eprescribe FAQs General Application FAQs

Transcription

1 Allscripts eprescribe eprescribe FAQs General Application FAQs What does eprescribe allow me to do? Based on Allscripts' award winning EMR technology, eprescribe enables physicians to improve patient care by helping to ensure the safety of every prescription written. eprescribe can perform the following processes: Patient prior adverse reaction checks Duplicate therapy checks Dosage checks Drug to drug interaction checks Formulary compliance checks Generic equivalent availability Electronic transmission to pharmacy What are some benefits to using eprescribe? The key benefit to physicians and patients alike is improved safety. In addition, physicians will save their organization time in prescribing documentation, transmission, filing, and numerous telephone conversations regarding lost, illegible, and non-formulary compliant prescriptions with the pharmacy. System Benefits: Improves patient safety with automatic drug interaction checking, dosage checks, adverse reaction checks, and duplicate therapy checks Provides access to patient medication history where and when you need it most even from home Reduces pharmacy phone calls Simplifies the prescription renewal process Provides formulary status on medications How do I get started? The process is fast and simple. You can register for eprescribe by visiting our website, You will need your DEA license number and state license number, as well as the expiration dates. You will be required to answer a series of questions to verify your identity and license information. Upon successful completion of the registration process, you will be asked to enter your practice location information, as well as some additional prescriber information. At that point, you may register additional providers or clinical staff at your site, or authorize someone else at the practice to continue the site registration for you. Where do I sign up? Only one physician per practice need to register, while the rest of the physicians can be added as users to the account. Please visit to register for the Allscripts eprescribe application. Once a physician is registered they will be the default administrator meaning they will be the only one with the ability to add additional users to the account. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 1

2 What are the steps involved in prescribing with eprescribe? Simply select a patient, select a medication, select a SIG [SIG is Latin for directions for use of medication dosage and frequency] and select a destination (send to a pharmacy or print the prescription). Will this meet Medicare requirements for eprescribe? Yes it will because, Allscripts eprescribe is CMS qualified meaning it can: 1. Generate a medication list 2. Select medications, transmit prescriptions electronically and conduct safety checks 3. Provide information on lower cost alternatives 4. Provide information on formulary or tiered formulary medications, patient eligibility and authorization requirements received electronically from the patient s drug plan. How will Medicare know I am using Allscripts eprescribe? Medicare is looking for physician s activities of eprescribe based on reporting one of three (3) G-codes entered on a practice s encounter form for an office visit. Note: One (1) of these codes must be entered every time a provider sees a Medicare patient in their office whether or not he prescribes a medication o All prescriptions were sent electronically (G8443) o o No prescriptions were written (G-code must still be entered) (G8445) Didn t write a prescription electronically due to an exemption (i.e. pt. request, controlled substances, etc.) (G8446) Hardware FAQs What type of computer do I need? You can use any type of computer, as long as it is connected to the internet. The speed of the application will vary depending on the type of broadband connection that your organization currently utilizes. What type of operating system do I need? Almost any type of operating system that can read a web page via the internet will work with eprescribe. Do I need a printer? Since, scheduled II, III, IV, and V medications can only be printed through eprescribe due to state and/or federal regulations, a Laser or Inkjet printer is required to print them. Your computer needs to be able to recognize your printer. It can either be directly attached (a local printer) or an accessible network printer. Can I use eprescribe on my mobile device? Yes, you can access the application from most touch-screen mobile devices as long as it is internet enabled, in order to access it please visit Does eprescribe support Windows Mobile 6? Yes, the mobile version of eprescribe supports Windows Mobile 6. Do I need a phone line or modem to fax prescriptions to a pharmacy? No phone line or modem is required. eprescribe utilizes the internet to send prescriptions to pharmacies that are connected to the Pharmacy Health Information Exchange, operated by SureScripts, which is the nation s leader in physician/pharmacy communications. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 2

3 Technical FAQs Can this application pull patient information from my practice management system? Yes, if you have an interface to your practice management system. How do I get my patients into the eprescribe application? eprescribe offers several options to populate your patient database. For smaller practices, eprescribe allows manual entry of patient demographics. For practices with a Practice Management System (PMS), a one time Master Patient Load (MPL), a live patient data feed or a Real Time Interface (RTI) is available. Allscripts has relationships with several leading interface companies, making the extraction and loading of your patient data fast and simple. Please consult our website for additional information and technical requirements. Does the system time-out if I forget to log out of eprescribe? Yes, the application will log you out after 20 minutes of inactivity for security purposes. Do I need special paper for printing prescriptions? Some states require that special security paper be used for certain types or all prescriptions. In most states, standard 8.5 x 11 in. white printer paper is acceptable. You may also purchase special security paper for your prescriptions. Allscripts has partnered with Micro Format Inc. ( to assist you with your paper requirements. What types of programs are downloaded to my computer? There are no programs downloaded to your computer, as eprescribe is a web based application. All you have to do is register, and within minutes you will be ready to eprescribe. Where can I review the End-User License Agreement and Business Associate Agreement for eprescribe? Our End-User License Agreement includes the Business Associate Agreement. You will be prompted to review and agree to the terms during the registration process. To review our End- User License Agreement, please click here. Application FAQs How do I get started? The process is fast and simple. You can register for eprescribe by visiting our website, You will need your DEA license number and state license number, as well as the expiration dates. You will be required to answer a series of questions to verify your identity and license information. Upon successful completion of the registration process, you will be asked to enter your practice location information, as well as some additional prescriber information. At that point, you may register additional providers or clinical staff at your site, or authorize someone else at the practice to continue the site registration for you. How can I manually add a patient into eprescribe? To add a patient, click on the Add Patient button. Then type in the five required fields which are first name, last name, date of birth, gender, and zip code. If you would like to enter in additional information, you may do so but it is not required. When finished, click on Save & Prescribe. What fields are required when entering in a new patient? Required fields are yellow on the screen and they include, first name, last name, DOB, Zip Code and Gender Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 3

4 What if the same patient is in the system twice? You have the ability to merge the two patient records and can be done so from the Settings Tab, and clicking on the link Merge Patients. Please note that the patient under Step 1 will be merged into the patient selected in Step 2, therefore the patient demographic information from Step 2 will remain. Will it just be our patients that we can see prescriptions for? When you search for a patient that search goes out to search Sure Scripts and searches nationally for all reported prescriptions for that patients. So, you will be able to see prescriptions prescribed nation wide for that patient. Where do patient ID numbers come from? From the existing Practice Management system, and if you do not have a real time interface the eprescribe application will assign a patient ID to your patient. You can replace this assigned patient ID with you site ID is you so choose. How will insurance plans be added? Insurance plans are added two ways. When a patient is selected for prescribing or checked in, eprescribe checks to see if any of our partners know about the patient. If the patient is found, the partner sends back insurance information, containing the prescription insurance plan information. If you do not receive a response, you can manually assign insurance to a patient. Click the Add Plan button at the bottom of the Patient Information Screen. Access this screen by clicking the edit link to the right of the patient name in the header. With the insurance plans, how are we going to know what medications are covered? There will be formulary indicators shown in the prescribing page that shows coverage levels for the medications. Formulary indicators: Are Red faces covered? It would depend on the insurance plan. Anything with the Red formulary status is a third tier drug for that patients insurance, and when selected formulary alternatives on the right hand side will populate. What are the steps involved in prescribing with eprescribe? Simply select a patient, select a medication, select a SIG and select a destination (send to a pharmacy or print the prescription). What is the difference between the buttons Select Dx and Select Med when prescribing? To prescribe by diagnosis, you first choose a diagnosis. This will start to link the medication to the particular diagnosis you are prescribing for. By clicking Select Med, you will skip past selecting a diagnosis and be directed to choose a medication to prescribe. What does it mean when I get a serious error and get thrown off the system? Simply log off and log back in. This may happen periodically if the system is overtaxed. When/if this happens do I lose everything I have done? You will not lose everything, but you will need to re-navigate back to where you were when the system threw you off. How do I know when the page is finished loading? It will say Done in the lower left-hand corner and the progression bar will disappear. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 4

5 Patient Demographic FAQs Can we remove a patient from the database once the patient is added? For example, a patient was entered by mistake. Is there an EIE (Entered in Error) for the patient record? No, for auditing purposes. However you can inactivate a patient from their editing screen. How do I add allergies or problems for patients? To add an allergy or problem for a patient, click on edit to the right of active allergies or active problems at the top of the screen. Can classes of drugs be entered for allergies? No, not right now. Drug allergies are assigned by drug name but processed by class for DUR checks. How do I edit patient information, allergies or problems? To edit patient information, allergies or problems, click edit at the top of the screen, next to the information you wish to change. Clicking on edit will take you to the appropriate screen for entering the allergy or problem. What if the date I entered is not recognized? Verify that the date is entered using the appropriate format (DD/MM/YYYY), it must have slashes or the system will not read it as a date. What if we do not know the patients drug allergies? This is not a required field, so it can be left blank. However, all known allergies should be added in order to get drug adverse reaction warnings. What if a patient does not have any allergic reactions to medications? If your patient does not have any allergies to medications, you can document asking and receiving this answer by selecting 'Add allergies' and clicking No known allergies. Where will the patient s historical medication list come from? There is a national database that contains historical pharmacy records from all over the country, so if a patient s prescription was filled at a pharmacy that reports to the national database, that prescription will show up in the patient s historical medication list. If the prescription was filled at a pharmacy that does not report to the national database, then the prescription will not show up in the patient s historical medication list. However, in this case, the prescription can be added to the historical medication under Review History and Adding a Patient Reported medication. When searching for problems do you have to search with words or can you use ICD9 codes? You can search using either. Where does the problem list come from? They are populated from the ICD-9 database. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 5

6 Writing Prescription FAQs I prescribe compounded medications and/or tapered drugs and they are not in the application, can I create them? Yes, you can easily create a compounded medication or a tapered dose of a medication by using the Free Form Script or Free Form Sig option in the application. Can I only print prescriptions? No, printing a prescription is not your only option. You will be able to electronically transmit your patients prescriptions to any U.S. pharmacy connected to the Pharmacy Health Information Exchange, operated by SureScripts. Can I delete a prescription if I accidentally selected the wrong medication? How do I delete it? For audit purposes, information is never truly deleted from eprescribe. If you have selected the wrong medication, but have not yet completed the prescription, simply click Cancel. If you have completed the prescription (Meaning clicked the Process Script Pad Button), click the Review History tab, select the desired medication, and then click Entered in Error [EIE]. If a prescription has been marked EIE and has been transmitted to the pharmacy or the printed script has been given to the patient, you must call the pharmacy and inform them of this fact. Marking a prescription EIE or D/C DOES NOT send this information to the pharmacy. You must inform (call) the pharmacy to make sure the prescription is not filled or dispensed to the patient. Can a diagnosis be assigned to a prescription once the prescription is processed and sent to the pharmacy? Can the Review History screen be used to add a diagnosis after the status is set to "Sent to Pharmacy"? No, but you can add a diagnosis to the patient record by clicking the edit button next to the Active Problems at the top and adding it to the record. Can a Patient Education sheet be printed in any other places other than the SIG build screen? For example, after the prescription has been sent to pharmacy It can only be printed from the SIG screen. Can the Review History be used to access an inactive prescription in order to send a new prescription? This will allow for less building because the SIG, quantity and pharmacy is already filled out. No, but it would be saved under a Patient's medication history so the user will need to select the appropriate radio button, which would be Patient History to prescribe a previously prescribed medication. If a user has been assigned POB rights in their profile, will they be able to send Prescriptions to the Pharmacy? Yes, if allowed by the providers policy. Can an MA send prescriptions to the pharmacy without a physician s prior approval? Yes, only if they have been set up as a POB. Will the process of discontinuing a medication send notification to SureScripts or to an original Pharmacy? No, if there was an error made and the prescription has been sent then they will need to call the pharmacy to alert them of said error. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 6

7 If the prescription has been sent to the pharmacy and we mark the prescription as entered in error, does this contact the pharmacy? Remember: Prior to processing the prescription pad, the remove link which is located right next to the destination drop down menu can be selected and the prescription will be removed from the Prescription Pad and not sent to the pharmacy. What does the abbreviation EIE mean? EIE stands for Entered in Error. This option appears when editing active allergies or active problems. The information will remain in the system. Please note that when you select EIE to record the medication as entered in error, eprescribe does NOT send a message to the pharmacy where the prescription was sent to. The prescriber will still need to contact the pharmacy to cancel the prescription. In the Review History screen, why does the status of the prescription state Pending? After a prescription has been printed, can the same prescription be printed again if the original print did not come through the printer properly? For example, the printer runs out of ink... Does the medication need to be discontinued or Completed and re-created in order to print another? The medication would need to be EIE so you will not receive a duplicate therapy warning, but there will be a need to generate another prescription. Is a doctor's signature captured prior to sending any electronic prescriptions that are sent to pharmacy? No signature is required, being that we have all of their credentials in the system. When I hit the print button, does it go right to the printer? No, the prescription will show up on the screen first to preview and then you will hit the Print button again to print the prescription. My patient is used to walking out with a prescription in hand. What can I do to accommodate that while using electronic prescribing? You can print the patient s med list. This is done from the Review History Screen, Print Active Meds. What does the abbreviation DAW mean? DAW stands for dispense as written. You may select this option when you want the pharmacy to fill the prescription with the brand name that you have selected and not a generic form of the medication. As an Assistant, if a Provider is selected prior to selecting a patient from the patient list, the New Rx button is not enabled. Correct. The proper flow is to select a patient, first. Then, select a provider and the New Rx button will be enabled. Is there a way to store the medications that I prescribe most frequently? Yes, eprescribe will save the medications you have previously prescribed in a customized list. When selecting a medication, you will have the option to Search My History, which will display a list of the medications that you have previously prescribed, along with the associated SIGs. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 7

8 Once a provider processes a task as "No", is there any documentation anywhere to the fact the task, itself, was originated or processed? Example: If a patient calls in asking if a previous requested medication was reviewed by the doctor and/or sent to the pharmacy. Any assistant answers the phone. Doctor had previously declined the medication prescription. How can the assistant see this action? In review history with the Inactive radio selected, your denied refill request will show as Rejected status. Where can I find refill requests sent to me from the pharmacies? As soon you send five scripts electronically from eprescribe, you will start receiving refill requests electronically from the pharmacies. They can be found on the Tasks tab within the application, and selecting the radio button My Tasks. How do I process a refill request? To process a refill, simply click on the Tasks tab. Click No to refuse the refill request and select a denial reason Click One to approve the refill request without additional refills Click Yes to approve the original script While processing the refill request(s), if you see a message indicating This Rx needs reconciliation. Click to resolve, click on the link to resolve the request. eprescribe will then automatically search for the patient within the application. Once you confirm the patient, the SIG screen will appear in which you can modify the sig. To approve the request, click on Send to Pharmacy. What would happen if two or more Assistants work on the exact same task at the same time? If one processed it to the pharmacy and the task is remaining in view on the other assistant's screen at the same time, and the second assistant tries to send it to pharmacy, what would happen? We sometimes have several assistants covering several of the same providers. This scenario plays out from time to time. The second assistant will not be able to process this task, anything within the application happens in real-time, so once a task falls off the task list it will fall off of everyone's task list including the doctor's. Can providers be notified in their Tasks list of refill requests from pharmacy? Yes, the tasks for the doctors are both pharmacy refills and tasks assigned by an assistant. Each provider needs to submit 5 prescriptions electronically and then they will start receiving refill requests through eprescribe. Does eprescribe alert me to possible drug interactions? Yes, eprescribe has several built-in drug utilization review (DUR) warnings. They include: Duplicate therapies Prior adverse reactions Drug interactions Dosage checks Can more than one person work with the same Physician at one time? Yes, if a physician has six assistants, all six assistants can have that doctor selected at one time. They system will not knock any of the assistants off if another is using the same physician. How do I enter my signature in eprescribe so that it prints on my prescriptions? eprescribe does not require a provider to enter a signature into the application. Prescriptions sent electronically do not require signatures. Printed prescriptions must be signed by hand. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 8

9 Pharmacy Related FAQs How long does it take for a prescription to reach the pharmacy? The prescriptions are sent electronically via the Pharmacy Health Information Exchange, operated by SureScripts. Therefore, the prescription should reach the pharmacy within minutes. Off to the right on my Pharmacy select list it is showing a percent, what does that mean? That is showing the accuracy of communication with that pharmacy. The higher the percentage the higher historical average for communication to that pharmacy. What do the stars for the pharmacies mean? That is an indicator of percentage of successful communication for electronic prescribing for that pharmacy. What pharmacy can I electronically prescribe to? The Allscripts eprescribe application has a retail pharmacy database within the application. If you do not find the pharmacy you are looking for you can fill out the can t find a pharmacy form located on the bottom right hand corner and submit it to us. We will make every effort to have the new pharmacy in the database as promptly as possible. Are all pharmacies in the list? Any pharmacy that is certified through SureScripts Rx Hub (the credentialing body of Rx pharmacies). For new large retail chain they are on a 15 to 30 day schedule, so there may be as much as a 30 day delay before a new chain location is added. What is the best way to search for a pharmacy? The best results come from a simple search. Using just the zip code will show all pharmacies in the entered zip code. The less information you enter the better your search results will be. Another way to search is to select the state and the numeric (numbers only) address of the pharmacy. If this returns too many results, enter the first four letters of the pharmacy name and research. For easy/efficiency of using the system is it easier to add the pharmacy first or the medication first? Entering a pharmacy first can be done by selecting the EDIT link located next to PHARMACY located in the patient header. It is easier to put in the pharmacy first, because it is then available for all prescriptions created. If the pharmacy has not been entered, when a prescription is created it prompts the user to enter in a pharmacy before going to the Script Pad view. Are mail order pharmacies available in the system? They are currently available to search for however right now you need to know the city and state to locate them. What does it mean when it says "Fax" next to the pharmacy? That indicates that the pharmacy will receive the prescription as a fax, it is still sent from the practice and the provider still gets credit for doing an electronic prescription. How do I know if the prescription was sent successfully to the pharmacy? You can check the status of the prescription sent by checking the Message Queue under the Reports tab. Prescriptions marked as CONFIRMED in the message queue are an indication that the prescription has successfully reached the pharmacy. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 9

10 Can I send scheduled medications electronically to pharmacies using eprescribe? Due to state and/or federal regulations, Schedule II, III, IV, and V drugs cannot be sent electronically from eprescribe. They can only be printed. Once printed you can also sign the prescription and fax it to the pharmacy from your fax machine. Will pharmacy be notified via SureScripts after an EIE (Entered in Error) or D/C (Discontinued) is processed and the status is "Sent to Pharmacy"? The physician or assistant will need to call the pharmacy to alert them of this error, by entering EIE or D/C in the application will not alert the pharmacy it will only be noted in the application. What if a pharmacy is not connected to the Pharmacy Health Information Exchange, operated by SureScripts? Allscripts provides and maintains a directory of pharmacies nationwide, which is what the eprescribe application searches for when a prescriber is looking for a pharmacy. Pharmacies receive prescriptions either electronically or by fax: the prescriber simply hits the 'Send' button; eprescribe takes care of the details. If a user can't find the desired pharmacy: 1. Print the prescription: why make the patient wait? 2. On the right-side panel, there is a form that the prescriber can fill out. Allscripts and its partners make every effort to find the pharmacy, correct the information, update the national registry, etc. The important point is that pharmacies do not need to update their technology to participate: if they have a fax machine, they're already part of the program of improving patient safety. Administrative FAQs How do I add additional users at my site to eprescribe? To add users, you must be designated as an Administrator. Select the Settings tab, click Add User and complete the designated fields. How many users can I add to my account? There is no limit to the number of users per account. How do I edit user information? To edit users, you must be designated as an Administrator. Select the Settings tab, click Edit Users and select the user to be changed, click Edit. When you are finished, click Save Profile. When setting up users, what is the difference between Administrators and Users? The security setting of Administrator allows the user to add and edit users at their site, change the DUR settings, and edit the site information. A site can have more than one administrator. To assign someone with the administrator settings, simply check Administrator when adding or editing a user s profile. A User setting will not display the Settings tab. Can I change the level of DUR warnings generated by eprescribe to fit my needs? Yes, eprescribe allows you to customize DUR warnings. Select the Settings tab, then select DUR Settings. Keep in mind that this will not be specific to each provider as it is specific for the entire practice using the eprescribe application. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 10

11 What if I lock my account? Your account will lock after three login attempts with an incorrect password. Only the designated administrator for your site can unlock your account. To do so, your account administrator can simply select the Settings tab, select Edit Users, then select the user who has locked their account. Once the user profile is presented, uncheck the box next to unlock account and click save profile. If you forgot your password, see What if I forget my password? What if I forget my password? If you forgot your password, simply click on the forgot password link and follow the instructions to obtain a new password. A designated site Administrator can also reset users passwords. Simply select the Settings tab, select Edit Users, and then select the user who has forgotten their password. At the top of the screen, click Reset Password. On the change password screen, the administrator can enter a new password, check user must change password at next login, and click change password to reset the user s password. The administrator should give you the new password and let you know that there will be a prompt to select a desired password once you log into the application with the given password. If you have attempted three login attempts with your incorrect password, your account will be locked. Please note that resetting a password does not unlock the UserID. To unlock, see What if I lock my account? Will passwords expire after a certain amount of time? If you feel you must change your password due to a breach of security, notify your Practice Administrator. Are User ID and Passwords case sensitive? Yes. Can I delete patients from my eprescribe account? No, you cannot delete patients from your eprescribe account due to regulatory requirements but you do have the ability to Inactivate a patient which can be done from the patient demographic screen, which can be found by clicking the Edit link next to the patient s name at the top in the patient header. How can I sign up for additional training? You may attend free, regularly scheduled, bi-weekly webinar sessions, or you may purchase on-site training or one-on-one webcast trainings. Please click on the following link for training details. Click here to visit our services page to purchase training sessions. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 11

12 Reporting FAQs What reports can I run in eprescribe? There are several standard reports that can be generated in eprescribe. Select the Reports tab to choose from the following: Prescription History by Medication Report Patient Medication History Prescription Activity Detail Prescription Activity Detail (OAS) POB Originator Pharmacy Utilization Summary Pharmacy Refill Report Message Queue What does OAS mean when printing reports? Originator/Authorizer/Sender - this report will list who originated a prescription, who authorized the prescription and who sent the prescription. What does the POB report do? This report can be generated to list who is Prescribing on Behalf of the doctor. Care 360 FAQs Why do I see Care360 in eprescribe? The collaboration between Quest Diagnostics and Allscripts adds significant new capabilities to the NEPSI solution. Now, in addition to eprescribing, through a single sign-on, eprescribe subscribers will be able to see how many lab results are pending and will be able to click through to the Care360 Physician Portal to order lab tests and view, flow, and graph laboratory results, as well as run analyses on their patient population. What do I need to access Care360 from eprescribe? In order to utilize this enhanced application, you will need to confirm that your hardware device is set up to run the free Java and Adobe software applications that the Quest Diagnostics functionality requires. This is a simple interim step to take to ensure your experience with this product is seamless. How does the Single Sign-On (SSO) work? The first time that you access the Care360TM Physician Portal from your application, you are prompted to log in using an authorized User ID and Password. This log in process is necessary to establish the connection between your application and Care360 and is only required once. NOTE: If you are prompted for log in credentials after your first successful log in to Care360, please call support for assistance (your initial log in credentials will not work on subsequent attempts). 1. Log in to your third-party application. 2. Locate and click the link for Care On the Care360 Login page, type your User ID and Password. 4. Click Log In. The appropriate Care360 Landing Page displays (the Home Page, the New Results page, or the Lab Orders page), depending upon your SSO settings. Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 12

13 After using Care360 through eprescribe, can I access Care360 from anywhere else? You will only be able to log into Care 360 through eprescribe. You will no longer be able to log into your Care 360 account from anywhere else. What is the customer support number for Care360? Please call (800) , select option 1, and then option 4. What if I am not a Care360 customer? If you are not currently a Care360 customer and would like more information, please visit Copyright 2009 Allscripts-Misys Healthcare Solutions, Inc. 13