Draft: Prescribe Medications

You can prescribe medications electronically from patient visits, phone notes, and portal messages in PCC EHR.

Prescribe Medications – Ready to Review Wt-Based Dosing Note

Open PCC eRx

From a visit, phone note, or portal message, click on the “PCC eRx” button.

When you click the button, PCC eRx opens within the patient’s chart.

Optionally Create an eRx Encounter: If you wish to review eRx information for a patient and there is no corresponding visit note, phone note, or portal message, click the “PCC eRx” button in the patient’s chart and choose the “Start an eRx encounter” option from the “Select an encounter” drop-down.

Review the Patient’s Details and History

Within PCC eRx, you can review the patient’s vitals, pharmacies, allergies, problem list, retail prescription history, prescription history, and medication history.

You can take different actions in each component, such as filtering the view to show active and inactive entries, marking the contents as reviewed, adding and retiring entries, or editing what is already there.

Learn About Each Component: To learn what information appears in each component of the PCC eRx screen and which actions you can take, read the PCC eRx Component Reference.

Go to the Prescribe Component

Click on the “Prescribe” button to jump to the Prescribe component of PCC eRx.

The Prescribe component is where you can write prescriptions for your patient.

Renew or Refill a Medication Instead: Instead of writing a new prescription, you can renew or refill a medication that is already in the patient’s history. Click the “blue swish” Renew Medication icon beside any entry in the patient’s Prescription History or Medication History to renew it. You can process refill requests from pharmacies on the Rx Queue.

Choose a Medication

In the Prescribe component, start typing the name of the product you want to prescribe in the “Add Medication” box.

As you type, a list of common, age-appropriate products matching your search term appears. Click on the product you want to prescribe.

Full Product Search: If your initial search turns up no results, select the “Full Product Search” radio button beside the search box. The Full Product Search expands the search beyond common, age-appropriate medications. Prescribers looking to prescribe durable medical equipment, for example, should use the Full Product Search option. Note that the Full Product Search does not account for age-appropriateness when returning results.

Prescribe from Favorites: Another way you can prescribe is from your Favorites list. Learn how to create, prescribe, and manage favorites in the PCC eRx Favorites article.

Optimize Search: You can save time when searching for drugs in PCC eRx by creating practice-wide search shortcuts, hiding unused drugs and dosing statements, and more. Read Optimize PCC eRx Searches with Shortcuts and Hiding to learn how.

Select a Dosing Statement

After you select a product, you are presented with a list of common, age-appropriate dosing statements and instructions. Choose a statement that exactly or closely matches the prescription you intend to write. The statement serves as a shortcut to start a prescription, which you can customize and expand upon in the next step.


Alternate Prescribing Workflows: If one of the dosing statements matches exactly what you would like to prescribe, you can click the green plus icon beside it to prepare the prescription and queue it to be reviewed, signed, and sent to the pharmacy. If you cannot find a dosing statement that roughly approximates the prescription you are trying to write, you can click “Enter Dose Manually” instead. This starts a prescription from scratch.

Customize and Complete the Prescription

After selecting a dosing statement, review the prescription in detail and fill out the remaining fields.

First, specify the dose form, amount, route, and frequency. This tells the patient how much to take and when to take it.

Then, specify the days supply and the dispense quantity and form. This tells the pharmacy how much to dispense and in what form.

The start date for the prescription defaults to today.

Optionally, you can:

  • direct the pharmacy to dispense as written (DAW), disallowing substitutions
  • specify a number of refills
  • specify a date to fill
  • indicate whether the pharmacy may send electronic renewal requests for the prescription
  • indicate who should receive follow-ups about the prescription, if you are writing it on behalf of another provider
  • write out instructions for the patient and pharmacy
  • document an internal note that’s only visible to other users at your practice
  • set a duration for the prescription
  • add indications
  • and specify prescription start and stop dates

If you prescribe under the supervision of another provider, indicate their name in the “Supervising Provider” field. If you are preparing the prescription on a provider’s behalf, indicate their name in the “Ordering Provider” field.

Days Supply, Duration, and Stop Dates: You can use the days supply, duration, and stop date fields to create prescriptions that stay neat and tidy once added to the patient’s medication history. Learn how in the “Days Supply, Duration, Stop Dates, and Autocalculation section below.

If the dosing instructions are more complex than the standard fields for quantity, route, and frequency allow, check the “Instruction Only” box.

The “Instruction Only” option allows you to write your own dosing instructions for the patient instead of requiring you to use the standard fields for quantity, route, and frequency.

Because instruction-only prescriptions allow you to bypass certain fields that are used for safety checking, they cannot trigger all forms of safety alerts.

Prescribe Multiple Months’ Supply of Schedule II Controlled Substances: If you are prescribing a Schedule II controlled substance, you can turn a single prescription into a three-month supply in one click. Only users in certain roles can prepare, sign, and send controlled substance prescriptions. You can learn more about prescribing controlled substances in the article Prescribe Controlled Substances Electronically (EPCS).

Weight-Based Dosing: When you select a weight-based dosing statement, it starts a weight-based prescription using the patient’s most recent weight measurement. On fixed-dose prescriptions, you can switch to a weight-based dosing scheme by entering values in the “Wt-Based Dosing” and “Weight” fields. To learn more about weight-based dosing in PCC eRx, read the “Weight-Based Dosing” section below.

Formulary Support: With enough information about the patient and their health insurance plan, Surescripts, the vendor who facilitates information exchange between PCC eRx and pharmacies, may be able to provide prescription benefit coverage information for the drug you are prescribing. This information appears in the “Formulary Support” section as you prescribe.

Recommended Adjustments: Drugs that carry considerations for patients with renal, liver, or other systemic impairment show the relevant organ in the Adjustments section as you prescribe. The recommended adjustment is based solely on the drug being prescribed, not the patient’s record.

Check Your Work

As you write a prescription, you can see a live preview of what the pharmacy will receive on the right side of the screen.

Check the preview and make sure the prescription isn’t missing any key information, such as a destination pharmacy or certain instructions.

You can update pharmacy information right on the prescription preview.

If you are missing certain instructions, red text on the prescription preview tells you what fields you need to fill out.

As you fill in the missing information, the preview updates to reflect your changes and the red text disappears, indicating that the prescription is ready to send.

Send, Print, or Save the Prescription

Once written, you can electronically send the prescription to the pharmacy, print a physical copy, or save and process it later.

Option 1: Send the Prescription

To send the prescription electronically, verify that “eRx” is selected on the prescription preview and click the “Process Now” button.

The prescription goes to the pharmacy electronically while you move on to your next task.

Authentication Required for Electronic Prescribing of Controlled Substances (EPCS): When processing electronic prescriptions for controlled substances, you must prove your identity by entering a personal password and a code generated by an electronic authentication token that is tied to your NPI and DEA credentials. To learn more about electronic prescribing of controlled substances and how to obtain an electronic authentication token, read Electronic Prescribing of Controlled Substances (EPCS).

Option 2: Print the Prescription

If printing is enabled for prescriptions at your practice, you can print the prescription instead of sending it electronically. Select “Print” on the prescription preview and click the “Process Now” button.

The ability to print prescriptions is only enabled where allowed by local regulations.

Option 3: Save the Prescription and Process it Later

If you want to queue the prescription to send or print later, click the “Save” button at the bottom of the window.

When you click “Save,” the prescription saves into the Review & Sign component of PCC eRx pending further action.

You can edit, send, print, or delete pending prescriptions at any time from Review & Sign.

When you finalize pending prescriptions in Review & Sign, you can put finishing touches on them as a batch before processing them to be printed or sent electronically to the pharmacy.


Work With Pending Prescriptions on the Rx Queue: In addition to working from a patient’s specific PCC eRx page, you can also edit, process, and delete pending prescriptions for any patient from the Rx Queue in PCC EHR. Learn more about the Rx Queue in the article The Rx Queue: Alternate Prescribing Workflows.

Review Completed Prescriptions

Prescriptions that have been printed or sent to the pharmacy remain in the Review & Sign component of the patient’s PCC eRx encounter and receive a timestamp indicating how and when they were processed.

You can find out more information about how and when a prescription was sent to the pharmacy by hovering over the timestamp or clicking the grey disclosure triangle icon beside it. The information in these areas can help you determine precisely when a prescription left your system.

Cancel Sent Prescriptions: Click the trash can icon next to sent prescriptions in Review & Sign to cancel and delete them from the patient’s Prescription History. Where possible, an electronic cancellation is sent to the pharmacy. To learn more about how to cancel and delete prescriptions, read the “Cancel and Delete Sent and Printed Prescriptions” section of this article.

Prescription Features – Ready to Review

PCC eRx empowers you to prescribe quickly, effectively, and safely with features that check for safety concerns, auto-calculate doses and dispense quantities, and more.

Medication Warnings and Safety Alerts – Ready to Review

PCC eRx alerts prescribers on the product search screen when a drug may be inappropriate for the current patient’s age, contraindicates one of their documented allergies, interacts with other drugs or certain foods, or duplicates a therapy that they are currently taking.

If you choose to prescribe a medication that is contraindicated for some reason or outside of normal parameters for the patient in question, automated safety checking protocols in PCC eRx present you with alerts that you must manually override before you can complete the prescription.

A user with Administration permissions in PCC eRx can customize the frequency and sensitivity of warnings and alerts at your practice, create a list of custom medication warnings, and manage the list of safety checking override reasons. To learn more, read Customize PCC eRx Alerts and Warnings.

Weight-Based Dosing – Ready to Review

When you search for a drug that is commonly prescribed using weight-based dosing, such as liquid antibiotics, PCC eRx presents weight-based dosing statements as an option or by default. Dosing statements are shortcuts to pre-fill a prescription, so you don’t have to complete every field manually. Weight-based dosing statements are typically expressed as a number of milligrams per kilogram per day (mg/kg/day) divided into a number of doses per day.

Choose a dosing statement that approximates the prescription you are trying to write. PCC eRx uses the information provided in the dosing statement and the patient’s most recently documented weight to start a prescription expressed as milligrams per kilograms per dose (mg/kg/dose), which you can then edit and refine to your exact liking.

The calculated volume per dose displays in red beside the dosing fields. If the calculation results in a volume that is impractical to measure or dispense, PCC eRx rounds it to the nearest dispensable amount within acceptable range.

You do not have to accept PCC eRx’s dose calculation, and can manually update any dosing field to meet the exact needs of the patient in question. If you want to recalculate a dose using a different number of mg/kg/dose or patient weight, you can change those values in the Wt-based Dosing section of the prescription and click “Calc Dose for Weight”. When you recalculate a dose, it updates the calculated volume per dose (in red) and the actual values in the dosing fields.


At any point while filling out a prescription that uses weight-based dosing, you can use the Calculated Values section in grey to double-check that the current dose values result in an appropriate total amount of medication for the patient.

Unlike the dose volume calculation in red, which only reflects PCC eRx’s most recent calculation based on a patient weight and number of mg/kg/day, the Calculated Values section updates dynamically whenever you change one of the actual dose values, giving you a real-time appreciation for the total daily dose for which the prescription is currently written.

Trust Your Judgment: Weight-based dosing calculations in PCC eRx are strictly based on your selections, information provided about the patient’s weight, and accepted guidance about the medication. They cannot replace your professional judgment about a patient’s specific needs or situation. Always defer to your own professional judgment when prescribing medications and tailor doses accordingly.

Days Supply, Duration, Stop Dates, and Auto-Calculation – Ready to Review

Prescriptions are written for a period of time. That period of time has different functions: patients need to know when to start taking their medications and how long to take them; pharmacies need to know how long medication supplies are intended to last and when they can be dispensed; and, your practice needs to know when medications are actively being taken.

Prescriptions in PCC eRx have fields to help you manage all of these concepts, and they work together using auto-calculation to keep prescribing simple.

Days Supply

The Days Supply field tells the pharmacy how many days a prescribed product is supposed to last. PCC eRx uses the Days Supply field to auto-calculate the total amount of product the pharmacy must dispense.

When you start a new prescription and the dosing statement includes a duration, the Days Supply field automatically matches that duration.


If there is no duration in the dosing statement, or you use the “Enter Dose Manually” option, PCC eRx automatically assumes you are writing a prescription for a 30-day supply.


To auto-calculate a dispense quantity and form, PCC eRx multiplies the dose quantity, frequency, and form or strength by the days supply, then translates the result into a quantity and form the pharmacy can logically dispense.


There are some cases where the Days Supply field is not used in the dispense quantity calculation, such as when you create a prescription for a piece of equipment, or for a medication that is dispensed as a standard tube, canister, box, or other package. In these cases, PCC eRx defaults to a dispense quantity of one.

When writing a prescription that is dispensed in a standard package size, always double-check that the dispense quantity is sufficient for the intended usage.

Duration

The Duration field indicates how long the patient is supposed to use the prescribed product. Duration bears a close relationship to days supply is used to auto-calculate a stop date for the prescription.

When you start a new prescription and the dosing statement includes a duration, the Duration field populates automatically.


If there is no duration in the dosing statement, or you use the “Enter Dose Manually” option, the Duration field remains blank.


When a duration is present, it is used to auto-calculate a stop date for the prescription. The stop date is the date the prescribed product will run out. Depending on the circumstances, it may also be the date the patient should stop using the product altogether.

On prescriptions with no explicit duration, the Days Supply field gets used in the stop date calculation instead.

When a prescription has a duration of less than 30 days, PCC eRx automatically checks the “Use Stop Date” box. When “Use Stop Date” is checked, the prescribed product automatically becomes inactive in the patient’s Medication History once the stop date has been reached.

Stop Date

The Stop Date field shows the date that the prescribed product will run out if the patient takes it as intended. In some cases, it is also the date the patient is supposed to stop using the product altogether.

Stop date is auto-calculated based on the start date and duration of the prescription, or the days supply if there is no duration.

PCC eRx always calculates a stop date based on the information available, but does not always make use of it. If you want a product to become inactive in the patient’s Medication History once the stop date has been reached, check the “Use Stop Date” box.

“Use Stop Date” is automatically checked off on prescriptions that have a duration of less than 30 days.

Stop dates display in the patient’s Prescription History and indicate when a prescription should have run out. You can use this information to prompt discussions about compliance.

Indications – Ready to Review

You can view common indications for medications while you prescribe, and use indications to transmit diagnosis codes with your prescriptions.

Search for a medication in the Prescribe component, then hover over it to view its common indications.

To transmit diagnosis codes with a prescription, add indications to it.

PCC eRx suggests indications from several different sources, such as the patient’s current visit, their problem list, and the most common indications for the medication. Click the suggested indications to add them to the prescription, or search for other options in the Indications field.


Indications map to SNOMED diagnostic terms on your PCC system, which in turn map to ICD-10 codes. When you save and finalize the prescription, PCC eRx transmits the ICD-10 code for each indication to the pharmacy and documents it in the Review & Sign component.

If you add an indication to a prescription that does not map to an ICD-10 code, PCC eRx transmits the text description of the indication to the pharmacy instead.

Formulary Support – Ready to Review

Whenever possible, PCC eRx displays formulary coverage information for patients and medications. Patients’ overall prescription benefit information appears in the Patient Information component. Medication-specific coverage details display as you prescribe.

In the Patient Information component, you can see the name of the patient’s prescription benefit manager, covered pharmacy types, and the plan name and status.

As you prescribe, a summary of the coverage details for the medication appear in the Formulary Support box next to the dispensing fields.

The coverage details are medication- and payer-specific, and may include information about whether the drug is brand name or generic, prescription or over-the-counter, its formulary status, the copay type and tier, the type of pharmacy that can dispense it, coverage factors such as whether prior authorization is needed, and therapeutic or payer-specified alternatives. To see the full coverage details for a medication, select the “click to to view full formulary details” link in the Formulary Support box.

Formulary information is provided by Surescripts, the vendor who facilitates information exchange between PCC eRx and pharmacies. At this time, formulary information is not in real-time, and instead relies on information being provided to Surescripts by insurance carriers. For the most up-to-date prescription benefit information, patients and providers should contact insurance carriers or pharmacy benefit managers directly.

Instruction-Only Prescriptions – Ready to Review

The “Instruction Only” option on prescriptions lets you write your own dosing instructions for the patient instead of requiring you to use the standard fields for quantity, route, and frequency.

You can use this option to prescribe a loading dose or taper, or to create any prescription that cannot be articulated using the standard dosing fields.

You can also use the “Instruction Only” option to build custom medication items.

Note: Because instruction-only prescriptions allow you to bypass certain fields that are used for safety checking, they cannot trigger all forms of safety alerts. For example, instruction-only prescriptions are subjected to allergy and duplicate therapy checks, but cannot trigger dose range warnings.

Prescription Drug Monitoring Program Links – Ready to Review

PCC can configure PCC eRx to display links to your regional prescription drug monitoring program (PDMP) and other important reference websites. Once configured, the links display in the Review & Sign component within the PCC eRx section of patient charts.

Click any link to open the associated website in a browser tab within PCC EHR. Once open, you can interact with the website just as you would in any internet browser.

When you have completed what you need to do on the website, click the red “x” icon on the browser tab to close it.

Common Prescribing Scenarios – Ready to Review

PCC eRx offers flexible options to manage complex yet common prescribing scenarios.

Create a Taper or Loading Dose – Ready to Review

Use the “Instruction Only” option on prescriptions where you want the patient to take a loading dose or taper.

The “Instruction Only” option lets you write your own dosing instructions for the patient instead of requiring you to use the standard fields for quantity, route, and frequency.

Note: Because instruction-only prescriptions allow you to bypass certain fields that are used for safety checking, they cannot trigger all forms of safety alerts. For example, instruction-only prescriptions are subjected to allergy and duplicate therapy checks, but cannot trigger dose range warnings.

Prescribe Equipment, Supplies, and Services – Ready to Review

When you want to prescribe equipment or supplies, use the “Full Product Search” option to search for the item.

If the item you wish to prescribe is available in the list, select it to start a prescription, then prescribe it normally.


If the equipment or supply you wish to prescribe is not available in the full product search, or you wish to prescribe a service such as speech therapy, a user with PCC eRx Administration privileges must create it as a custom medication item before you can prescribe it.

Once the equipment, supply, or service has been created as a custom medication item, you can search for it as you would any other medication and prescribe it normally.

You can learn how to create custom medication items in the article Create Custom Medication Items in PCC eRx.

Contact PCC Support for Help: Special prescribing scenarios carry many considerations, and what works for one practice might not work for another. Contact PCC Support if you need help writing prescriptions for less common items.

Prescribe Compounds – Ready to Review

When you want to prescribe a compound, start by searching for it by name in the medication search.

Your PCC system has standard entries for All-Purpose Nipple Ointment (APNO) and Magic Mouthwash. These entries contain itemized lists of ingredients and their ratios, each of which undergoes safety checking when you prescribe.

Standard compound entries may be e-prescribed just like any other medication.

If you wish to change the “recipe” of a standard compound entry or request that a new compound be added to your PCC system, contact PCC Support.

Optionally Create Compounds as Custom Medication Items: You can optionally configure compounds on your PCC system using the custom medication option. This approach is valid, but only allows you to create intruction-only prescriptions for compounds, which can be e-prescribed but do not trigger all forms of safety alerts. You can learn more about custom medication items in PCC eRx by reading Create Custom Medication Items in PCC eRx.

Prescribe a Three Month Supply of Schedule II Drugs – Ready to Review

In a single click, you can turn a prescription for a schedule II drug into a three month supply. Among practices using PCC eRx, this function is most commonly used for prescribing maintenance medications for the treatment of ADHD.

Prescriptions for schedule II drugs include an option to create a three month supply, which is situated beside the Date to Fill field.

When you check the box, PCC eRx populates the Date to Fill field with today’s date, then automatically calculates dates to fill for two additional prescriptions, each separated by the same number of days as is specified in the Days Supply field.

Depending on the patient’s needs, what an insurance carrier will cover, and your local regulations, you may wish to pre-date the prescriptions for months two and three so that they can be filled before the previous month’s supply runs out. This is called pre-dating.

If you pre-date the second prescription in the series, the third automatically updates to match. You can also pre-date the third prescription independently from the second and first.

All pre-dated prescriptions clearly indicate how many days in advance the patient may fill the prescription before the previous month’s supply runs out.

Prescriptions for a three month supply save and send just like any other prescription for a controlled substance. Once saved or sent, prescriptions for a three month supply appear as singular, tidy entries on the Rx Queue and in the patient’s medication and prescription histories.

Send Prescriptions to Different Pharmacies – Ready to Review

When you finalize multiple pending prescriptions for a single patient from the Review & Sign component, you can choose multiple pharmacy destinations for those prescriptions before sending them out the door.

With several prescriptions queued for a patient, go to the Review & Sign component in PCC eRx and click “Finalize Prescriptions”.

The Prescription Review window lists the queued prescriptions beneath their current destination pharmacy. The patient’s additional pharmacies display as tiles at the bottom of the window, along with the option to add a pharmacy.

To change a prescription’s destination pharmacy, select it from the list then drag it over to the new pharmacy. When the new pharmacy turns yellow, release the prescription to pair it.

Once paired together, the prescription displays beneath its new pharmacy destination in a list view. You can assign other prescriptions to that pharmacy by dragging and dropping them into the list.

You may have as many different pharmacy destinations as there are queued prescriptions. When all prescriptions are ready, click “Send Prescriptions” to process the whole batch.

Delete Pending Prescriptions – Ready to Review

You can delete pending prescriptions from several places in PCC eRx before they get printed or sent to the pharmacy.

Pending prescriptions save into the Review & Sign component in PCC eRx within the patient’s visit.

You can also find them on the Rx Queue in PCC EHR.

In either place, click the trash can icon beside the prescription to delete it. When you delete a pending prescription, its details do not enter the patient’s medication or prescription histories.

Cancel and Delete Sent and Printed Prescriptions

Pathways: Delete from review and sign or medication history
Delete from R&S (icecream pcc#2888 9/29/22 clonidine): click trash can > confirm delete action > cancellation sent pop-up > removes from R&S and Rx Hx but leaves it in Med Hx, leaves in Prescriptions component in EHR with canceled icon and “Discontinued” status label.
Delete from MedHx (icecream pcc#2888 9/29/22 ibuprofen): click trash can icon > confirm delete > enter reason for deletion > prompts you to call pharmacy to cancel > leaves record in R&S and Rx Hx with indication that it was canceled, leaves in Prescriptions component in EHR with no indication of cancelation

Reprint Prescriptions – Ready to Review

You can print void and original copies of processed prescriptions from the Review & Sign component in PCC eRx.

Click the printer icon beside any processed prescription to print a void copy of it for documentation purposes.


Void copies are watermarked with the words DO NOT FILL so that they cannot be used at a pharmacy.

To print an original copy of a processed prescription, hover over the printer icon in Review & Sign and click the secondary icon that appears beside it.

Original copies may be used at a pharmacy to fill the prescription.

In addition to Review & Sign component, you may also print void copies of processed prescriptions from a patient’s Prescription History.

It is not possible to print original copies of processed prescriptions from the Prescription History component.

Note: Local regulations dictate whether prescription printing may be enabled for your practice. The ability to print copies is only available at practices where printing is generally enabled.

View and Manage ePrescribing Errors

View Medications and Prescribing Activity Elsewhere in PCC EHR

Create and Prescribe Prescription Favorites

Document Historic, OTC, and Sample Medications

If you provide a sample medication, or a patient reports use of an over-the-counter or historic medication, you can record it directly in the patient’s Medication History.

For more information about adding historical medications in PCC eRx, read the Medication History article.

Renew and Refill Prescriptions

Prescribing Roles and Permissions – Ready to Review

In the User Administration tool in PCC EHR, users may be assigned one of five different PCC eRx roles:

  • Non-Clinical Staff: Non-Clinical Staff may edit patient pharmacies but may not create or send prescriptions.

  • Clinical Staff: Clinical Staff may create prescriptions for providers to review, sign, and send.

  • Provider Agent: Provider Agents may create and send prescriptions on behalf of a credentialed ordering provider. Provider Agent prescriptions automatically appear for signing on the ordering provider’s queue.

  • Mid-Level Provider: Mid-Level Providers may create and send prescriptions under their own provider credentials while indicating a supervising provider.

  • Provider: Providers may create and send prescriptions under their own provider credentials.

Prescribing roles and permissions should be assigned to users according the rules and regulations of the jurisdiction in which you practice. To learn more about prescribing roles in PCC eRx, read Set Up PCC eRx User Access.

  • Last modified: October 3, 2022