Aug 20, 2015
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I work in an outpatient pharmacy, and I frequently run into situations where I may have to call the patients provider and discuss their treatment/therapy. I've always been able to communicate with primary care providers and with providers at hospitals. Recently had a situation where a patient was on 5 medications that prolong the QTc interval, 2 of them being the highest doses of very high risk medications. The patient was a 90 year old female who is at a higher risk for torsades. I needed to verify that the patient's EKG was being monitored, and preferably know that her last QTc was under 500. When I called the provider the nurse said that I need an ROI for that information. I have never had someone tell me that I need an ROI to coordinate care for a patient. I did not dispense the medication because I didn't feel it was safe without knowing her QTc. The nurse refused to even tell me if it was done recently.

Do outpatient pharmacists need ROIs to communicate care for a patient between primary care clinics? For things like verifying that EKG have been done?
 

Sine Cura

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Feb 5, 2010
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They are ****ing idiots

It's possible they may have internal procedures mandating that but I highly doubt it. Perhaps they have never received such a call from an outside pharmacy.
 
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SELDANE

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Feb 3, 2007
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Whenever I worked outpatient pharmacy I was never as technical or thorough. I simply stated the interaction and asked if the provider still wanted me to dispense the medication. Regardless, a pharmacist (inpatient or outpatient) should not need a ROI to communicate when trying to coordinate patient care.
 

msweph

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Jun 27, 2013
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Wtf is a ROI?

And the nurse should have answered your question. You are doing your job by checking with them.

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OP
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Aug 20, 2015
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ROI = release of information. I thought it was very odd she responded to me in that way. But legally didn't know if I needed an ROI. I've communicated many times with other nurses/doctors about vitamin D levels or QTc concerns and never had the issue. I didn't think I needed an ROI either!
 

radio frequency

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Dec 18, 2012
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When you say outpatient, do you mean retail, or health system outpatient? If retail and you have no access to the medical chart, I'd just send the provider a fax or give a call stating that you want to ensure patient's EKG is being followed due to QTc prolongation risk. Document, call it a day. Ball's in their court then. You don't need to know the number, you just need to know they're on it.
 

ldiot

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How can you have corresponding responsibility but have this information withheld? They are complete idiots.
 

Deja

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Feb 1, 2009
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yeah the nurse is an idiot... but you should also know that you don't need it so you can tell her to get her supervisor lol isn't this a common law question on board exam? lol
 

giga

U.S. Public Health Service
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You absolutely do not need an ROI per HIPAA, and I can't imagine the institution has a local polciy that prohibits disclosing PHI to a pharmacist. That's absurd. The nurse is either misinformed or just has some chip on her shoulder. I would have respectfully informed her that you are a covered entity under HIPAA and that you need the information in order to provide treatment, and that an ROI isn't necessary by law under those circumstances. If that wouldn't have convinced her, I would have asked to speak with a supervisor. Honestly, it's disrespectful that she would give you such a hard time with this, not to mention her actions led to an unnecessary delay in providing treatment to the patient.
 
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ldiot

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I don't like to make anyone's life more difficult but when you deal with this kind of stupidity you need to ask for a supervisor.
 

BidingMyTime

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You probably weren't even talking to a real nurse, probably at best a MA, and possibly just an unlicensed person who answers the phone and/or deals with insurance issues. If that ever happens again, ask to talk to that person's supervisor or to talk to the physician. There is no reason you shouldn't be able to get that information, and most likely you were talking to someone new and not medically trained.