology is challenging even for a technology savvy individual. One indicator of a system, the skills of individuals at an E.H.R. company or the dedication to solving a technology issue is the connections to other companies. Electronic prescriptions (ERx) are sent through a network/hub developed by the three large Pharmacy Benefits Managers (PBMs) known as Surescripts/Rx Hub. Surescripts allows E-prescription companies to link up directly to their network as well as E.H.R. system vendors. There are two primary levels of certification for Surescripts. The first provides the capability to send prescriptions, refill prescriptions and receive refill requests from the Pharmacy. The second level of certification provides all the formulary files for almost every plan in the country as well as the medication history of a patient. Some E.H.R. vendors choose to connect through an e-prescribing company (e.g. Dr. First) for one or both of these major components.
The second level of certification requires large files to be moved and managed. A small vendor might not have the technology capability and/or the financial resources to complete both level of certifications. A good question to ask a contact at the E.H.R. Company that you are evaluating is if they have direct connections for Surescripts? If not, ask why and explore other facets of the system – has the vendor been denied to link to a Health Information Exchange for lack of technology capabilities? If so, ask why?
If there appears to be a gap in the technology, consider exploring the credentials of the technology team – are they led by a CIO with experience in technology as well as a degree in Computer Science or Engineering?