My experience is that of Jim and David. While the patients may have unrealistic expectations, I think that they can A) expect the script to be there within 15 minutes or less and B) expect the script.
This is neither the fault of the pharmacy or the practitioner. This is the fault of eRx and its not being thought out properly. When we handed out paper scripts printed from the EMR (especially when I was allowed to give them to Medicaid patients -- another ridiculous piece of government bureaucracy), the patient's expectation was 0 seconds when they get to the pharmacy. Faxes made it in under 10 minutes almost every time (albeit they had a higher failure rate).
While it is true that virtually 100% of my eRx arrive at the pharmacy (if I hit the send button like Steven), what good is it if they vary in time from five minutes to overnight? Yes, overnight.
If you were a patient and drove 15 minutes with two sick kids to the pharmacy even if you believe the pharmacies who tells you it was likely sent but hadn't arrived, "what would your expectation be?" If they were told it WOULD DEFINITELY be one hour, and it was one hour, I think expectations come into play.
There are basically four ways a script makes it to the pharmacy:
1. Paper delivered by patient
2. Called in by the office
3. eRx
4. Fax
In the first two, the patient is told I got your script you just handed me or I got the phone call from your office (yes some times they didn't check their answering machine), but in both scenarios, the patient is told we will have your script ready in a few minutes or maybe even 20 minutes. If the patient expects it sooner than that, I think they are being unreasonable.
However, on the other two, what is the patient supposed to EXPECT. If the pharmacist tells them "If it has been eRx, it hasn't made it, but it will be here some time between now and who knows. So, the patient just stands there watch five other people get their meds ahead of them. Same with fax.
I pretty much love ePrescribe. And, I use it almost exclusively. But, a month ago, I thought it was really cool to say as I did it, "And your script is......AT your pharmacy). Now, I tell them it could be up to 20 minutes.
The problem is, unlike eMail, it does not go straight to the pharmacy. In fact, I ePrescribed a script last night at 8:40 PM. Given they close at 9 pm and the medicine was mission critical (Nystatin for thrush, lol), I called. The pharmacist was my next door neighbor. He told me it would probably be over an hour as it has to go to Bum.....Egypt. This is true. It's up to Surescripts and down to Allscripts up in the cloud.
Ironically as I think I posted before, Indy's idea is a good idea. But, I can't do a two step process. If it is going to be this slow, there should be a one line email that goes to the pharmacy stating a drug and practice has just been sent. I wouldn't want to get into any patient data if it weren't HIPAA compliant, but if I sent a Z-pack on Bill Smith at 6:00 pm, my guess is they figure out that the Z-pack send from my office at 6 pm was probably intended for Bill Smith when he arrives.
