How to E-Prescribe Compounded Medications

How to e-prescribe a compounded medication to Bayview Pharmacy

Bayview accepts electronic prescriptions from any Surescripts-connected EHR. This page covers what to enter, because compounded preparations are not in your drug database, and how to reach us from the four most common ambulatory systems.

Why the formula is not in your drug search

A compounded preparation has no NDC. Under the NCPDP SCRIPT standard your EHR sends a medication description rather than an NDC, and we dispense from that description. That is why the description you enter has to be complete: active ingredient(s) and strength, dose form, quantity, and directions. Every formula page in our prescriber catalog has a copy button that gives you that text.

The three rules

Put the formula in the prescription body

Not in Notes to Pharmacy. Some systems keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Name the strength and dose form in words

"Ketamine 10 mg/mL oral suspension" arrives ready to fill. "Ketamine, see notes" does not. Include quantity and directions in the same field.

Controlled substances are EPCS only

Fax and phone are not electronic prescriptions in any state we serve. Schedule II to V preparations must be transmitted electronically with two-factor authentication.

If your EHR forces you to pick a listed drug: choose the closest entry for the active ingredient, then put the full formula in the prescription body (the Sig or directions field). For controlled substances, choose an entry your system recognizes as controlled, usually the bulk powder for that ingredient, or EPCS will not validate.

Controlled substances

E-PRESCRIBE ONLY (EPCS). Faxed, phoned, and handwritten prescriptions for controlled substances cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.

Transmit with two-factor authentication through your EPCS-enabled EHR. Select a drug entry your system recognizes as controlled (usually the bulk powder for the active ingredient, for example Ketamine (bulk) powder rather than a branded product), then put the full formula in the prescription body. Schedule III and IV prescriptions may carry up to five refills within six months.

Step-by-step guides for our controlled preparations, with validated formulation codes, are on the formulation pages:

Steps by EHR

Epic

Before you start: medications your IT team adds by hand as user-defined records are print-only in Epic; they cannot be sent electronically. To e-prescribe a compound, order an existing database entry for the active ingredient and carry the formula in the instructions. If you send the same compound often, ask your Epic pharmacy analyst to build a compound order record for it.

Open the encounter and go to Meds & Orders (or the Orders activity), then search the active ingredient and select the closest listed product.
In the Order Composer, type the full preparation in the Sig or patient instructions: active ingredient(s) and strength, dose form, quantity, and directions. Add the same in the Note to Pharmacy field; it transmits with the prescription.
Set the Order Class to Normal (electronic). If it is set to Print, the prescription will not transmit.
Choose the pharmacy. If none is set, the Pharmacy Search window opens when you sign. Search Bayview Pharmacy, Warwick RI, or NCPDP 4106882, select it, and accept.
Sign. For a controlled substance, complete Epic's EPCS two-factor signing; choose a drug entry that Epic recognizes as controlled (bulk powder for the ingredient) or the EPCS step will not validate.

eClinicalWorks

Before you start: a CustomRx entry (Type: CustomRx, then New in the Select Rx window) cannot be transmitted electronically in eCW; it can only be printed or phoned. To e-prescribe a compound, select an existing drug entry for the active ingredient and carry the formula in the Take field.

Add Bayview once: in the patient's Pharmacy section click Add, check Show All to search the full Surescripts directory, search Bayview Pharmacy (or phone 401-284-4505), confirm the address is 3844 Post Road, Warwick, RI, and set it as primary. The E column confirms e-prescribing and the C column confirms EPCS.
In the Progress Note open Treatment, click Add, find the active ingredient, and open the Rx Editor.
Type the full preparation in the Take field: active ingredient(s) and strength, dose form, quantity, and directions. Set refills, then Apply and OK.
Click the arrow next to Send Rx and choose ePrescribe Rx. Select Bayview, check the medication, and click Send. Notes to the pharmacist in this window are optional; do not rely on them for the formula.
Confirm delivery under Hub, ePrescription Logs: the status should read Success.

athenahealth (athenaOne)

Set the pharmacy once: at check-in or from the patient's chart use the Default Pharmacy Search link, search Bayview Pharmacy, Warwick, RI 02886, and choose the entry marked eRX. If it does not appear, use Add Pharmacy with NCPDP 4106882.
In the encounter's Assessment and Plan, add a medication order. Search the active ingredient; if the compound is not in the drug list, use athenaOne's free-text medication option and enter the full preparation as the medication name.
Put strength, dose form, quantity, and directions in the Sig, not only in pharmacy notes.
Sign the order. It moves to SUBMIT status and transmits through the interface; a confirmation note appears when the pharmacy has received it. Do not intercept or reprint it.
Controlled substances: your account must be EPCS-enabled with two-factor authentication before athenaOne will transmit them.

Oracle Health (Cerner PowerChart)

Set the pharmacy once: click the Patient Pharmacy icon in the toolbar. In Review Patient Preferred Pharmacy open the Search tab (it prefills the patient's city and state), change the filter to Warwick, RI or search the name, right-click Bayview Pharmacy, choose Add to Patient Preferred, then right-click again and Set as Default.
Open Orders, click Add, and search the active ingredient. If your build includes a non-formulary or free-text medication order, you may use it; otherwise select the closest listed product.
In the order details enter the full preparation in the Special Instructions (patient directions) field: active ingredient(s) and strength, dose form, quantity, and directions. Add pharmacy comments if your build has them, but keep the formula in the instructions.
Confirm the order is routed to the preferred pharmacy and sign. Only US pharmacies appear in the search; Bayview is in Warwick, Rhode Island.
Controlled substances require EPCS with two-factor authentication and a drug entry the system recognizes as controlled.

Use a different EHR? The same three rules apply. Text us or call (401) 284-4505 and we will walk through it with you. After your first electronic compound to Bayview, call to confirm it arrived as you intended.

Not e-prescribing?

For non-controlled preparations only: fax a signed order form to (401) 284-4506, or call (401) 284-4505. Order forms are on each formulation page and in the prescriber portal. Controlled substances cannot be faxed or phoned.

Compounded preparations are not FDA-approved. A valid prescription is required. Licensed to dispense in RI, MA, CT, NY, NJ, NH, and FL. Reviewed by Ryan Dyer, RPh.