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Interaction Performance Issues - Any ideas?

August 27, 2019, 1:43 pm
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When we have patients with lots of medications it can take several seconds for the Interaction check to occur.
Example: patient with 25 medications takes 14 seconds for the interaction button to update.

I’ve opened two cases with ECW support about this but in both situations after we look at things I’m told that it’s behaving as it should and it just takes longer for the interaction check to occur on patients with many medications. It seems like there has got be someway we can get this working better. I saw another practice’s ECW cloud hosted version seemed to be much faster than our on premise ECW installation.

We had to move to new servers to get on to v11 a few months ago and it seems we didn’t have this issue before the upgrade/change.

Does anyone know how the interaction functionality works…as in does it go out to the internet to perform this interaction check or does all of it happen locally? I’m trying to understand how we could throw more resources at this. We recently added more RAM for the database performance that helped overall but it seemed to have no effect on the interaction slowness.

Thanks

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EPCS and State Specific requirements

August 30, 2019, 2:00 pm
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Greetings eCW Users!
We’re contemplating turning on and supporting EPCS, but want to know a couple of things first. 
1) Is anyone using EPCS in a state that has specific requirementsregulations (i.e. ink signature);  if so, what is that experience like?
2) Is there anyone in the state of PA specifically and what is that experience like?
3) What is your overall experience with setting up providers with EPCS (Exostar Hardware device, token, ATHY app, OTP’s, Experian, etc.)?
4) What is your experience with support? 
5) Do you have a dedicated EPCS administrator?
6) Are there any additional contracts outside of eCW required and how was that experience?

Thank you for anyall feedback and help!

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Primary Pharmacy Changed

September 5, 2019, 9:45 am
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Over a week ago, we noticed that many our patients had their primary pharmacy changed. Initially, we thought a user mistakenly changed a few. After running a report, we found almost 1000 patients who went to a local pharmacy around the corner get defaulted to a Walgreens in Las Vegas. The logs obviously have no record of the change and there has not been an update since the initial call with support.

Has anyone encountered this?

Thanks,
Allen

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Suggested Strength on RX refills

September 30, 2019, 1:00 pm
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For most of our e-RX refill requests, the provider is always getting the dialog with the Suggested Strength to apply to the medication.  Often the strength is listed in the medication like Metformin HCL 850mg Tablet.  If our providers apply the suggested strength which I believe is required to send the RX then it switches to Approved with Changes which I believe sends it as a fax? (eCw support is disputing that with me so I have to find examples.)  If they cancel the suggestion and do a local edit so it sends, does the NDC associated with the medication take care of sending the strength?  An error comes up with the local edit that says it just updates RX history and nothing is sent to the pharmacy.  Trying to ensure best practices are used and not a lot of faxes are sent.

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Signature on Printed prescriptions

October 17, 2019, 6:24 pm
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Hi all,

How do I enable automatic signatures on printed prescriptions? This would be for non-controlled meds. We are able to do it when e-scribing but tot sure where the setting is for regular printed scripts.

Thanks!

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Cancel RX function

October 20, 2019, 6:59 pm
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Hello,
I am so excited to learn there is an ERX cancel function.
Does anyone know what pharmacies it works with?
It does not currently work with Walmart.
Thanks

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v11: Equip/Supplies MUST be faxed - cannot e-prescribe…true or false?

October 24, 2019, 9:35 am
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We’re being told after our upgrade to v11 last weekend that ALL Equip/Supply prescriptions (e.g., test strips) must be faxed since they don’t have an NDC assigned.

Really?

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Refilling discontinued/stopped meds?

November 3, 2019, 6:42 pm
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We’ve been trying to do a little cleaning and providers have been asked to remove duplicate meds from the pts Current Medications, and mark them as discontinued.

When the rx comes back in as a refill request, it comes with automatically Denied, and with a message “Rx was stopped or discontinued, please check Rx History”. You are not able to select the Approved option and send it. It makes sense why ecw would give that msg though if they see a refill request for a discontinued medication, but it would be great if the provider could still Approve it.

This creates a bit more work on the providers, as they have to select Denied New Rx to Follow, and select the med and formulation again.

Does anyone have a better workflow for this or any suggestions?

Thank you

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E-Refill Change Requests Bug

November 8, 2019, 6:43 am
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Hi all

I am curious of others have experienced this bug. It seems isolated to v11.40.14 but I am not sure.

This is extremely annoying and eCW is indicating for providers to create a TE instead (more clicks).

Have others run into this and if so what response have you received from eCW.

Thank you
Tyler

As discussed on the call,

Unable to respond to Change Requests via any available response type such as Approved, Approved with Changes, or Denied for Controlled or Non-Controlled Rx is reported as BUG in the current version.

The following scenario presents a workflow where this issue may occur:
1. Navigate to the E Quick-Launch button and click ‘Change Request’.
2. Select the alternative.
3. Click ‘Send e-Prescriptions’. 

In the scenario above: In the latest general release (V11.40.14), users are unable to respond to Change Requests with any available responses.

In the interim, the available workaround is that once they approve the Change Rx, they can create Telephone encounter and add medication which was selected as Alternative in the Change Rx (i.e., new medication dispensed for the patient) and stop the old medication if required.
The change request which is there in the queue let be as it is and The request gets expired if it’s not responded within 72 hours.

JIIRA: PE-47199

Please let me know if you have questions on this case.

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EPCS - Signature Error

November 11, 2019, 10:02 am
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Our clinic has been trying to switch over to EPCS before Jan. 01 2020 and with every step forward, we take two steps back. We’ve managed to make it to hitting “send” after the Application Login PW and OTP is entered, which leads with the following error:

“An error has occurred, hence you cannot send this controlled prescription online. Doctors are required to give a fax, handwritten or printed prescription with doctors signatures”

eCW has spent almost an entire week on this now and has failed to deliver any solution. Thanks all!

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Cannot remove medications from My Favorites, and they all have NDC errors

December 29, 2018, 11:30 am
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I’ve noticed for a while now that when I click on the “Remove as Favorite” star icon next to medications in the drop down from the Treatment > Manage Orders screen, nothing happens. If I log out and log back in - including over several days - the med is still there with the little red X on the star next to it. Very frustrating.

Also, I’ve quit using My Favorite meds as often because they always generate an NDC error and require me to “update the NDC” code on the pop-up screen. So, most of the time it’s just easier to select a med from the drop down and modify it.

And why does nothing in this EHR work anymore? It’s very frustrating. Everything is a work-around. That might have been excusable in 2008. But now???

Thanks for any help!!!

BTW we use the Multim database.

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Brands versus generic refill reminder

November 15, 2019, 7:16 am
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Has anyone come up with a alert system that reminds prescribers when a patient gets BRAND only.  In otherwords I have patients who will pay a higher copay because they believe brand worked better and insist on brand.  But in a busy practice we don’t always remember each patients nuance at the time of sending the Rx.  Any suggestions?

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EPCS -“Failed as NDC validation for EPCS”

November 20, 2019, 12:07 am
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If you use EPCS and find that you get the following error “Failed(Error: Failed as NDC validation for EPCS”.  But you are certain the medication has a correct NDC attached.  Issue if most likely you clicked on refill in right chart panel. 

We encountered this issue with medications and found that we have make sure we are using “start” in order for it to go thru.

Correction 2/4/2016 - ignore message above.  We had to open ticket and were told something is going wrong on back end.

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Dispense As Written - eRx

December 19, 2019, 11:59 am
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It seems like in the old days there was a DAW box (Dispense As Written) for the printed and signed Rx that one could initial to prescribe brand only meds.

And if it was faxed, it seemed like there was a way to mark this box - but I may be misremembering that.

Anyway, how does one do a DAW prescription for the eRx?

Do you just write DAW int he Notes section? (see attached) - and then the pharmacist sees the note?

I couldn’t find any eCW documentation on this option.

We are using chrome v11e version.

thanks

Kelly Locke, MD

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Diabetes Supplies (Lancets, Pen Needles, Strips)

December 20, 2019, 12:04 pm
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Has anyone figured out how to thoughtfully complete diabetic supply ordering? As of current, they tell you it is an “equipment” and should be faxed without a full signature. However, many supplies are mapped to sure scripts via NDC code. Example: BD Pen Needle Nano U/F.  This type of needle comes in 29 Gauge 32 gauge. But to find the 29 gauge you have to search “BD Ultra-Fine Pen Needle”, If you do “BD pen” using the contain feature, is doesn’t bring them all up.

Overall the search functionality of diabetic supplies is a nightmare, because in this case the patient wanted Nano 4mm 32 gauge. None of which are searchable without knowing it was BD, and even still the descriptors do not match the market.

I am hopeful someone in the community has mastered this, because I spoke with a local endocrinologist and they responded by merely telling patients to have their pharmacy fax a paper document (fail eRX initiative).

Thank you for thoughts.

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Unable to disable pop-up in RX window for prescriptions

January 4, 2020, 12:48 pm
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In the past week I have not been able to disable the pop-up in the RX window when I want to prescribe a medication. I prefer to free-type sometimes because it gives me more flexibility and takes less time than going through the pop-up. The pop-up box is still there but it is checked and grayed out so that I can not uncheck it. I think this began after our last Medispan update. Any ideas on how to fix it? I looked through my settings and could not find one for the RX pop-up. I am on v11, using our own server.

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Bulleted Meds on the PN

January 23, 2020, 1:20 pm
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I noticed one of our new doctors today had her meds ordered in bullet points, I thought it looked a lot cleaner and easier to read, but wasn’t able to figure out how. I must be missing a setting somewhere.

Does anyone know how to enable this option?

Thanks

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EPCS Hardware Tokens

August 21, 2019, 8:18 am
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We are looking over the two available packages for EPCS as we are needing to implement soon. Seeking feedback on the hardware tokens.
How well do the hardware tokens work? Reliable? Durable? Anyone needing to purchase replacements often? Is it worth it to have 2 tokens for each clinician? Lastly, if we go with only 1 token and purchase say 4 spares to have sitting in a drawer for an “emergency”, is this possible or are the tokens already assigned to a clinician when purchasing?
Sorry for all the questions, just gathering as much as I can smile

Thank you in advance!!

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PDMP Texas - instantly add more nearby states to search

January 29, 2020, 12:30 pm
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I found an amazingly easy way to add nearby states.

For our location, we get patients from KS, CO, NM, and OK for instance.

To enable adjacent states INSTANTLY :

Go to the Texas PMP site:

https://texas.pmpaware.net/login

Log in with your Texas PMP Aware user name and password. Your user name should be your email. You can reset your password if you forgot it.

Once logged in to Texas PMP Aware ,
1) Click on MENU
2) You will see several columns of links. In the USER PROFILE column, click on DEFAULT PMPi STATES

3) You should see a list of about 35 states there.

4) Click as many states as you want. I chose CO, KS, OK, NM for instance.

5) In the lower right click on UPDATE DEFAULTS to save your choice.

You’re done !  Your next search in eCW should include those other states.

This may work with other states that are managed by APRISS.  I can verify it works for Texas.

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NDC codes on eRX…my providers worst nightmare

January 30, 2020, 12:50 pm
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It seems for the last 3+ years my providers and myself have been beating our heads against the wall constantly with NDC codes on eRX.  It’s my understanding that the yellow triangle shows up when the NDC is missing….however it doesn’t display when it’s no longer a valid code.  We are always current on our Medispan update…

What’s your best practice to help providers with NDC on ERX?

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