CEHRS Electronic Prescribing and Medication Management — Questions and Answers
Question 1: Which regulatory authority issued the foundational rule that established legal standards for electronic prescribing of controlled substances (EPCS)?
- The Office of the National Coordinator for Health IT (ONC)
- The Drug Enforcement Administration (DEA) (Correct answer)
- The Centers for Medicare & Medicaid Services (CMS)
- The Joint Commission
Correct answer: The Drug Enforcement Administration (DEA)
The DEA published its Interim Final Rule on Electronic Prescriptions for Controlled Substances in 2010, establishing the technical and identity-proofing requirements that prescribers and software vendors must meet to transmit Schedule II–V controlled substance prescriptions electronically.
Question 2: A pharmacy calls the clinic because a controlled substance e-prescription lacks evidence of two-factor authentication. What does this MOST likely indicate?
- The prescription was routed through the wrong pharmacy network
- The prescribing provider did not complete EPCS identity proofing or logical access controls (Correct answer)
- The patient has an outstanding balance on a previous prescription
- The DEA number on the provider record has expired
Correct answer: The prescribing provider did not complete EPCS identity proofing or logical access controls
EPCS regulations require that prescribers complete identity proofing and use two-factor authentication each time they sign a controlled substance prescription electronically. Missing authentication is a sign that the EPCS setup was not completed or bypassed, making the prescription invalid.
Question 3: When an EHR displays a drug–drug interaction alert during order entry, what is the MOST appropriate role of the EHR specialist?
- Override the alert immediately to keep the workflow moving
- Cancel the prescription without notifying the provider
- Bring the alert to the prescribing provider's attention for clinical review and decision (Correct answer)
- Contact the patient to ask about their allergy history
Correct answer: Bring the alert to the prescribing provider's attention for clinical review and decision
The EHR specialist is not licensed to make clinical decisions about drug interactions. The correct action is to ensure the clinician is aware of the alert so they can evaluate it and document their clinical reasoning — whether they override it or change the order.
Question 4: Medication reconciliation in an EHR is BEST defined as:
- Verifying that all prescribed medications were billed to the correct payer
- Comparing a patient's current medication orders to all medications the patient was previously taking to identify discrepancies (Correct answer)
- Calculating the correct weight-based dosage for pediatric patients
- Automatically refilling prescriptions that are within 7 days of expiration
Correct answer: Comparing a patient's current medication orders to all medications the patient was previously taking to identify discrepancies
Medication reconciliation is the clinical process of creating the most accurate possible list of all medications a patient is taking and comparing it to the provider's orders. This process is critical at care transitions (admission, discharge, transfers) to prevent omissions, duplications, and dosing errors.
Question 5: Which national network is most commonly used to route electronic prescriptions between EHR systems and retail pharmacies in the United States?
- CommonWell Health Alliance
- DirectTrust
- Surescripts (Correct answer)
- eHealth Exchange
Correct answer: Surescripts
Surescripts operates the largest e-prescribing network in the U.S., connecting prescribers, pharmacies, and pharmacy benefit managers. It handles both standard e-prescriptions and EPCS transmissions that meet DEA requirements.
Question 6: Which of the following is a PRIMARY patient safety advantage of e-prescribing compared to handwritten paper prescriptions?
- Prescriptions are automatically filled without requiring patient pickup
- The pharmacy can modify the prescription without contacting the provider
- Errors caused by illegible handwriting or misinterpreted abbreviations are eliminated (Correct answer)
- Patients are billed directly through the e-prescribing network
Correct answer: Errors caused by illegible handwriting or misinterpreted abbreviations are eliminated
Illegible handwriting has historically been a leading cause of medication errors — including wrong drug, wrong dose, and wrong route. E-prescribing transmits structured, machine-readable data that eliminates transcription errors at the pharmacy and reduces dangerous misinterpretations.
CEHRS Electronic Prescribing and Medication Management
Which regulatory authority issued the foundational rule that established legal standards for electronic prescribing of controlled substances (EPCS)?