Take advantage of e-prescribing for prescription refills

Prescription refills! How can something so necessary generate so much frustration?

You got all the original prescriptions written at the same time — but after a while, somehow, the refills are all coming due at different times, and they don’t coincide with your follow up office visits. So now you need to contact the doctors’ office for a refill. That means going through the phone menu. Then you have to either carefully recite your name/date of birth/contact phone number/prescription name/dose/instructions/pharmacy information to a staff member, or you have to talk to a voice mailbox and remember not to leave any of those critical details out of your message. Then you have to wait for someone at the doctors’ office to check your chart, authorize the refills,  call your pharmacy, and read the information to the phamacist or the pharmacy voice mailbox. And then you have to wait for the pharmacy to actually fill your prescription.

And guess what? You doctor isn’t exactly in love with the process, either. It requires a lot of valuable time from skilled staff members providing this free courtesy service — and doing it with minimal risk of irrgular hthe risk of medical errors. It ties up phone lines and personnel who are also handling sick calls. Multiple people have to “touch” your refill request, creating a risk of human error each time.

 

Fortunately, our office has electronic prescribing.  Although we’ve had some technical problems while upgrading our server, we’re now fully operational again.

E-prescribing reduces a lot of the wait-time involving telephone calls to request refills, it reduces a lot of the potential for errors when people are passing messages from one to the other, and at each step, it reproduces the exact information about medications that often have similar sounding names and complicated dosage forms.

If your pharmacy is set up for e-prescribing — and almost all of them are now — the process is more like this:

  • You call your pharmacist to have your routine refills ready for you to pick up.
  • Your pharmacist notices you don’t have any refills on some/all medications.
  • The pharmacist sends a refill request via a secure internet information exchange, in our case, via SureScripts.
  • You refill request appears on the queue for your doctor/nurse/PA on our computer system within minutes. Because it is linked to your previous prescription, the drug description and dosage information is automatically identical to your previous prescription.
  • The doctors’ office computer flags any discrepancies in the request: For instance, if the pharmacy requests a refill on a drug that was supposed to be discontinued, or it requests a refill for a dose that was changed, that request will be flagged for special review and manual matching. Prescriptions that are identical to our records will be matched automatically.
  • The prescriber clicks the drug in the queue to refill it, making any changes in instruction, number of pills, etc.
  • The prescriber hits “save” and “send.” The refill again goes through the secure clearinghouse. It comes to the pharmacy linked to the actual original script so the pharmacist can see any changes.
  • Your pharmacy proceeds to refill your drug, then you pick it up or get delivery.

Notice that most of the steps than involved time and effort on your part are eliminated. Also, a computer is much better at doing error checking for routine tasks, because computers don’t get bored or rushed. This system only requires humans to review things that are not routine, so they don’t lose their edge doing those reviews all day.

 

If you’ve been calling the office and leaving messages for refills, try e-prescribing and see if it makes life a little less annoying.

Also, if you’re getting 30 day supplies of medications, ask you doctor and pharmacist about getting 90 day supplies of your generic drugs. Besides eliminating 2/3 of the trips to a pharmacy to pick up your pills, your insurer will usually charge less than a full 3 times the copay of a 30 day supply — you save money. And if you are on a plan that puts a limit on the number of prescriptions you can receive a month, you may be able to increase your 6-prescription-a-month limit as high as 18 prescriptions a month by staggering the requests into different months.