As a former employee of a mail-order pharmacy, I do not see the co-relation of direct clinical patient care to mail-order and e-pharmacies. My specific duties in this position included obtaining proper documentation from the patient’s providers as all insurances require patients to have direct clinical patient care before covering a prescription and most physicians will not give prescriptions without direct clinical patient care. The types of documentation obtained included, but was not limited to: patient vitals, lab results, office notes, nurse visits, physician’s orders, letters of recommendation explaining why the patient needed a specific treatment, and in some cases, a full list of previous treatments attempted along with their results.
3. Medication errors, handoff process and information quality. Chiru, Alina M; Baxter, Ryan. Business Process Management Journal 19.2, (2003): 2011-2016
Whether you love it, hate it, support it, or detest it The Affordable Care Act as it stands, has been making waves across both news headlines and the medical community alike. For the most part, the focus of the act has been placed on the impact it will have on the consumer or the patient. However, the pharmaceutical division of the medical community is among the groups that are most impacted by the Affordable Care Act. In particular, retail pharmacies are feeling the effects of the act via the reimbursements and provisions surrounding the reimbursement policies that have been altered with the passing of the Affordable Care Act. Reimbursements and the provisions implemented upon retail pharmacies by the Affordable Care Act could prove to be detrimental towards the success and profits gained by private retail pharmacies.
Erica Lindsay, PharmD, MBA, JD, is a health care attorney practicing in the greater Chicagoland area. She has worked in pharmacy management and compliance for more than 15 years. Dr. Lindsay consults clients through complex pharmacy regulations and guidelines, including 340B, Medicare and Medicaid billing, and HIPAA compliance. She is on faculty of PharmCon providing instruction on pharmacy legal and regulatory issues. Dr. Lindsay is active in various organizations including the American Bar Association where she is Vice of the Nursing and Allied Healthcare Professionals Task Force and members of the Health Care Compliance Association, Cook County Bar Association, and the Chicago Bar Association. She is a graduate of Florida A&M University
Non care setting - Medications are often stored and administered in a variety of non-health care settings. These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following: Acquisition of medications (e.g., from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients
When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed
The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.
Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,
Adoption of EHR can derive a great amount of benefits in clinical outcomes such as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such as patient safety, effectiveness, and efficiency. Patient safety is defined as ‘avoiding injuries to patients from the care that is intended to help them’(Menachemi and Collum, 2011, p. 49). Often times, lack of time can contribute to omission of asking patients important questions such as drug allergy information and confirming important patient identifiers such as addresses/phone numbers. Improvement of medication error is a well-noted benefit of EHR as seen in numerous researches. According to a study, researchers found that a CPOE system was contributory in reducing serious medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported similar findings in patient safety improvement. When e-prescribing is used, prescriptions can be checked for any drug interactions with
Computerized Physician Order Entry (CPOE) is a complex technology mandated by Centers for Medicare Services (CMS) in Meaningful Use criteria for adoption by healthcare providers (Self & Coffin, 2016). CPOE is technology for reduction in medication errors through implementation of standardization of processes to support legibility and reduction in the number of people required to participate in the order workflow, thus decreased delays and errors result due to miscommunication (Hoonakker et al., 2013). Although CPOE highlights improvement in quality and safety, healthcare organizations have expressed difficulty in the implementation due to physician resistance (Hoonakker et al, 2013). This resistance not only contributes to patient safety
One of many administration burdens to physicians and medical office staff is the nees to respond to prescription refill requests. E-Prescribing gives providers acess to review, authorize and transmit several refill authorizations in a matter of seconds. In case of emergency a refill can be quickly done to aid a patient that is traveling and out of
Additionally, the facility should have a system in place that alerts the staff regarding high dosages. One way to alert the pharmacist would be via a computerized system that monitors the dispensing of all medications. The system should contain an up to date database for referencing medications. Also, the computerized system should have parameters set for alerting pharmacy and nursing staff for all high dosages. When taking cost into consideration, the facility might not have the feasibility to implement an entire computerized dispensing system that provides dosage alerts and cross check off of medications. To maintain patient safety with limited funds, the facility should have remote access to a pediatric pharmacy where all pediatric medications can be cross-checked and verified. If the facility was unable to have a pediatric pharmacist on staff, the remote access would provide a safety net for pediatric medication dispensing. In addition to the pharmacy staff having access to a computerized system, the physician should as well. Had the physician had computer access and been required to enter medication orders, the tenfold error could have been noted and not reached baby Miguel.
Finding the right pharmacist can be a long and arduous process. That’s why so many people have begun to fill prescriptions through the mail. Mail order prescriptions are an excellent option for those in need of medicine from a pharmacist on a regular basis. At Purdy Cost Less Prescriptions, based in Gig Harbor, Washington, they fulfill mail order prescriptions daily. If you’re considering a new pharmacist to fill prescriptions, here are three reasons to choose a company that offers mail order prescriptions:
After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread
Set-up and workflow of my pharmacy is pretty good for patient centered care. Patient does not have to wait too long for their prescriptions to be filled. Patients can call for their refills via telephone or online, which makes their life easy as they don’t have bother coming in-person for refills. Patient profile shows all medication history as well as number of refills remaining. This makes it easy for pharmacist to know whether to refill a prescription or call doctor for refill request. After confirming to fill a prescription pharmacist runs claim through insurance and print label after claim is successful. All medication is arranged alphabetically on shelves, thus it is easy and quick to retrieve. Then after technician fills medication and then pharmacist checks it. This workflow is quite smooth and quick to process. Final check is done by pharmacist, who confirms right medication for right patient as well as the NDC dispensed, amount dispensed, direction for use, and day supply. All these steps of process take place on working table in sequential order, which helps to reduce errors in filling and have effective prescription filling. Once the prescription is filled pharmacist do all paper