Comments on Doctor Grumpy in the House: E-prescribing Crap

We frequently hear that the U.S. pharmaceutical co...

2009-07-28T04:04:32.264-07:00

We frequently hear that the U.S. pharmaceutical companies have to charge so much for their drugs because of the amount of money they spend on the research and development of new drugs. The truth is that European drug companies spend just as much on research and development but charge much less for their drugs.

However, the European companies don’t spend the billions of dollars on TV advertisements and ads on radio and in magazines. They also don’t spend the billions of dollars on lobbyists that the U.S. companies do.

ps- I can appreciate Kacey's dislike of TAP's lexi...

2009-06-20T12:01:44.140-07:00

ps- I can appreciate Kacey's dislike of TAP's lexicon, but a day full of correcting unnecessary mistakes and getting yelled at by angry patients because their drugs aren't ready due to said mistakes wears a body down...especially when the mistakes are LIFE-THREATENING (metronidazole? no, mr. coumadin patient, I think not)...saints swear after a week with us...

Dr. Grumpy, I cannot thank you enough for being aw...

2009-06-20T11:53:09.076-07:00

Dr. Grumpy, I cannot thank you enough for being aware of the many, many failings of this system! Although electronic prescribing is touted as the new best thing, it's nothing more than more ridiculousness. TN already has a legibility law requiring prescriptions to be typed or written in BLOCK LETTERS, but there's no enforcement or subsequent penalty. Mandating the e-RX system does nothing but ensure increased errors, especially since it lacks a standardized sig code! It's bad enough taking voicemail/paper RXs instructing "1 tablet po by oral route prn as needed for pain" (sadly, this is not an exaggeration); e-RXs give my pharmacy computer aneurysms all damn day from idiotic, idiosyncratic drug listings, instructions, and doctor contact information.

You're also correct in that prescriptions ineligible for electronic transmission (i.e., controls) do NOT instruct us, the lowly pharmacy minions, to contact the prescriber by another means. We check the exception queue and read "DENIED BY PRESCRIBER." end transmission. But my very favorite component of all of this mess is that once a doctor has signed up for electronic prescribing, WE CAN NO LONGER FAX THE OFFICE FROM OUR SYSTEM. That's correct, e-Rx usurps faxing entirely, which makes it even more frustrating when I call the doctor's office & whichever bitchmonkey answers the phone tells me to send the request electronically or by fax, because they don't do verbal authorizations. Fantastic. That's usually when I suggest the patient finds a new doctor.

Thanks for explaining something I never knew about...

2009-06-06T10:56:33.938-07:00

Thanks for explaining something I never knew about. I am still old fashioned enough that I actually pick up my Rx's at the doctor's office and hand carry them to the pharmacy. I guess I shouldn't be surprised that pharmacies have been ripped off.... the whole country is being prepared for Socialized Medicine and we all will learn a different way of living or not living.
I read TAP's blog first and came over here. He has so much to say and teach...it's a shame that he goofs it up with all the dirty, offensive words.

Yeah, I'm not completely sold on the E-Rx either. ...

2009-06-02T21:00:27.681-07:00

Yeah, I'm not completely sold on the E-Rx either. From a tech/intern standpoint, it's just another hassle. I've had several occasions where we've had to clarify/change an order for one reason or another, and we get a verbal auth from the office. The doctor/nurse/whoever *sends a fricking E-Rx of the same thing we get a verbal auth.* Now I understand this might be necessary to keep a patient profile up-to-date, but it's there a 'store to profile' feature to this (or shouldn't there be)?

However, changes that *could* (and I can't emphasize this enough) improve efficient have to start somewhere, even if it starts with a setback or two (or more). We'll see, but I have a feeling this will be about as successful as Exubera...

PC- you should have told him that wasn't something...

2009-06-01T06:36:30.454-07:00

PC- you should have told him that wasn't something to be proud of.

Guess what. I filled a prescription the other day...

2009-05-31T20:19:22.610-07:00

Guess what. I filled a prescription the other day for a guy who, at the window asked if it was e-prescribed. I checked and said..yes it was. He said AND I QUOTE " I wrote the software for that".
um. thanks.....

These are a total pain for patients too. Sometime...

2009-05-31T20:01:22.073-07:00

These are a total pain for patients too. Sometimes I like to hold on to a script and fill it at my leisure for certain reasons--like I am not quite out, have to finish a similar med before starting a new one, etc. With the e-prescription, it is sent to my pharmacy and I am expected to pick it up within a week. For my local pharmacy, I was told they mail the prescription to you after a week and bill you or something, instead of re-stocking it.

Sometimes I have had doctors send it to a pharmacy without even asking me! They go to another room, come back, and say: oh I sent ... to your pharmacy before asking me if I even wanted to take said medication. What if I don't want the med? Then I have to call the pharmacy and say no, don't fill this. There isn't an un-submit as far as I know.

Sometimes I ask for a script when I know I won't be in for a couple months, and may need it before that time is up. I hate requesting refills through the pharmacy because they never let you know when they have actually reached your doctor and gotten it filled. I always end up needing to call, or coming in to early or too late.

The pharmacy system is very close to a meltdown. The current wait at my pharmacy for new fills is 2-3 hours, if you tell them it's a rush and you are out, or 2 days for a typical fill. Outrageous. The number of errors is also on the rise, some of them very dangerous such as giving a patient double the dose of pill of something that didn't have much of a size difference. I'm glad I check before leaving the pharmacy. They have also shorted me pills on numerous occasions. One time I didn't have any proof and had to pay for an early refill as I didn't realize they gave me 30 not 60 until halfway through the month. I'm careful now!

Something needs to change soon.

Thanks for all the informative and funny posts! I'm a neuro patient and can relate to quite a bit of it (New Daily Persistent Headache).

Best wishes.

Medicine and Pharmacy aren't practiced like they u...

2009-05-31T15:52:01.726-07:00

Medicine and Pharmacy aren't practiced like they used to be. These new stunts that they're pulling just makes me confused. Likely: More errors, more money wasted, more time wasted, more angry patients, more angry physicians, more angry pharmacists, and more angry people. Apparently, our professions get screwed, whether we like it or not.

I have to agree that these are a PITA as well... f...

2009-05-31T15:42:26.521-07:00

I have to agree that these are a PITA as well... from the patient's perspective! You don't know how many times I have gone to the pharmacy after my appointment and the script hasn't even shown up yet... then there is the requisite calling the doctor's office to see if it was actually transmitted or if it is just delayed. Just give me a piece of paper already! I -HATE- this.

Too bad - it sounds like it could be a piece of ca...

2009-05-31T15:03:17.123-07:00

Too bad - it sounds like it could be a piece of cake if it were better designed. Maybe Apple should create a programme and call it the Iprescribe, then it would work!

Excellent post Dr. Grumpy!! Of course, I could act...

2009-05-31T14:44:13.512-07:00

Excellent post Dr. Grumpy!! Of course, I could actually write that on all your posts! I can't wait to get over to TAP and read his post. We at the Lipstick Pharmacy (not our real names) hate e-prescribing too.

The e-prescribing companies have basically assuming that the biggest problem with prescriptions is that they are illegible (so I guess that's why all your drop-down menus are ridiculous).

We receive e-prescriptions all the time all are perfectly legible...and perfectly illogical. We still have to call the offices just to make sure we don't dispense the wrong thing...arrrgh.

Oh, and you know what else is weird...sometimes it takes several hours for the e-script to appear and sometimes it is instantaneous.

And if the doctor practices out of several offices...the e-script companies haven't addressed that yet either.

Sorry if I soap-boxed in your comment section. :)