incorrect prescriber contact info on electronic RX's

[grumpyRph]

venting, but also, if you have any insight as to why this happens or ways you've found to fix it, i'm eager to listen.

this is probably the single thing that drives me up a wall the most on a day to day basis.

what on earth is up with an electronic rx sent to a pharmacy that gives completely wrong contact info for a doctor? the worst culprit: hospitalists. another common one i see is urgent cares. basically it's urgent cares and clinics from a big medical facility.

I've never been on the other end of sending an electronic rx (the sender's side), but i actually really want to see what it's like. I have to believe it CANNOT be that hard. Why? cause so many offices/clinics DO get it right, so it IS possible. So I just have to assume it's laziness, incompetence on the sender's end. I wish there was an easier way to communicate ELECTRONICALLY IN THE REVERSE direction to the office than to rely on phone calls and faxes which are about half the time completely incorrect.

and the offices get SO MAD when you call the wrong numbers and you get the inevitable fax back "NOT OUR PATIENT!!!!". we had one this week i had to call on because the good-ol' hospitalist sent us an rx where the sig read: "take 1 tablet qid for 7 days, take 1 tablet qid for 10 days". and there was absolutely no way to get in touch with this evil man (ok so he's prob not evil).

any insight you might have to combat this problem? any insight on the sender's side as to why this happens?

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[WVUPharm2007]

Probably because they have a lot of **** to do and making sure the contact info is right is about #200 on their list of things to do at that moment.

 

[zelman]

Probably because they have a lot of **** to do and making sure the contact info is right is about #200 on their list of things to do at that moment.

You do realize that "making sure the contact info is right" means "generating a valid prescription," right? The law (in states where I am licensed) requires that the provider's address and phone number be on the prescription. Not a random address and phone number. If I cannot reach the provider by dialing the number, the prescription is invalid. If it's just some random location in the same network of facilities, it might as well be "Phone: 411".

 

[WVUPharm2007]

You do realize that "making sure the contact info is right" means "generating a valid prescription," right? The law (in states where I am licensed) requires that the provider's address and phone number be on the prescription. Not a random address and phone number. If I cannot reach the provider by dialing the number, the prescription is invalid. If it's just some random location in the same network of facilities, it might as well be "Phone: 411".

Not disagreeing, but they DGAF. Why should they? It won't inconvenience them. You'll eventually figure out where it is supposed to go. They won't ever be fined or even told they did something wrong by a medical board authority. It's just like when they write "Use as directed." Do you think they care that you can't submit that to insurance without an insta-chargeback from the third party? They have no skin in the game of actually making sure the Rx is correct. If something isn't filled out all the way, it's on the pharmacy.

Actually, #200 on the list of things they care about is probably overranking it.

Think of it like the stupid computer generated Rx requests corporate pharmacy send out en masse to physicians' offices. Do you care that it dramatically increases the workload of the medical techs/nurses? Do you care that they sometimes get resent after the Rx is sent in? Do you care that the idiot patients can send in a request even though they just called one in?

No, you don't. And if you do, it's roughly #200 on the list of things you give a damn about on a given day.

It's the same thing, but in reverse.

 

[Sine Cura]

Hospitalists are very unlikely to give a **** but dis-incentivize office laziness by making the customer complain to urgent care or their large-health-system PCP. Fine then. Strips and lancets are not mission-critical.

We have these dip****s at a particular FQHC who are absolutely too clueless to redirect faxes or recognize that they have a revolving door of mid-levels and the patient still goes to that clinic. Just because the mid-level named on the fax quit (by the way we already know that; that's why there's a note that we acknowledge that on the fax) doesn't necessarily mean the patient severed their relationship with that clinic

As far as refill requests to EDs and urgent care clinics and dentists or doctors that don't take faxes, um yeah we do give a **** 'cause that is intentionally wasting time and smart pharmacy staff knows better than to create unnecessary work and to waste time

 

[JustFillIt]

Probably because they have a lot of **** to do and making sure the contact info is right is about #200 on their list of things to do at that moment.

You have not forgotten what your position is also have you?

If I get the wrong doctor office on a Rx I say screw it. The way you are squeezed in retail anymore I have resorted to telling the patient to call their own damn doctor and request a refill.

 

[group_theory]

From a provider side - I log in (EPIC), open patient chart, select drug (picking right name, right dosage form, right direction), ask patient which pharmacy (making sure it's correct), and i hit send (then go through all the clicks for drug interactions, allergy checks, duplicates, etc). I don't even know if my name, address, phone number, fax number, NPI, DEA, state license, etc are correct when it is sent. It is not listed or shown on my end and there isn't a drop down menu or anything for me to change. And even if it is incorrect, there's no way for me or my office to change it. It'll involve calling someone in IT with high level clearance who can change it, and since it is a credential/prescription information issue, I suspect it will be a ticket order and that requires multiple approval).

My office NP used to work at 2 other places before she joined us ... so she has 3 different logins for EPIC ... she has to pick the right one (if she doesn't, she doesn't get her office schedule, all the phone calls queries, returned lab results, prescription refill requests, orders to sign, etc). If the hospitalist works at multiple hospitals or a doctor works out of multiple offices - I can see where the "mix up" can occur - the EMR sometimes isn't set up to match the reality of the workforce .... and from a provider's end - we don't see the name/address/phone number when we go to order something.

So it's not laziness or incompetence .... we just don't see it.

And I do wish there is a way to two-way communicate ... it will save you guys time with phone calls, my nurses time with phone calls, save me time from phone calls (calling to cancel Rx when patient change their mind on which pharmacy they want the Rx sent, but then change their mind later on).
But the state of EMR is a disaster

In addition, @WVUPharm2007 is right - there's a lot of competing interest during that office visit - not just the prescriptions, but making sure appropriate documentation, often there are forms to fill out (nursing home forms for encounter, or perhaps FMLA forms, or DMV forms, short-term disability forms, etc). Then checking the right boxes to meet PQRS requirements, checking the right boxes to support appropriate E&M codes, etc. At some point I should also pay attention to the patient and address their concerns 😉

 

[Sine Cura]

Do clinics or hospitalist offices have office managers?

 

[grumpyRph]

Probably because they have a lot of **** to do and making sure the contact info is right is about #200 on their list of things to do at that moment.

But in the end that’s such a disservice to the patient cause then if they make a mistake or need to be contacted because of an allergy or a drug interaction then the patient is just SOL?

It should really be in the top 5 of their priority. So they can just prescribe whatever they want and then vanish into the world like a fugitive ?

If it’s 200 on their priority list then at least make number one proofreading an Rx they’re sending out

 

[grumpyRph]

From a provider side - I log in (EPIC), open patient chart, select drug (picking right name, right dosage form, right direction), ask patient which pharmacy (making sure it's correct), and i hit send (then go through all the clicks for drug interactions, allergy checks, duplicates, etc). I don't even know if my name, address, phone number, fax number, NPI, DEA, state license, etc are correct when it is sent. It is not listed or shown on my end and there isn't a drop down menu or anything for me to change. And even if it is incorrect, there's no way for me or my office to change it. It'll involve calling someone in IT with high level clearance who can change it, and since it is a credential/prescription information issue, I suspect it will be a ticket order and that requires multiple approval).

My office NP used to work at 2 other places before she joined us ... so she has 3 different logins for EPIC ... she has to pick the right one (if she doesn't, she doesn't get her office schedule, all the phone calls queries, returned lab results, prescription refill requests, orders to sign, etc). If the hospitalist works at multiple hospitals or a doctor works out of multiple offices - I can see where the "mix up" can occur - the EMR sometimes isn't set up to match the reality of the workforce .... and from a provider's end - we don't see the name/address/phone number when we go to order something.

So it's not laziness or incompetence .... we just don't see it.

And I do wish there is a way to two-way communicate ... it will save you guys time with phone calls, my nurses time with phone calls, save me time from phone calls (calling to cancel Rx when patient change their mind on which pharmacy they want the Rx sent, but then change their mind later on).
But the state of EMR is a disaster

In addition, @WVUPharm2007 is right - there's a lot of competing interest during that office visit - not just the prescriptions, but making sure appropriate documentation, often there are forms to fill out (nursing home forms for encounter, or perhaps FMLA forms, or DMV forms, short-term disability forms, etc). Then checking the right boxes to meet PQRS requirements, checking the right boxes to support appropriate E&M codes, etc. At some point I should also pay attention to the patient and address their concerns 😉

That’s so maddening because it seems like such a simple and important thing to be able to change and edit (where the prescriber or at least where a prescriber’s agent can be reached)

Siiiiiiiiiiigh

I appreciate the insight and response tho 🙂

 

[Sine Cura]

Well wouldn't there be office managers or similar personnel that can look into that.

I do know that hospitalists offices get super annoyed that they get refill requests for their scripts but if there is no way to send electronic messages nor actually reach someone by phone or leave a voicemail, then fax is all that's left.

 

[Zynx]

I'm a pharmacist in a hospital that uses Epic. I know that nursing and pharmacy each have their own support teams. I would expect physicians have similar. Often enough most people don't realize this, and I put in Epic tickets for stuff to get fixed regardless.

It may be a bit of a stretch to call up the hospitalist and say "please contact your Epic support group and have them fix your contact info". But that would probably be the most appropriate way to handle it.

Alternatively, if a fellow pharmacist called me up with this concern, I wouldn't have any problem with putting in the Epic ticket on my side (but I may be in the minority, or at least I can see some pharmacists declining to do this, possibly just because they would feel unsure about what they are doing).

 

[johnpharm01]

Welcome to pharmacy 101. Even though rxs are electronic they still have problems. I have to imagine a prescriber would have to ok their contact information when they first create their profile, then update as needed (i.e. changes in place of employment etc) So if it was done right to begin with then there would be no problems. Who oks legal documents with incorrect information on it? Birth certificate, checks, drivers license. And then makes excuses as to not correct it. Work in retail pharmacy 200 is a short list.

I always would employ the patient as a tool to motivate a prescriber. I am sorry I have tried to reach you dr using the phone number he/she provided but can't get your script clarified, are you able to reach them?