Inpatient pharmacy, outpatient script

[xiphoid2010]

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Hey, those of you working hospital pharmacies, do you fill outpatient script?

The old DOP here filled some of the hospital staff's non-maintenance meds for free. Now I have been approached a few times since his departure, but have not been willing to continue it out of legal and logistic concerns.

Anyone more familiar with this?

 

[cycloketocaine]

Hey, those of you working hospital pharmacies, do you fill outpatient script?

The old DOP here filled some of the hospital staff's non-maintenance meds for free. Now I have been approached a few times since his departure, but have not been willing to continue it out of legal and logistic concerns.

Anyone more familiar with this?

We don't do it, we don't have a retail permit for the pharmacy nor have the systems to bill a prescription provider.

 

[Ackj]

The hospital I worked at was part of a fairly large organization that included a few other hospitals and clinics. I know we collected rxs and sent them to another hospital to get filled, and they were picked up back at our hospital. I don't remember anybody paying for them, although I also don't remember it being a very common situation, and this was quite a while ago.

 

[xiphoid2010]

In Texas, a class C pharmacy (hospital) legally may fill outpatient scripts as long as it complies with the same requirements of a class A pharmacy (retail). But I am not interested in all the hassle or get dinged if something isn't done right. Just hate turning them down and hearing "but we used to..."

The old DOP allowed those Rx to be filled for free. But since we don't have the system setup for billing, that's probably he only allowed non-maintenance meds.

 

[psychoandy]

Hey, those of you working hospital pharmacies, do you fill outpatient script?

The old DOP here filled some of the hospital staff's non-maintenance meds for free. Now I have been approached a few times since his departure, but have not been willing to continue it out of legal and logistic concerns.

Anyone more familiar with this?

The only time my pharmacy will fill rx's (and by "fill" i mean personally responsible for, since noone else will probably help you) are for emergent extraordinary situations, and would most certainly NOT do it as a professional courtesy to staff just because the outpatient pharmacy isn't open. If they have an Rx, there are plenty of 24hr chains in the area.

Not only is it legally blurry and extra work (i always have to remember exact labeling requirements from pharmacy lab, etc), but it is not reimburseable and essentially are giving away free drug, so I would put a stop to it or restrict to supervisor approval.

 

[spacecowgirl]

I don't think you want to go down that road.

 

[Old Timer]

You had better be careful because you purchased some of your drugs at special prices with the caveat that they not be sold at retail. Second, this is a direct hit on your P&L. I would speak to the administration and have a distinct policy in place for how they would like to handle this. Without proper record keeping, this would be considered shrink.

 

[njac]

something similar came up today. Not looking forward to the conversation I get to have with my DOP tomorrow when I explain what's been going on in the ED...

 

[spacecowgirl]

something similar came up today. Not looking forward to the conversation I get to have with my DOP tomorrow when I explain what's been going on in the ED...

We have had similar issues. Sending home Diastat from the Pyxis? Ugh. If you're worried that a kiddo will have a seizure in the next few hours before the pharmacy opens, maybe they shouldn't be discharged. The scary thing is that we probably don't even know the half of it.

 

[rxlea]

We're pretty good about not letting things like this happen. However, patient care comes first. I wanted to share a pretty good anecdote as an example but I decided against it.

As for the staff getting scripts, not going to happen. They have to go to outpatient.
Sent from my DROID3 using Tapatalk

 

[Its Z]

Non-profit 340b self insured hospital doing employee scripts bypassing PBM and retail stores is whole another story. It can add millions $ back into hospitals bottom line.

 

[xiphoid2010]

Seems like everyone share my concern. Yeah, it just seems like to big a can of worms. Guess it was right to draw the line.

 

[streetpreacher]

When I am at the hospital and we are asked about filling outpatient prescriptions, we don't fill them because we are only licensed for inpatient. I'm aware of some hospitals that do have outpatient prescription services in addition to inpatient, but it's all in how the pharmacy is licensed. We do have some instances where a patient has no way to get a medication that they are currently taking while an inpatient, but our policy on that the attending physician has to hand the medication to the patient upon discharge. This takes the direct responsibility away from us but also ensures the patient gets a medication if they don't have it readily available.

 

[Rph888]

Non-profit 340b self insured hospital doing employee scripts bypassing PBM and retail stores is whole another story. It can add millions $ back into hospitals bottom line.

if the op's hospital is 340b he should start up this program and legitimately save $$ for the hospital. this would be a nice feather in his hat, build up that resume, get that cfo to like him even more!!

downside is the liability as stated in this thread...

 

[WVUPharm2007]

if the op's hospital is 340b he should start up this program and legitimately save $$ for the hospital. this would be a nice feather in his hat, build up that resume, get that cfo to like him even more!!

downside is the liability as stated in this thread...

My old hospital used to do that. Biggest effing hassle ever. I'd be there all alone on a Saturday afternoon...160 census...an hour behind because I'm already understaffed...and in trots in some damned hospitalist demanding I get his kid's amoxicillin filled ASAP after I tell him to come back in a few hours. Don't forget...when you get rid of that PBM contract...you become the ONLY place the ENTIRE hospital can get meds...24/7/365. IF they want to go to CVS, Wags, or wherever, they have to pay cash. When it gets busy in the winter due to increased census? Yup...same thing with outpatient. And you know they won't let you increase staffing that much. November - March goes from hell to unfathomable.

The difference in how much stress I used to live with then and how relaxed I am now really strikes me when I look back on it. The most I make someone wait for anything now is like 20 minutes. And it's not like I have 3 people coding simultaneously...if it takes 25 minutes, they are just annoyed...nobody dies...

 

[Its Z]

My old hospital used to do that. Biggest effing hassle ever. I'd be there all alone on a Saturday afternoon...160 census...an hour behind because I'm already understaffed...and in trots in some damned hospitalist demanding I get his kid's amoxicillin filled ASAP after I tell him to come back in a few hours. Don't forget...when you get rid of that PBM contract...you become the ONLY place the ENTIRE hospital can get meds...24/7/365. IF they want to go to CVS, Wags, or wherever, they have to pay cash. When it gets busy in the winter due to increased census? Yup...same thing with outpatient. And you know they won't let you increase staffing that much. November - March goes from hell to unfathomable.

The difference in how much stress I used to live with then and how relaxed I am now really strikes me when I look back on it. The most I make someone wait for anything now is like 20 minutes. And it's not like I have 3 people coding simultaneously...if it takes 25 minutes, they are just annoyed...nobody dies...

Thats not true. 340b employee scripts can be filled through local retail pharmacies as long as its set up. I understand your previous frustration. But its because you had a lousy leadership at your facility. Its not that way everywhere.
Nonetheless 340b is a great program for both patients and health systems.