Home Forums Discussions Problems Issue with prescribing controlled medications

I want to get an opinion on the following message I sent to AC tech support. Any comments or advice is appreciated.

I am contacting you to inform you of an issue that I'm having with the e- prescribing system in amazing charts. I recently set up amazing charts to allow me to prescribe controlled substances through the New Crop interface. However, there is an issue with using this interface for the controlled substances.

When I prescribe from amazing charts, I usually can just hit the prescription writer and then enter the appropriate information and send the script to the pharmacy. However, when I want to prescribe a controlled substance, I have to go through the "manage via New Crop screens". This is where the problem comes up. In the patient's list of current medications, if there are medications that were entered by the technician that were prescribed by another practitioner, when I open the "manage via New Crop screens" tab, I get the following message:

Invalid refill or dispense #
AC cannot continue to e-prescribing until the following errors are fixed:
Rx dispense must be a number greater than zero and contained 10 digits or fewer.
Rx Sig may not be empty.

The problem is, when medications from another prescriber are entered into the medical record, there is a place to put the Sig., but there is no place to put in the number dispensed. So any medications that are entered into the medical record from another provider cannot be adjusted to allow the New Crop screen to open.

If all of the current medications listed in the patient's chart were medications that I personally prescribed, then it's not an issue because all of the pertinent information is available to the system. However medication entries from other providers lack the "dispensed number" and the only way to get the New Crop screen to load is to delete these medications from the medical record.

This appears to be a significant issue that requires some type of programming fix in order to allow entered medications to be appropriately recorded so the New Crop system will recognize them as being valid and will open up into the New Crop prescribing screen.

Unless I am missing something, there is no way to prescribe controlled substances with the system in its present state.

Please advise.

Ed
I get a different error message, which I sent to AC tech.

"Scheduled drugs, per DEA, may not be transmitted or faxed with your current account configuration.
Electronic Prescribing for Controlled Substances (EPCS) is now available nation-wide: contact your EHR for details.
To proceed, uncheck boxes to process scheduled drugs separately."

I'm still waiting for reply.
Did you try to instant chat with them?

You've nailed it. I've run into the same thing for different reasons. If I really need to manage a prescription through the NewCrop screens, then I use the prescription writer and put 1 in the dispense # field, and then just don't print or send the prescriptions anywhere. It's such a PTA that I'll never jump through the hoops to enable e-Rx of controlled substances.

NeuroDawg

If you practice in NY you will be forced to e prescribe everything including controlled substances in March of 2016. (this was postponed for 1 year already)

Dear Marc,

I didn't have time to instant chat, so I sent an e-mail. When I get a response, I will post it here.

When I first heard you could e-scribe controlled substances I was elated. I thought it would be the best thing since sliced bread (carbs are evil you know). Alas, I was wrong. What a PITA!!!! I paid $240 or so for a useless deal. I want my money back. It is impossible to use, cumbersome, etc. I downloaded the Verizon thingamajig and I have no idea what to do with it. I have patients that come in with 30 meds and I am supposed to put in all those meds so i can prescribe Lortab! What a croc of you know what. This e-scribing stuff is worthless. I'm done with it.

Ed
AC tech answered my e-mail with a phone call and succeeded in activating epcs for us.
I've been in touch, at various times, with Michael Garside, and Jerreth (epcs specialist) via email, chat and phone. Long arduous process, but done, with appropriate thanks to them, and their endless patience.

Gerardo
We don't, in our peds practice, have many controlled substances or frequent requests for them.
However, I couldn't agree more about the PIA ("the" deleted).
Two level verification means that we first have to enter verizon password, then get text or phone 6 digit key and enter that. All this after running istop inquiry with NYS. We'll likely stick to writing rather than eprescribing for as long as possible.

The pols who wrote these requirements into law should send their staff to our offices to handle all of the nonsense. On second thought, don't want them in OUR office!

I thought so when this all started, and it is coming to pass.
I am trying hard to unwind all my scheduled drugs like banks are trying to unwind derivatives.
I practiced in the '70's when you couldn't give a little old lady a Tylenol#3 at bedtime for arthritis. We can go back. Gin was good then, and will work now.

Tom
I can foresee the day when gin is regulated as a controlled substance, dispensed in carefully measured amounts. Give pols an inch and they'll confiscate all of my good bourbon.

Okay folks... I heard from AC tech support and here is their response and mine:

From: Eric Fusco
Sent: Thursday, May 21, 2015 11:25 AM
To: eadavison@verizon.net
Cc: Jerreth Cerina
Subject: EPCS

Good Morning,

I have read over what you have sent us. The dispense numbers all need to have a value and the sig needs to be there. So if you are entering from the current medications screen it will give you the option for a sig but you will need to go to the write scripts screen and find the medication and then add a value and click prescribe. Please do not click transmit. This process will change the dispense number to allow you to access that screen. I have included one of my tier 2 techs in on this email and we went through the process and this is the only way to access that screen. If you have any other questions please feel free to email us.

Dear Mr. Fusco,

That solution is not acceptable. I have elderly patients who come in with 15 to 20 medications from another prescriber which have to be entered into the chart. Neither my staff nor I have the time to go through the whole list and pretend to prescribe them, just so the dispense field has a value in it. That value should be entered when the medication is recorded in the med entry section of the chart. This MUST be addressed with the development team and fixed with a formal update, because the workaround that you are describing is ludicrous.

Ed Davison

From: Jerreth Cerina
Sent: Thursday, May 21, 2015 1:48 PM
To: Eric Fusco ; eadavison@verizon.net
Subject: RE: EPCS

We have already entered this issue as a critical Bug. In a future release this will get fixed unfortunately for now in order to get to the Newcrop screens you will need a Dispense #.

Thank you

Dear Mr. Cerina,

Thank you. As long as this is being formally addressed, we will try to deal with it as best we can.

Dr. Davison

Critical Bug?!? It's been present for as long as I can remember. If it takes this long for a critical bug to be fixed, what are the coders doing, adding functions that know one wants or needs (like silly start/end dates for smoking history)?

Another option is to DELETE all the meds, prescribe what you want, then add again.

Update on this older thread....

The problem with EPCS continues to exist. Although when receiving electronic refill requests for controlled drugs from a pharmacy, there is no need to update sigs and dispense/refill quantities, it remains impossible to get to the Newcrop screen under all other circumstances when sigs, disp numbers, and refills are not updated.

I have spoken with Newcrop personally, and demonstrated the problem via web session, and it clearly is a bug/block on AC's end. Has anyone from AC been put "on the case" to resolve this issue? It is simply impossible to go through someone's med list with 5 or 6 meds that have to be re-prescribed in order to make sure they have the proper sig/dispense#/quantity in order to generate ONE controlled substance electronically.