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How many of you out there use e-prescribing to get the Medicare bonus? Raise your hands. And how many of you with your hands up really find it’s easier than regular prescribing? I thought so.
I use it, too, although I am far from enamored with it. But, like most of you, I take Medicare, and don’t want to lose the bonus (or eventually be penalized). How do I hate thee? Let me count the ways.
My biggest gripe is controlled substances, an area where technology has clearly outstripped regulation. I can understand wanting to control some drugs, such as those on schedule II or maybe even schedule III, but my e-prescribing system won’t let me refill even minor things, like pregabalin (Lyrica) or zolpidem (Ambien). Here in Arizona, it also won’t let me fill carisoprodol (Soma) or Fioricet (acetaminophen, butalbital, and caffeine).
But it still sends e-refill requests on these drugs, when it knows I can’t refill them! You’d think it would have some way of filtering requests for controlled and noncontrolled substances, and sending the former by fax. It’s legal to send the refill request by fax, but one wonders: How much more secure is a fax to my office than the Internet?
So when an approval for a refill request for a controlled drug comes up online, I have this choice: I can ignore it and hope they’ll eventually fax me something, or I can try to approve it online.
When I do the latter it says, "This is prohibited. Click on the ‘contact me’ button to have the requesting pharmacy contact you by another method."
Sounds like a good idea, right? But when I do that, I’ve learned that all it does is tell the pharmacy that I denied it, which isn’t even close to the truth. So they tell the patient I denied it, and the patient gets angry and yells at my office.
I’ve verified this sad tale with different patients and local pharmacists. Because of getting burned like this, I now just ignore online controlled drug requests and wait until the patient or pharmacy contacts me. How efficient is that?
Another issue I have with our e-prescribing system is writing mega-pill amounts. It won’t allow greater than 999 pills per refill. I have no idea why.
For most scripts this isn’t an issue. But it occasionally crops up, usually with 90-day supplies of carbidopa-levodopa (Sinemet) or gabapentin (Neurontin). When that occurs, I’m pretty much stuck ordering the 999 or mailing the patient a paper script.
I don’t think e-prescribing is a time saver, either. The script I could write by hand in less than 1 minute often takes 3-5 minutes to send online if it’s a new script, or a new patient, or both.
Friends of mine who work in pharmacies tell me it hasn’t cut back on medication errors, either. And a quick search of the Internet finds similar complaints from both sides, so apparently I’m not alone.
I have nothing against progress, or technology, or even saving paper. Yet, requiring a technology to be used before it’s ready for prime time only replaces one set of problems with another – to the detriment of the patient.
How many of you out there use e-prescribing to get the Medicare bonus? Raise your hands. And how many of you with your hands up really find it’s easier than regular prescribing? I thought so.
I use it, too, although I am far from enamored with it. But, like most of you, I take Medicare, and don’t want to lose the bonus (or eventually be penalized). How do I hate thee? Let me count the ways.
My biggest gripe is controlled substances, an area where technology has clearly outstripped regulation. I can understand wanting to control some drugs, such as those on schedule II or maybe even schedule III, but my e-prescribing system won’t let me refill even minor things, like pregabalin (Lyrica) or zolpidem (Ambien). Here in Arizona, it also won’t let me fill carisoprodol (Soma) or Fioricet (acetaminophen, butalbital, and caffeine).
But it still sends e-refill requests on these drugs, when it knows I can’t refill them! You’d think it would have some way of filtering requests for controlled and noncontrolled substances, and sending the former by fax. It’s legal to send the refill request by fax, but one wonders: How much more secure is a fax to my office than the Internet?
So when an approval for a refill request for a controlled drug comes up online, I have this choice: I can ignore it and hope they’ll eventually fax me something, or I can try to approve it online.
When I do the latter it says, "This is prohibited. Click on the ‘contact me’ button to have the requesting pharmacy contact you by another method."
Sounds like a good idea, right? But when I do that, I’ve learned that all it does is tell the pharmacy that I denied it, which isn’t even close to the truth. So they tell the patient I denied it, and the patient gets angry and yells at my office.
I’ve verified this sad tale with different patients and local pharmacists. Because of getting burned like this, I now just ignore online controlled drug requests and wait until the patient or pharmacy contacts me. How efficient is that?
Another issue I have with our e-prescribing system is writing mega-pill amounts. It won’t allow greater than 999 pills per refill. I have no idea why.
For most scripts this isn’t an issue. But it occasionally crops up, usually with 90-day supplies of carbidopa-levodopa (Sinemet) or gabapentin (Neurontin). When that occurs, I’m pretty much stuck ordering the 999 or mailing the patient a paper script.
I don’t think e-prescribing is a time saver, either. The script I could write by hand in less than 1 minute often takes 3-5 minutes to send online if it’s a new script, or a new patient, or both.
Friends of mine who work in pharmacies tell me it hasn’t cut back on medication errors, either. And a quick search of the Internet finds similar complaints from both sides, so apparently I’m not alone.
I have nothing against progress, or technology, or even saving paper. Yet, requiring a technology to be used before it’s ready for prime time only replaces one set of problems with another – to the detriment of the patient.
How many of you out there use e-prescribing to get the Medicare bonus? Raise your hands. And how many of you with your hands up really find it’s easier than regular prescribing? I thought so.
I use it, too, although I am far from enamored with it. But, like most of you, I take Medicare, and don’t want to lose the bonus (or eventually be penalized). How do I hate thee? Let me count the ways.
My biggest gripe is controlled substances, an area where technology has clearly outstripped regulation. I can understand wanting to control some drugs, such as those on schedule II or maybe even schedule III, but my e-prescribing system won’t let me refill even minor things, like pregabalin (Lyrica) or zolpidem (Ambien). Here in Arizona, it also won’t let me fill carisoprodol (Soma) or Fioricet (acetaminophen, butalbital, and caffeine).
But it still sends e-refill requests on these drugs, when it knows I can’t refill them! You’d think it would have some way of filtering requests for controlled and noncontrolled substances, and sending the former by fax. It’s legal to send the refill request by fax, but one wonders: How much more secure is a fax to my office than the Internet?
So when an approval for a refill request for a controlled drug comes up online, I have this choice: I can ignore it and hope they’ll eventually fax me something, or I can try to approve it online.
When I do the latter it says, "This is prohibited. Click on the ‘contact me’ button to have the requesting pharmacy contact you by another method."
Sounds like a good idea, right? But when I do that, I’ve learned that all it does is tell the pharmacy that I denied it, which isn’t even close to the truth. So they tell the patient I denied it, and the patient gets angry and yells at my office.
I’ve verified this sad tale with different patients and local pharmacists. Because of getting burned like this, I now just ignore online controlled drug requests and wait until the patient or pharmacy contacts me. How efficient is that?
Another issue I have with our e-prescribing system is writing mega-pill amounts. It won’t allow greater than 999 pills per refill. I have no idea why.
For most scripts this isn’t an issue. But it occasionally crops up, usually with 90-day supplies of carbidopa-levodopa (Sinemet) or gabapentin (Neurontin). When that occurs, I’m pretty much stuck ordering the 999 or mailing the patient a paper script.
I don’t think e-prescribing is a time saver, either. The script I could write by hand in less than 1 minute often takes 3-5 minutes to send online if it’s a new script, or a new patient, or both.
Friends of mine who work in pharmacies tell me it hasn’t cut back on medication errors, either. And a quick search of the Internet finds similar complaints from both sides, so apparently I’m not alone.
I have nothing against progress, or technology, or even saving paper. Yet, requiring a technology to be used before it’s ready for prime time only replaces one set of problems with another – to the detriment of the patient.