The chronicity is basically like this:
Used to be we had to hand write them on tamper proof paper, which as you can imagine writing for two or three different strengths three times was not only laborious (9 scripts) but bound to cause more errors. Then write Do not fill before: Stupid thing about that system was how many times did we/I leave the pad around for anyone to grab.
Then we started printing either to 8 1/2 by 11 -- we went right to the Star Micronics print out three at a time. You would write Do not fill before. So, we just got two stamps that said Do not fill before June 1 and the other said Do not fill before July 1 which was technically correct so it worked. Just changed June to August the following month. This was bad because patients constantly lost scripts, sold scripts, went to different pharmacies, etc. BUT, at least now if they went in to get a prescription and Wal-try didn't have them, they could hand carry the script to another pharmacy. Now, we have to EPCS it again.
For me, EPCS was better because we just had better documentation and you could go into NewCrop and hit one button without the PIN and send up to 9 scripts I believe. All set up by the nurse.
Then NewCrap and I have no idea why the developers freaked out and couldn't understand logic, wouldn't allow you to send more than one of the same strength script. So, no matter what you typed on it, you can only send one of each. So, you can send 7 scripts at a time, but they would have to be Adderall XR 10 and Adderall 5 and Ritalin 20, etc. Which made no fuc.... sense. I was on the advisory board for NewCrop and my contact had to break the news to me. She tried to tell them. There is no difference diversion wise from sending
Concerta 36 fill by
Concerta 36 fill by
Concerta 36 fill by
Click send versus
Concerta 36 fill by
Click send
Concerta 36 fill by
Click send
etc.
In both cases they all made it to the same pharmacy basically at the same time.
Now in version 11.2 and up, you can EPCS from within AC and I believe you can send them in batches with the fill by thing either done automatically or manually -- don't use it myself. Most EMRs will send them in batches and do the auto thing.
But, one EMR for sure will then record all three in the patients med list.
I am lucky because when I went to my pharmacy (and EPCS was all anyone was talking about in Maine -- before Trump and Covid), my pharmacist said put the onus on the pharmacy and write 1 of 3, 2 of 3 and 3 of 3. That works for ALL our phamacies except Hannaford as they will only take on month at a time.
Here is what is stupid and it is why September has Physician Suicide Awareness Day in it.
Opioids: Can only do one script per month and generally do three months before a medication check (so three months of scripts)
Benzos: Can do 5 refills if done by six months (good luck with that), but mostly we do 2 and do a med check so three months. EASY
ADHD: Can't write refills but can send three scripts.
THIS IS FUC....... STUPID!!!!!!! This entire headache and bullshit would be gone if they allowed a refill number on the damned script. What is the damned difference.
And, like every other drug, if the pharmacy only has 10 pills, they should simply document they owe the patient 20 and not make us send another script.
But, the farmacist can see that it has been 28 days or 30 days and should be able to figure out if it is too soon to fill without our writing Do not fill by, etc. etc.
"Anywhere I wrote Fill by, in general, I mean Do not fill before."
Last edited by Bert; 07/14/2023 7:11 PM.
