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Topic starter
It seems more frequent now that the names of medications are being changed (sometimes very minor changes) and this can cause problems for the eRx.
I think one example is 'NORVASC TAB' vs. 'NORVASC TABS'.
When a refill/order with the wrong name, the physician ends up getting an error back.
We have thought of running reports for all the "problem" meds, and then trying to have someone adjust the med list. This would be very time-consuming.
Is anyone else experiencing issues? How are you addressing/handling?
Thanks in advance...
Posted : September 14, 2014 11:00 pm
after every MediSpan update, our support team prints out the Uncoded Medication Custom List Entries Report, and updates all custom lists needing to be updated.
Posted : September 15, 2014 10:35 pm
Topic starter
We are following a similar process to update the 'Lists', but our issue seems to be related to a patient that has an active prescription for "Med A" and calls us for a refill. The refill request is completed but errors back to us since "Med A" is no longer valid.
Thus, close out "Med A" and new prescribe "Med B".
Therefore, we are pondering every time a Med Update, run a report for all patients who got a scrip for "Med A" in past 6 months, and having someone manually go through each chart to update the Med List to now reflect "Med B".
Again, sometimes the change is rather trivial in name. And we are therefore trying to determine if any way to automate this, or easy/simple way to remind staff when precessing refills, etc...
Thanks.
Posted : September 15, 2014 10:46 pm
One cannot monitor NDC changes which happen continuously. As mentioned with monthly knowledege based updates we can only clean up and remove expired meds through reports. It is the resposibility of the nurse delegates or providers to respond to flags when ERXs error. Users should go into the patient chart to do Clinical List Updates, correct medications with current NDC numbers, and resend eRXs. These medication remain on patient list regardless of Knowledge Base updates and need manual updating continually. It needs to become a practice workflow.
Beth Ashabranner, RN, CCRN, BS 
Ambulatory Systems Clinical Analyst
CVPH Medical Center
518.562.7303/Fax 562.7094
Posted : September 15, 2014 10:50 pm
Just a thought, can you run a report in inquiries and send a bulk flag to all of those patients charts that are affected? Still a workflow issue but it might help
Posted : September 15, 2014 11:46 pm
Tried that and it went belly up because users ignore and the message goes to ALL (Enterprise) and individual Locations of Care could not remove pop-up alert.
Beth Ashabranner, RN, CCRN, BS
Ambulatory Systems Clinical Analyst
CVPH Medical Center
518.562.7303/Fax 562.7094
Posted : September 15, 2014 11:51 pm
Topic starter
I am intrigued by the thought of placing it as a Care Alert.
Especially if I write a specific Care Alert message (always format as "Med Alert - xxxx"), and then perhaps use some MEL coding to highlight: in banner, on refill screen, etc..
I admit, have not thought through the actual programming, just pondering.
Posted : September 16, 2014 12:06 am
Give it a try you never know but ultimately the practice is responsible to see that the patient gets the meds ordered. My frustration are delegates who discard flags alerting them of corrections needed. What if that were their family member with a cardiac med? Regardless, they have a duty to the patient to act. So workflow, workflow but tools are nice if they work. The last GE report have over 8000 individual out of date meds on patient charts. The practices did not have time to tackle the list due to resources and we are a department of 4 team members and have bigger fish to fry with Meaningful Use - Stage 2. Best of luck and I would be interested to know what you come up with.
Beth Ashabranner, RN, CCRN, BS
Ambulatory Systems Clinical Analyst
CVPH Medical Center
518.562.7303/Fax 562.7094
Posted : September 16, 2014 12:18 am
I did something similar...I ran in inquiry (after hours because it took so bloody long) for each of the meds on my uncoded med report). I meant to send it as a pop up to the patients' charts, but it ended up going to the responsible providers' desktops as well. That didn't go over so well 
They were rather bombarded. I agree that it needs to be workflow that the nursing staff needs to update the patients' med lists to keep it current. It is a pain, though...
Wendy Walecka, MS RN
Affinity Health System
Appleton, WI 54911
Posted : September 17, 2014 3:42 am
