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Pharmacies not receiving scrips even though we show success on our end?

January 1, 2017, 9:36 pm
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We are having increasing problems with our eprescriptions that go through Surescripts not making it to the pharmacies.  We mostly have trouble with CVS, Walgreens and a few others.

On our end, it shows successful, but when the patient presents themselves to the pharmacy, the pharmacy has no record of the prescription.  We have called the pharmacy, but they still say they have no record of the prescription anywhere.

I put in a ticket with eCW, but all the tech did was verify the script got from eCW to Surescripts.  His solution was that we had to give the ID number from the scrip to the pharmacy and tell them to contact Surescripts to find out why they didn’t get the prescription.

The Surescripts website in the FAQ’s says in this situation, we are to contact our emr vendor : “4.Report the incident to your e-prescribing software vendor so that they can open a support case on your behalf which will help reduce the chance of a future occurrence.”

I’m thinking that since eCW is our go -between, they should have done more?

What has been your experience with things like this? 
Thank you,
Karla

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Dosage Calculator in V10 SP2

January 10, 2017, 8:04 am
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Upgraded to V10 SP2.5.2 over the weekend.
Dosage calculator doesn’t seem to function as in SP1.  Frequency drop down no longer contains custom frequencies we’ve created (ie two times a day, three times a day, etc.).  Therefore only the standard drug frequencies appear.  However if the standard drug frequency is something like “every 8 hours” or “every 12 hours”, then the calculator simply won’t calculate anything.  We are a pediatric practice and prescribe meds like Amoxicillin frequently.  Standard frequencies for Amoxicillin in eCW are “every 8 hours” and “every 12 hours”.  ECW states these issues are known bugs that may be fixed in blahblahblah…

The workaround, providers need to manually type in the frequency of “two times a day”, “three times a day”, etc.

Wondering if anyone else has experienced this and received a different response from eCW.

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Can’t prescribe meds to two separate pharmacy with new update

January 16, 2017, 10:20 pm
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We installed V10 Service Pack 1 C20 recently and can no longer send the same prescription to 2 different pharmacies.

When the staff refills a medication, the prescription will lock. If they then want to go in and send the same medication refill to another pharmacy, they cannot do so.

Has anyone run into this? If so, what has been your workflow to send to the other pharmacy.

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eRx screen

January 23, 2017, 11:56 am
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Is there a way when I send an eRx, that the eRx will be sent but not have to wait for the confirmation of success or failure message to have to show up in order to close the eRx screen? Sometimes the wait can be long to get the popup message of the medication being sent successfully.

On days like today, when SureScripts is down, this is especially frutstrating. I am in with a patient, watching the window become unresponsive for 60-300 seconds before giving me the error that the Rx is placed as pending because of a server error.

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External Rx History

January 23, 2017, 10:55 pm
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Anyone out there using the External Rx History functionality in the Current Medication area? If so, how did you go about getting the patient permission part figured out? Did you incorporate additional language in existing permission forms? Did you create a separate form for just this?

Any information is appreciated!

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eRX Overriding Precription Listings

January 25, 2017, 8:04 am
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Is there a way that the eBean refill requests will not over ride our prescription listings?  They have the tendency to change our dosing fields, so the individual Take, Route, Frequency fields are replaced by a single line of text.  For example: If Dr. writes Fluticasone Nasal spray as “1 to 2 spray in each nostril; Daily “ the pharmacy sends a refill request via erx it may be changed to “spray 2 in nostril daily”

Often times, the strength fields are also being replaced, so 0.5 mg become just 0.5.

Thanks!

Ray Welsh-Dalton

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Medications refill populates under “other” on progress note

December 16, 2015, 1:46 pm
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Why does medication from the Right chart panel populate under “other” in the progress note when refilled?

Let me explain exactly my process and hopefully someone can tell me at what step I’m messing up on.

1.    Pt comes in with list of meds currently taking from previous provider and nurse’s types in those meds under the current medication section on the progress note.
2.  Pt wants refill that day.  Provider goes into the treatment window and pulls up current meds and associates a dx code with the meds and refills
3.  The next month pt comes in wanting refill of same meds and provider refills from the Right chart panel pushing that information into the progress note except instead of going under the dx code that he associated it with the month previous, it populates under “other”
Why? What am I doing wrong?

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Changing EPCS Effective dates

February 1, 2017, 8:59 am
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It was advertised and demonstrated at the conference that we could send in several prescriptions for Schedule II Medications and post-date.  For example, send in three 30 day Adderall prescriptions which are effective 30 days apart, to account for 3 months. Our practice has yet to successfully execute these. They seem to work fine on the eCW side, but the pharmacies NEVER receive the subsequent prescriptions - only the first month’s Rx.

Has anyone else had similar issues? Anyone able to drill down to the root problem? Is this our software or the Pharmacies? We prescribe to several - Kroger, Tom Thumb, Walgreens, CVS. None are able to handle it.

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Notifying Pharmacy of a Stopped Med

November 17, 2015, 8:16 am
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In a Telephone Encounter I can go to the Rx tab, click on Current Meds, click the “S” icon to Stop a particular med and this stop action will then appear as a row within the Rx tab of the TE.  However, when I then go to “Fax Script”, that stopped medication is not part of the fax.  In fact, I have never seen anything appear in the, “Existing Prescriptions not requiring Refills” section of the script fax preview.  Is there any way to communicate a cancellation or stopping of a medication to a pharmacy other than calling the pharmacy?  It’s a long story, but I’m asking this due to an ongoing problem we are having of not getting enough eRefill requests but instead large amounts of fax refill requests.  Thank you!

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EPCS and 3 months of controlled med

March 16, 2016, 12:32 pm
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Some of our providers would like to use EPCS, but would like to continue to prescribe 3 months of medication at a time, notating the fill dates of one each month, to avoid having the patient either call in every month or return to clinic each month.  We did turn on an item key to allow the same (NOT CONTROLLED) medication to be prescribed (started) under a diagnosis, and have created a work around for refilling those meds. 
Can our docs use the EPCS token to eRX controlled meds refills for 3 months at a time? Is there a separate item key that needs to be enabled.  Either way, can someone tell me the workflow for this.  I’d really appreciate it.
Thanks,
Karen

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How to handle compounding pharmacy Rx’s

September 23, 2016, 8:04 am
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Hello!

I work with a few clinics who have a compounding pharmacy nearby and the patients have very unique prescriptions. The provider wants to see this in their med list, but the Rx is specific to each patient, it’s usually some type of hormone medication where each patient may a different dosage or %, etc.

Has anyone discovered an easy workflow for this? I’ve seen the Custom Rx’s get out of control and they aren’t very in love with the idea of putting the sig in the notes in current meds.

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Product suggestion : Integration of Rx and HPI

September 14, 2016, 9:16 am
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Scenario:  Patient is given Rx for antidepressant such as an SSRI

Program checks to see if PHQ2 / PHQ9 ; if one not done it launches it or MD can indicate med used for other purpose (such as neuropathy)


Scenario 2:  Pt started on dementia drug

Program checks to see if MMSE or similar assessment tool is done

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EPCS and issues

December 9, 2015, 9:42 am
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I just activated my first physician and it was smooth however within minutes I get emails from other physicians telling me they have received a message that contained a report of all of their sent prescriptions and the LOCK on the sent prescriptions is now there.

I have been trying to find documentation on this process however I have not read about this happening.

Nothing is easy! Things change or appear without the user knowing that this is going to happen. I feel so unprepared every time I activate a feature because there is no documentation.

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Np’s seeing a patient and MD prescribing Suboxone

August 23, 2016, 12:55 pm
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We are trying to expand our MAT clinic to include NP’s, but running into a problem with prescriptions since NP’s can not prescribe suboxone yet.  The Np will see the patient, but the MD will have to prescribe the meds. Does anyone have any good workflow ideas??

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EPCS and Support Staff

September 21, 2016, 11:10 am
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Hello all,

We are about ready to pull the trigger and start EPCS in our practices. I have reviewed the documentation and the webinars/videos and have questions.

On a Telephone Encounter medication request, our support staff completes all of the Rx tab information (IE: Nurse pulls forward the Current Rx info for the provider, completes the DDR, etc) and then sends to the provider for authorization. Usually the provider will look it over and reassign back to the Nurse to have scripts sent/faxed/printed.

With EPCS activated, when the Nurse attempts to send a controlled medication, will they get the EPCS pop-up screen or will they get the standard Print to Paper prompt?

Also, if for some reason we want to print a controlled prescription to paper, are we still able to do so? If yes, how?

Thanks in advance for your assistance!
Marjo

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Fixing sent eRx

February 25, 2017, 6:24 pm
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We prescribe our medications (including controlled substances) electronically as much as possible. However, there are instances in which the prescription was sent incorrectly. What we currently do is stop the current med, add the med again (can’t use current meds to fix the error), and send the fixed med.

Is there a more efficient route? Why can’t current med button be used to create a copy of incorrect med so we can fix it and send it?

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Never received an e prescription renewal since using eclin

April 3, 2013, 3:00 pm
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since going live I have never gotten an erx renew using eClinicalworks.
At the last users group meeting I had this investigated and was told Surecripts had the wrong user SPI number in the system.
This was corrected
We have called pharmacies requesting e renewals with no success
My erx’s go out with no problems
But no e prescription renewals.
Please can someone help me!

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Medications refill populates under “other” on progress note

March 28, 2017, 8:55 pm
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Why does medication from the Right chart panel populate under “other” in the progress note when refilled?

Let me explain exactly my process and hopefully someone can tell me at what step I’m messing up on.

1.    Pt comes in with list of meds currently taking from previous provider and nurse’s types in those meds under the current medication section on the progress note.
2.  Pt wants refill that day.  Provider goes into the treatment window and pulls up current meds and associates a dx code with the meds and refills
3.  The next month pt comes in wanting refill of same meds and provider refills from the Right chart panel pushing that information into the progress note except instead of going under the dx code that he associated it with the month previous, it populates under “other”
Why? What am I doing wrong?

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Stopping meds

April 5, 2017, 1:03 pm
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OK.. I think I might be crazy (crazier) or it has just been one of those days.

In the past, several upgrades ago, I thought that you could click on the S for stop and then send that to the pharmacy like you would be escribing a med.

Now, that does not exist. The engineer told me that it was changes months ago and the office has to call the pharmacy to stop the medicine.

Am I dreaming that this feature ever existed?

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Current Medication Update in Progress note

April 15, 2015, 9:27 am
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Hello,

We went live 8/5/2014 on eCW and are still learning the ropes.

We are teaching our teams to use T N U D and occasionally get some push back.

Is there ever a time when your teams are using “delete” medication as part of the reconcilliation workflow (other than for an incorrect entry) ? 

One recent new employee came to us from a practice using eCW and reports at that previous practice, their routine was to delete medications the patient was no long taking (rather than discontinue).

If any one has a diagramatic Med Rec workflow or Med Rec P&P and would be willing to share—I woudl love to see it.

If helpful, my direct email is kdodds at orthopedicone dot com

Thank you and have a wonderful Wednesday.

Kathie

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