Naval Hospital Bremerton E-Prescribing Initiative benefits Providers and Patients

By Douglas H Stutz, Naval Hospital Bremerton Public Affairs

The old yarn about trying to decipher a doctor’s scribbled shorthand note for a prescription is coming to an end with a new electronic prescription initiative implemented at Naval Hospital Bremerton (NHB).

NHB is the first military treatment facility in the Department of Defense (DoD) to use the electronic prescription initiative, or e-prescribing. This capability allows civilian prescribers to electronically forward their prescription request(s) on behalf of their patient to NHB’s Pharmacy to fill instead of utilizing a handwritten paper script.

Electronically open for business... Naval Hospital Bremerton is the first military treatment facility in the Department of Defense (DoD) to use the electronic prescription initiative, or e-prescribing. This capability allows civilian prescribers to electronically forward their prescription request(s) on behalf of their patient to NHB’s Pharmacy to fill instead of utilizing a handwritten paper script. E-prescribing helps to clarify the dosage, quantity, and actual medication, increasing patient safety. It also prevents the potential for losing a written prescription (Photo by Douglas H Stutz, NHB Public Affairs).
Electronically open for business… Naval Hospital Bremerton is the first military treatment facility in the Department of Defense (DoD) to use the electronic prescription initiative, or e-prescribing. This capability allows civilian prescribers to electronically forward their prescription request(s) on behalf of their patient to NHB’s Pharmacy to fill instead of utilizing a handwritten paper script. E-prescribing helps to clarify the dosage, quantity, and actual medication, increasing patient safety. It also prevents the potential for losing a written prescription (Photo by Douglas H Stutz, NHB Public Affairs).

After NHB Pharmacy leadership briefed over a dozen medical business managers back in January 2014 on the initiative, the command went live for e-prescribing on March 14, 2014. The first e-prescription (eRX) was received March 20 at 9:55 a.m. Currently over 50 local civilian prescribers are participating in sending their patient’s prescription electronically to the NHB pharmacy.  

“This capability allows civilian providers to securely send their prescription and associated instructions electronically to Naval Hospital Bremerton for any of our NHB beneficiaries. We’re the first site to roll out the function but eventually all Department of Defense military treatment facilities will have access to this capability,” said Lt. Cmdr. Eric Parsons, NHB Pharmacy Department head.

According to Parsons, the electronic prescription initiative is part of a Congressional mandate that centers on ‘meaningful use’ of the Electronic Healthcare Record (EHR) system.

“This initiative helps civilian healthcare providers meet that standard by using the EHR for what’s it’s designed to do which is eliminate paperwork and electronically connect a provider with a pharmacy such as ours,” said Parsons, citing that if all hardcopy prescriptions were to be sent electronically, based on the past 365 days, that would be 47,375 prescriptions annually.

“We were so happy to find out that NHB was doing this. We love it. This is much more convenient for patients and much more cost efficient for providers,” said Ms Laurie Kehler, Clinic supervisor at Harrison Medical Center, Bremerton, Wash.

Prior to implementation of the e-prescribing capability, if a beneficiary went to see a doctor outside of NHB and as part of the overall treatment had to pick up medication(s), the provider would have to hand write the prescription for the patient to fill at the NHB Pharmacy.

“Receiving the prescription electronically helps to clarify the dosage, quantity, and actual medication, increasing patient safety. It also prevents the potential for losing a written prescription,” stated Parsons, adding that once a script has been sent to NHB’s Pharmacy, it can ‘sit’ for up to a year before being filled once the patient actually shows up to request the medication.

Parsons also attests that once the initial electronic prescription has been sent, received and filled by NHB, future refills remaining on the prescription can then be simply phoned in by the beneficiary and picked up at the drive-through option if so desired.

“Ideally we want all hard-copy requests for any prescription to go electronic,” Parsons said, noting that local doctor offices are excited to use the service due to it being much simpler, safer and more streamlined.

However, the system is currently no set up to handle any controlled substances such as Percocet or Vicodin. All controlled substances must be hand written prescription as in the current process.

Parsons attests that this is not only a secure method for transferring prescription data which means better accuracy, increased patient safety and less prescriptions lost or misplaced, but as the pharmacy staff get used to processing the eRXs, the familiarity will translate into more timely processing of the prescription than the old method of transcribing a written script. 

Cmdr. David Hardy, NHB Clinical Support Services director, was on the TriService design and implementation team that determined NHB would be the perfect location to test the initiative. 

“NHB is the ideal site to be the inaugural site due to our outstanding staff’s can-do attitude and their willingness to contribute to a successful effort.  We are not only testing the software for issues, we are also forging the way the new software is operationalized and integrated into our daily workflow,” explained Hardy, adding that lessons learned here will be rolled throughout the DoD healthcare enterprise.   

The design team has developed implementation and user guides with NHB staff contributing significantly to refinement of those documents, such as Parsons developing a comprehensive set of training slides which he will begin teaching to all of DoD Pharmacy in June. 

The design team has been comprised of the DoD PITAC (Pharmacy Information Technology Advisory Council) that consists of pharmacy information technology subject matter experts from Navy, Army, Air Force and Defense Health Agency, the Composite Health Care System (CHCS) Program Office, and Leidos (the contractor that maintains CHCS). 

The electronic prescribing address for NHB’s e-pharmacy is

DoD Bremerton ePhcy, 1 Boone RD Code 08RAZD, Bremerton WA, 98312, Phone: 360-475-4425, Fax: 360-475-4786.