Hi!
Our admins/MA's start refill requests in CPS 12.2 and route them to the MD's. In most cases, they attach the refill form to whatever document they're already in - usually a phone note.
We've found that unchecking "Rx Refill - Sign" works to prevent them from accidentally signing a prescription refill if the form is opened by itself, but NOT if they're filling it out as part of another note.
Taking away their right to sign in general would prevent the accidental signature, but they don't always have refills attached and it would drive our MD's nuts to have to sign off on a bunch of stuff they don't have to deal with now. We also tried explicitly denying the right to sign clinical list updates, but that didn't work either.
Anyone have any tips for ways that we could prevent users from signing a note that has a refill request form in it, but still allow them to sign if it doesn't?
Thanks a bunch!
From a Security standpoint, I think you are stuck. We have had to resolve this with workflow changes, and training.
- If the patient calls in, and is requesting a refill, then our staff starts the Rx Refill note from the patient's chart. Only the provider can sign.
- If the phone note (or other type) is already started, and a refill needs to be processed, the MA does not Queue up the medication. They only fill out in the phone note or comment section what is being requested and the provider will do the refill process based on that info.
The biggest key to avoiding an MA from signing an Rx is to make sure that the box for "Sign clinical list changes" is checked. That way, when a provider routes the note back to an MA or Nurse, the Rx is signed before another user can have the chance to open it.
If anyone has a better plan, I am game to hear it, but this was our best solution for the problem you shared. Let me know if you have any 1uestions. 🙂
Document types are where signing privileges applied. There are no permissions that apply to forms. A user can attach a rx refill form to any document type. If they have signing privileges for that document type, they can sign it.
That said, you should certainly limit users/groups (we predominately use active directory security groups to manage privileges) to signing appropriate document types, among the rest of the permissions.
I'm guessing at your workflow, but perhaps adjusting the workflow slightly to change the document type to rx refill (a bit of a nuisance), or just click on the rx refill button to start a new update would work better. The phone note could be signed/completed and the rx refill may be the next step of the process.
-dp
Thank you both - that's what I was thinking, but I'm ever hopeful that there's a magic trick to prevent a work flow change.