Triggers allow you to build new prescription notifications, refill reminders, and send patients prescription status change updates. These Triggers are designed to reduce prescription management overhead and keep patients informed about their prescriptions.

As an Enterprise User, you can configure Triggers that can be used across your Practices. This functionality allows you to set a standard for your organization, controlling both message timing and brand voice.

Prescription Triggers

Prescription Triggers are centrally located and managed in one place within Artera Harmony Federal Edition (AHFE). To access this page, use the Navigation Bar, select Automations > Triggers.

Triggers are sent based on Practice specifications like Events, Providers, Locations, and lines while preserving an Enterprise-wide cadence and message content. 

Page Overview

1. Outbound: All Prescription Triggers will be saved within the “outbound” tab.
2. Trigger Details:

1. Name: This is established when creating the Trigger and serves as the Trigger's title.

2. Last Updated: This will display the last date and time the Trigger was updated.

3. Type: This is the type of Outbound Trigger such as Appointment or Prescription.

4. Send From: This is the Resource the Trigger should be sent from. “Location” will be listed here.

5. Practices: This displays the total number of Practices configured to send this Trigger.

6. Filters: This displays the total number of Audience, Event, and Resource Filters configured for this Trigger.

7. Timing: This indicates when the Trigger will be sent to patients.

8. Method: The icons display which message types the Trigger can be sent by. This will display a phone icon to indicate a phone call.

9. Merged: This indicates if the Trigger has been configured to support Merged Messaging.

10. Status: This indicates if the Trigger is On or Off and able to send messages.

11. Message: Click this link to preview the phone message content. This does not display a Spanish translation added to the Trigger.

12. Actions: Clicking the three-dot menu will allow you to Turn On/Off, Edit, Duplicate, or Delete the Trigger.

13. Search Filters: Filter the Triggers page to locate Triggers by Name, Practice, Event, Resource, or Message Text. NOTE: Only one filter in each category can be applied at once.

14. Bulk Actions: Select this button to turn Triggers on/off in bulk, saving you time and effort.

15. Create New: Click this button to create a new Trigger.

16. Rows per Page: Select how many Triggers per page you would like to see. Each Trigger will appear in a row.

Create a New Prescription Trigger

1. From the Navigation Bar, select Automations > Triggers.

2. Select Create New in the top-right corner.

• Add a Trigger Name. This will serve as the Trigger's title, so be sure to use consistent naming conventions. Next, select Prescription from the Trigger Module drop-down and select Location from the Send From drop-down menu. 
  NOTE: Location is the only Resource available for Prescription Triggers to send from.
  Tip: As you progress through each step, the Details panel on the right-hand side will update with the Trigger's information.

Configure AHFE Practices

1. Select the Practices that will send the Trigger. 
   NOTE: By default, all Practices will be auto-selected. 

2. To locate specific Practices, click the Selected Practices tab and use the search bar to search by Practice name. Include Practices in the Trigger by using the check box near the appropriate Practice. Tip: Update the Rows per page up to 100 for larger Enterprises with many Practices.

3. To bulk select your search results, use the check box located to the left of “Practices”.
   

Configure Filters

Audience

Configure the Audience filters for the Trigger. This indicates the targeted patient population for the Trigger.

1. Prescription Status: These system-default statuses are mapped to the corresponding statuses in your EMR. The available statuses are: Active, Parked, Cancelled, Discontinued, Completed. 
   NOTE: When configuring a Trigger based on the Timing Event of Prescription Status Change, make sure you are not also filtering out that Prescription Status here.

2. CSA Schedule: This indicates the CSA Schedule of the medication, allowing you to send different messages based on a medication class. You can select multiple values at the same time. The available values are: Schedule I, Schedule II, Schedule III, Schedule IV, Schedule V.

3. Dispense Method: Filter based on how the prescription will reach the patient. The available values are: Delivery, Pickup.

4. Remaining Refills: Use this filter to include the number of remaining refills available as a restriction. This can be specified as Equal To, Greater than or equal to, Less than or equal to.

Before you proceed to the next step, review your selected Filters. Review the Details side panel and select the "Include #" hyperlink beneath Audience Filters. The Audience filters you selected will display in a bulleted list.

Configure Trigger Messaging

Next, you will indicate whether the Trigger should be connected to an existing Conversation Flow. If not, leave this option set to No and skip to the “Not connecting Trigger to Conversation Flow” section below.

Connecting Trigger to Conversation Flow

If you would like to connect the Trigger to a Conversation Flow, select Yes and use the drop-down menu to select the Conversation Flow from the list. The Conversation Flow’s Smart Phrase will be automatically assigned to the Trigger, and no further message configuration is needed. 
NOTE: Only Conversation Flows with a status of “On” will display in the drop-down list.

Not Connecting Trigger to Conversation Flow

If you’re not connecting to a Conversation Flow, enter the message for the automated phone call to the patient. Patients must say “hello” or another greeting to start the message. Enter the Trigger’s message for the phone call that will be made to the patient. When a patient receives the automated phone call, they must answer with “hello” or another greeting to prompt the message to begin.

NOTE: AHFE uses answering machine detection to determine if the message should be delivered as a voicemail. For more information, click here.

Preview Calls

Validate how your call message will sound to the patient by previewing the phone call. In the message composer, select the phone icon. Enter your 10-digit phone number and select “Call Me”. When you receive the call, be sure to say “hello” to activate the call.

NOTE: In a preview phone call, any Smart Phrases included in the call message will be randomly populated with generic placeholders.

Merge Messages

When configuring a Prescription Trigger, leave the “Merge Messages” field set to no as this functionality is not supported with Prescription Triggers.

Set Prescription Trigger Timing

Next, determine when to send the Prescription Trigger to the patient. There are four message Events or Prescription Triggers, each with associated send rules. For “Prescription Created” and “Prescription Refill Date” Events, you can specify a time offset for the Trigger. 

Prescription Trigger Events

• Prescription Created:  Send when the EMR creates a prescription and AHFE receives the integration message. You can set a time offset (e.g., 15 minutes after creation).

• Prescription Refill Date: Send based on the next eligible refill date. You can set an offset (e.g. send Refill Reminder 1 Day Before Prescription Refill Date). 
  NOTE: AHFE stores the next refill date and time that is received from the EMR. This date and time determines when AHFE will send theTrigger, based on the rules you have configured, such as TCPA Hours or business day adjustments.

• Prescription Status Change: Send when the EMR updates a prescription's status.. During implementation, your EMR statuses are mapped to AHFE's default statuses. Available statuses include: Active, Parked, Cancelled, Discontinued, Completed.

• Dispense Status Change: Send the Prescription Trigger to the patient based on the status of the prescription dispense record being updated in the EMR. During implementation, your EMR statuses are mapped to AHFE's default statuses. Available statuses include: Preparation, Ready to Pick Up, Cancelled, Completed, Declined, Delayed.

Send Only on Business Days?

This rule is only available for "Prescription Created" or "Prescription Refill Date" triggers. 
NOTE: This setting will be grayed out and cannot be enabled unless the automated Prescription Trigger is set to send at least 15-minutes after the chosen message event. Business Days are determined by your Practice and line Hours. Any day that your Practice or line is open for any duration of time counts as a Business Day in AHFE.

Patient Status or System Status Change Ignores Business Hours

If you configure the Prescription Trigger to occur upon the message events of "Prescription Status Change" or "Dispense Status Change", the Prescription Trigger will go out regardless of Business Hours. Instead, the timing of the message depends on when your system of record sends status updates to AHFE.

TCPA (Telephone Consumer Protection Act) Guidelines

AHFE enables you to send or suppress automated reminders based on TCPA guidelines. Choose between sending the message immediately, scheduling the message within the TCPA guidelines, or not sending the message at all. Click here for a breakdown of TCPA Hours and how it impacts communication.

When configuring Prescription Triggers, we typically recommend choosing to Adjust Delivery Time when available, which will respect TCPA hours. 

Managing Prescription Triggers

It is important to have a Prescription Trigger strategy to ensure that your Triggers stay up to date over time.

Editing a Trigger

As an Enterprise user, you can edit Prescription Triggers so that the Triggers are updated for all Practices that use them:

1. Navigate to Triggers.

2. Select the Prescription Trigger you wish to edit by clicking its three-dot Action menu on the right side and choose Edit.

3. Change desired section: Trigger Type, Trigger Content, Trigger Timing, or Trigger Aggregation.

4. Select Update when done to save your changes.

Creating Triggers From Template

You can create Triggers and then use them as a template for new Triggers that have similar functionality. 

This is especially helpful when creating Event-specific Triggers, e.g., copying the Prefill Reminder - 7 Day to use for the Prefill Reminder -1 Day.

1. Go to the Actions menu of the Trigger you would like to copy by clicking the (...) Actions menu. Select Duplicate.

2. Edit the appropriate sections.

3. Once you have reviewed your Trigger, click Create or Create and Turn On.

FAQs

How is the “Prescription Refill Date” determined?

It is determined based on the next_possible_fill_date column on the Dispense Table. AHFE determines refill eligibility and calculates a date to populate that column. 

What is the “CSA Schedule” for a prescription?

Drugs, substances, and certain chemicals used to make drugs are classified into five distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential. The abuse rate is a determinate factor in the scheduling of the drug; for example, Schedule I drugs have a high potential for abuse and the potential to create severe psychological and/or physical dependence. As the drug schedule changes-- Schedule II, Schedule III, etc., so does the abuse potential-- Schedule V drugs represent the least potential for abuse. Schedule I and II drugs have different rules when it comes to prescribing and refilling and typically follow a different process. Click here for more information.

How does “Location” work as the “Send From” resource for prescriptions?

1. AHFE will obtain the prescription location from either the Prescription Table or the Dispense Table depending on the timing event selected.

   • If it is using the location from the Prescription Table, that means the Trigger will send from the Practice where the prescription originated (prescribed from).

   • If it is using the location from the Dispense Table, that means the Trigger will send from the pharmacy Practice where the prescription is being dispensed from.Timing Events

2. Timing Events

1. Prescription Created and Prescription Status Change use Location from the Prescription table

2. Prescription Refill Date and Dispense Status Change use Location from the Dispense table

Is Merged Messaging available for Prescription Triggers?

Technically yes, however it is not recommended to be used with Prescription Triggers due to how Smart Phrases included in the message will function.