Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 Sharon,I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to "get" e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say "we never received it". The last time I asked, I had only given the patient's last name and she said "we never got it". And I said, "how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name)." So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying "We can't investigate further without the message ID." So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. SetoSouth Pasadena, CAWalter,Are you doing e-fax or true e-prescribing?I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.comwww.impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 , imagine multipying what you’ve just noted times a bit in rural western Pennsylvania. You might give hard copies along with e-rx-ing also. I do the e-rx-ing because I’ve paid for Surescripts, I’m trying to comply with MU, and I’m a believer that eventually, even in medieval PA, it will work. None the less, it’s the human side of “refills because I lost my prescription,†or “can you change my prescription from 30 days X 5 to 90 days X 3†or “I just changed insurance compainies and...â€, or “my insurance co just changed it’s formulary again as it did 5 days earlierâ€, etc., which is the incessant challenge. And, yes, I am trying to plug the holes moving forward. As I have said, the necessity is the environment of decreasing reimbursement and increasing costs along with all these CNN and Fortune articles noting all these doctors going bankrupt or otherwise going into administrative positions supervising the worker bee’s. Personally, I’d rather go into construction before succumbing to an administrative “authorizing†the “prior auth’s†job. -WK From: Seto Sent: Monday, January 23, 2012 7:37 PM To: Subject: Re: E-prescribing hassles Sharon, I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to "get" e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say "we never received it". The last time I asked, I had only given the patient's last name and she said "we never got it". And I said, "how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name)." So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying "We can't investigate further without the message ID." So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. Seto South Pasadena, CA Walter, Are you doing e-fax or true e-prescribing? I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.com www.impcenter.org =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 Walter,You have my sympathies in trying to bring medicine in Western Pennsylvania into the 21st Century. Did you pay for SureScripts as an add-on to your EMR? It may be worth it to you for the integration. However, I know of 3 free options for e-prescribing:AllScripts ePrescribehttp://www.nationalerx.com/Allscripts ePrescribe for iPhonehttp://itunes.apple.com/us/app/allscripts-eprescribe-for/id393019025?mt=8Practice Fusion EMR. This is the EMR I use, but you can use it just for e-prescribing and not as an EMR.http://www.practicefusion.com/pages/ePrescribing.htmlI have no financial interests in any of the mentioned products or services. SetoSouth Pasadena, CA , imagine multipying what you’ve just noted times a bit in rural western Pennsylvania. You might give hard copies along with e-rx-ing also. I do the e-rx-ing because I’ve paid for Surescripts, I’m trying to comply with MU, and I’m a believer that eventually, even in medieval PA, it will work. None the less, it’s the human side of “refills because I lost my prescription,” or “can you change my prescription from 30 days X 5 to 90 days X 3” or “I just changed insurance compainies and...”, or “my insurance co just changed it’s formulary again as it did 5 days earlier”, etc., which is the incessant challenge. And, yes, I am trying to plug the holes moving forward. As I have said, the necessity is the environment of decreasing reimbursement and increasing costs along with all these CNN and Fortune articles noting all these doctors going bankrupt or otherwise going into administrative positions supervising the worker bee’s. Personally, I’d rather go into construction before succumbing to an administrative “authorizing” the “prior auth’s” job. -WK From: Seto Sent: Monday, January 23, 2012 7:37 PM To: Subject: Re: E-prescribing hassles Sharon, I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to "get" e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say "we never received it". The last time I asked, I had only given the patient's last name and she said "we never got it". And I said, "how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name)." So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying "We can't investigate further without the message ID." So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. Seto South Pasadena, CA Walter, Are you doing e-fax or true e-prescribing? I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.com www.impcenter.org =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 I hear you on the free options. I really doubt the problems are as much inherent to Surescripts as they are to the participant pharmacies and otherwise to the technology of huge central clearing houses for zillions of silly prescriptions. Like I said, I’m a believer that eventually the system will work reasonably well, at least enough to rely on it plus the occasional call back. Even then, it doesn’t solve the human element of lost prescriptions, formulary moving targets, insurance changes, patient quantity changes, etc. If all one is dealing with is Accupril and Amlodipine, it’s no big deal, especially if the patient has a smart phone. How about the patient on Amlodipine/Lopressor/plavix/aricept/namenda/metformin/glipizide/simvastin/protonix/amitiza..., using a rotory phone, you get it plus a bunch more. How about half your schedule with this profile. It’s an enormous human problem. Of course technology can solve it, within limitations, and over time. No one can do this for free. That’s why I keep pounding for policy approaches. -Walter V. Kowtoniuk From: Seto Sent: Monday, January 23, 2012 9:12 PM To: Subject: Re: E-prescribing hassles Walter, You have my sympathies in trying to bring medicine in Western Pennsylvania into the 21st Century. Did you pay for SureScripts as an add-on to your EMR? It may be worth it to you for the integration. However, I know of 3 free options for e-prescribing: AllScripts ePrescribe http://www.nationalerx.com/ Allscripts ePrescribe for iPhone http://itunes.apple.com/us/app/allscripts-eprescribe-for/id393019025?mt=8 Practice Fusion EMR. This is the EMR I use, but you can use it just for e-prescribing and not as an EMR. http://www..practicefusion.com/pages/ePrescribing.html I have no financial interests in any of the mentioned products or services. Seto South Pasadena, CA , imagine multipying what you’ve just noted times a bit in rural western Pennsylvania. You might give hard copies along with e-rx-ing also. I do the e-rx-ing because I’ve paid for Surescripts, I’m trying to comply with MU, and I’m a believer that eventually, even in medieval PA, it will work. None the less, it’s the human side of “refills because I lost my prescription,” or “can you change my prescription from 30 days X 5 to 90 days X 3” or “I just changed insurance compainies and...”, or “my insurance co just changed it’s formulary again as it did 5 days earlier”, etc., which is the incessant challenge. And, yes, I am trying to plug the holes moving forward. As I have said, the necessity is the environment of decreasing reimbursement and increasing costs along with all these CNN and Fortune articles noting all these doctors going bankrupt or otherwise going into administrative positions supervising the worker bee’s. Personally, I’d rather go into construction before succumbing to an administrative “authorizing” the “prior auth’s” job. -WK From: Seto Sent: Monday, January 23, 2012 7:37 PM To: Subject: Re: E-prescribing hassles Sharon, I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to "get" e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say "we never received it". The last time I asked, I had only given the patient's last name and she said "we never got it". And I said, "how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name)." So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying "We can't investigate further without the message ID." So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. Seto South Pasadena, CA Walter, Are you doing e-fax or true e-prescribing? I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.com www.impcenter.org =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 ,We tell patients outright if we are having trouble with their pharmacy. For us, lately, it has been Medco. But CVS is the worst in our area. There are so many pharmacies to choose from, that often a patient can go across the parking lot to another one. And they do. My favorite pharmacy (from both the physician side and the patient side) is Custom Care. I have found that the compounding pharmacies have the best customer service and hire the best staff. YMMV, (no financial interest whatsoever in any of these co's, just personal experience) Pratt Sharon,I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to " get " e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say " we never received it " . The last time I asked, I had only given the patient's last name and she said " we never got it " . And I said, " how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name). " So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying " We can't investigate further without the message ID. " So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. SetoSouth Pasadena, CA Walter,Are you doing e-fax or true e-prescribing?I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.comwww.impcenter.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 I have found that many times when the pharmacy says they don't have the rx, it is because they are looking for the rx based on what the patient says (called, faxed, or e-rx'd). 99% of the time, the pharmacy miraculously finds the rx that they call us to tell us they never got -while i am on the phine with them. Apparently, the phone vs. Fax vs. E-rx systems don't all jive in all pharmacies. Let your patients know how it is being sent so that they can tell the pharmacy the right info. If it is really bogging you down time-wise to make changes based on patient preferences or patient error (or even the patient's new formulary), then it's probably time to institute some " lost rx " and " change in rx " fees. I would suggest making the new fees effective as of 1/1/12, with a 90 day grace period (but you don't have to tell the patient about the grace period). Your staff can gently tell patients over the phone that " this time " there won't be a fee, but that going forward there will be if they lose/change/forget an rx. My $0.05, Pratt I hear you on the free options. I really doubt the problems are as much inherent to Surescripts as they are to the participant pharmacies and otherwise to the technology of huge central clearing houses for zillions of silly prescriptions. Like I said, I’m a believer that eventually the system will work reasonably well, at least enough to rely on it plus the occasional call back. Even then, it doesn’t solve the human element of lost prescriptions, formulary moving targets, insurance changes, patient quantity changes, etc. If all one is dealing with is Accupril and Amlodipine, it’s no big deal, especially if the patient has a smart phone. How about the patient on Amlodipine/Lopressor/plavix/aricept/namenda/metformin/glipizide/simvastin/protonix/amitiza..., using a rotory phone, you get it plus a bunch more. How about half your schedule with this profile. It’s an enormous human problem. Of course technology can solve it, within limitations, and over time. No one can do this for free. That’s why I keep pounding for policy approaches. -Walter V. Kowtoniuk From: Seto Sent: Monday, January 23, 2012 9:12 PM To: Subject: Re: E-prescribing hassles Walter, You have my sympathies in trying to bring medicine in Western Pennsylvania into the 21st Century. Did you pay for SureScripts as an add-on to your EMR? It may be worth it to you for the integration. However, I know of 3 free options for e-prescribing: AllScripts ePrescribe http://www.nationalerx.com/ Allscripts ePrescribe for iPhone http://itunes.apple.com/us/app/allscripts-eprescribe-for/id393019025?mt=8 Practice Fusion EMR. This is the EMR I use, but you can use it just for e-prescribing and not as an EMR. http://www..practicefusion.com/pages/ePrescribing.html I have no financial interests in any of the mentioned products or services. Seto South Pasadena, CA , imagine multipying what you’ve just noted times a bit in rural western Pennsylvania. You might give hard copies along with e-rx-ing also. I do the e-rx-ing because I’ve paid for Surescripts, I’m trying to comply with MU, and I’m a believer that eventually, even in medieval PA, it will work. None the less, it’s the human side of “refills because I lost my prescription,” or “can you change my prescription from 30 days X 5 to 90 days X 3” or “I just changed insurance compainies and...”, or “my insurance co just changed it’s formulary again as it did 5 days earlier”, etc., which is the incessant challenge. And, yes, I am trying to plug the holes moving forward. As I have said, the necessity is the environment of decreasing reimbursement and increasing costs along with all these CNN and Fortune articles noting all these doctors going bankrupt or otherwise going into administrative positions supervising the worker bee’s. Personally, I’d rather go into construction before succumbing to an administrative “authorizing” the “prior auth’s” job. -WK From: Seto Sent: Monday, January 23, 2012 7:37 PM To: Subject: Re: E-prescribing hassles Sharon, I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to " get " e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say " we never received it " . The last time I asked, I had only given the patient's last name and she said " we never got it " . And I said, " how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name). " So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying " We can't investigate further without the message ID. " So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. Seto South Pasadena, CA Walter, Are you doing e-fax or true e-prescribing? I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.com www.impcenter.org =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com ======= Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 Great Idea ! CCote To: Sent: Monday, January 23, 2012 9:05:45 PMSubject: Re: E-prescribing hassles I have found that many times when the pharmacy says they don't have the rx, it is because they are looking for the rx based on what the patient says (called, faxed, or e-rx'd). 99% of the time, the pharmacy miraculously finds the rx that they call us to tell us they never got -while i am on the phine with them. Apparently, the phone vs. Fax vs. E-rx systems don't all jive in all pharmacies. Let your patients know how it is being sent so that they can tell the pharmacy the right info. If it is really bogging you down time-wise to make changes based on patient preferences or patient error (or even the patient's new formulary), then it's probably time to institute some "lost rx" and "change in rx" fees. I would suggest making the new fees effective as of 1/1/12, with a 90 day grace period (but you don't have to tell the patient about the grace period). Your staff can gently tell patients over the phone that "this time" there won't be a fee, but that going forward there will be if they lose/change/forget an rx. My $0.05, Pratt I hear you on the free options. I really doubt the problems are as much inherent to Surescripts as they are to the participant pharmacies and otherwise to the technology of huge central clearing houses for zillions of silly prescriptions. Like I said, I’m a believer that eventually the system will work reasonably well, at least enough to rely on it plus the occasional call back. Even then, it doesn’t solve the human element of lost prescriptions, formulary moving targets, insurance changes, patient quantity changes, etc. If all one is dealing with is Accupril and Amlodipine, it’s no big deal, especially if the patient has a smart phone. How about the patient on Amlodipine/Lopressor/plavix/aricept/namenda/metformin/glipizide/simvastin/protonix/amitiza..., using a rotory phone, you get it plus a bunch more. How about half your schedule with this profile. It’s an enormous human problem. Of course technology can solve it, within limitations, and over time. No one can do this for free. That’s why I keep pounding for policy approaches. -Walter V. Kowtoniuk From: Seto Sent: Monday, January 23, 2012 9:12 PM To: Subject: Re: E-prescribing hassles Walter, You have my sympathies in trying to bring medicine in Western Pennsylvania into the 21st Century. Did you pay for SureScripts as an add-on to your EMR? It may be worth it to you for the integration. However, I know of 3 free options for e-prescribing: AllScripts ePrescribe http://www.nationalerx.com/ Allscripts ePrescribe for iPhone http://itunes.apple.com/us/app/allscripts-eprescribe-for/id393019025?mt=8 Practice Fusion EMR. This is the EMR I use, but you can use it just for e-prescribing and not as an EMR. http://www..practicefusion.com/pages/ePrescribing.html I have no financial interests in any of the mentioned products or services. Seto South Pasadena, CA , imagine multipying what you’ve just noted times a bit in rural western Pennsylvania. You might give hard copies along with e-rx-ing also. I do the e-rx-ing because I’ve paid for Surescripts, I’m trying to comply with MU, and I’m a believer that eventually, even in medieval PA, it will work. None the less, it’s the human side of “refills because I lost my prescription,†or “can you change my prescription from 30 days X 5 to 90 days X 3†or “I just changed insurance compainies and...â€, or “my insurance co just changed it’s formulary again as it did 5 days earlierâ€, etc., which is the incessant challenge. And, yes, I am trying to plug the holes moving forward. As I have said, the necessity is the environment of decreasing reimbursement and increasing costs along with all these CNN and Fortune articles noting all these doctors going bankrupt or otherwise going into administrative positions supervising the worker bee’s. Personally, I’d rather go into construction before succumbing to an administrative “authorizing†the “prior auth’s†job. -WK From: Seto Sent: Monday, January 23, 2012 7:37 PM To: Subject: Re: E-prescribing hassles Sharon, I jumped on the e-prescribing bandwagon as soon as I could and have been doing it for at least the past 5 years. It has gotten better, as more and more physicians and pharmacies participate, but for some reason there are still a few pharmacies which can't seem to "get" e-prescriptions. For example, I get an electronic refill request through my EMR, and I approve it. Sent, done. Then the next day, I get a faxed request asking for a refill of the same medication. I figure it's just a duplicate and they haven't had time to process the electronic refill yet, so I ignore the fax. 2-3 days later, I get another faxed request for the same medication. I then call the pharmacy and ask if they ever got my original electronic refill order. It used to be that half the time they did receive it but their automated fax refill process doesn't sync with their actual prescribing data, so they will keep sending the fax request until someone cancels it. Annoying. But not as annoying as what's been happening lately, which is that the clerk will just say "we never received it". The last time I asked, I had only given the patient's last name and she said "we never got it". And I said, "how do you know which patient I am talking about? I only gave you the patient's last name (which was not an uncommon name)." So now I don't know if they really didn't get it, or if they are just being lazy. I have taken to reporting all problem e-prescriptions to SureScripts, the vendor used by my EMR. They have a website that accepts reports of problem e-prescriptions. However, after typing in all the pertinent data, I get an e-mail back from SureScripts saying "We can't investigate further without the message ID." So far I've tried 3 times to get the message ID from my EMR vendor, but for some reason they won't tell me how to find it. I haven't gotten anywhere except for them to suggest that I try using Google Chrome instead of Safari as the web browser. So fortunately the vast majority of e-prescriptions go through successfully, but I keep thinking that if I make a big enough deal about these few problem pharmacies, then they will also get their act together and all my e-prescriptions will go smoothly. And if I don't do anything, they'll remain thorns in my e-prescribing side. Anyways, e-prescribing is still not as trouble-free as they make them out to be. Seto South Pasadena, CA Walter, Are you doing e-fax or true e-prescribing? I found MUCH less was lost after I switched to e-prescribing. Just a thought. Sharon McCoy www.sharongeorgemd.com www.impcenter.org =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= =======Email scanned by PC Tools - No viruses or spyware found.(Email Guard: 7.0.0.27, Virus/Spyware Database: 6.19110)http://www.pctools.com======= Quote Link to comment Share on other sites More sharing options...
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