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Topic starter
Hello,
We are on CPS 12.2.2, and work with an in-house pharmacy that is using Pioneer Rx. We have an intermittent issue that is hard to troubleshoot.
A provider will change a prescription in the new Prescriptions form, and they will change a medication from "10MG 1 tablet by mouth everyday for cholesterol" to "20MG 1/2 tablet by mouth everyday for cholesterol". Same dose, different strength.
However, our pharmacy will see the new dose (20MG) and the original instructions (1 tablet). As you can see, this is twice the dose the provider intends.
I don't know if this is CPS and the HTML prescriptions form causing a translation error, Surescripts network, or Pioneer Rx. The fact that this doesn't happen often, and I can't replicate it makes things even harder. All the examples our pharmacy has found so far are months old, and Surescripts no longer has the XML files.
Any thoughts or ideas are appreciated. Is anyone else seeing this issue? I have a ticket in with GE, but they also need a recent example to investigate.
Thank you,
Daniel Carpenter
Posted : August 14, 2018 3:45 am
We are on the same version as you and have noticed big issues with all of our EPCS prescriptions. We deny every single request coming in with a reason of "refilled by other means" and then we re-build the prescription. If we don't do this, our prescription immediately fails. We have only done this with EPCS because we haven't seen the issues you are describing above although it doesn't mean that it isn't happening. Our fix on the failures isn't slated until CPS 18v2.
I know denying every single request seem crazy but perhaps that might be your only option to prevent this?
Posted : August 14, 2018 4:19 am
I'm on Centricity EMR 9.10.2 but utilize the Prescription form as well. I recently had a similar occurrence with a local pharmacy. In my example, the provider manages their own Rx Renewal tab and a refill request had come into the clinic. The provider had made a change to the med instruction and quantity as they wanted the patient to now take 1.5 tablets vs 1 tablet and so they adjusted the instruction to reflect this and the quantity was changed from 30 to 45. The provider made this change "utilizing the pencil". Everything looks appropriate on our end but the pharmacy received the appropriate updated instructions but not the updated quantity.
I too created a ticket but was informed the time had run out to send it to Surescripts for comment.
Plan: I also can't reproduce mainly because I'm not working off of an Rx refill request from this particular local pharmacy.
It is not ideal but to ensure the patient is getting their appropriate medication I have suggested to the clinic when making changes to the Rx to not make the changes from the Rx refill request from the pharmacy but to deny that request. Then create an encounter to access the prescription form, "update medications", locate the medication, click "change" to adjust the Rx and then send the Rx to the pharmacy electronically.
The idea is to avoid using the Rx refill request coming in from the pharmacy as it doesn't seem to be updating appropriately at the pharmacy end.
I can post an update if I should obtain another example and Surescripts is able to provide feedback.
Posted : August 14, 2018 6:11 am
Topic starter
Thank you for the responses. It is good to know that we are not the only ones with issues. If we can get any further info on our end, I will let you (and GE) know.
Thanks again,
Daniel Carpenter
Posted : August 15, 2018 6:34 am
