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For those of you using ECPS, I have a question. I just started this and it appears that the Rx is not showing up in history unless I send the prescription twice. Have any of you noted that?
Thanks

That's EPCS
Electronic Prescriptions of Controlled substances
Thanks

It seems hit or miss, I check to see if it is "captured" and if not I click on the med to keep it as part of the record, painful but not sure of any other way to keep track of it any easier.

I haven't, but I wouldn't send it twice. At least it records it at the bottom of the NewCrop page if you click on the magnifying glass next to the medication in current meds.

I just signed up for EPCS and have tried several times to write an rx--without success. Is it just me or is this system for EPCS overly complicated and poorly designed?

Hi John,

Yes….and no. There is a definite learning curve, after using it a few weeks it will be much easier.

A few of the things I have noticed:

Initially I go through Amazing Charts and create the prescription, go to the final screen where you would normally print the prescription, and just exit out of that. This saves it to Amazing Charts. Without doing this, you may be able to send the prescription, out without a record of it in AC.

Make sure that the desired pharmacy is listed in the Amazing Charts list. And, no more than 5 pharmacies, or else it will not work.

Once you send the prescription through New Crop, you only have a very short period of time, I am guessing around 10 seconds, to authorize it. If the system is slow, or if you are slow, then just send through New Crop again.

Again, after a few weeks it will be much more intuitive.

Hope this helps!

Happy new year

Gene

Thanks Gene. I had never written an rx directly in NewCrop and their screens are way too busy. I'm sure you're right, in a few weeks I'll learn to separate the wheat from the chaff. Today I've done a few more and it's already going better.

I have used EPCS for a while, had no issues, but it is a cumbersome process that should be easier.This is obviously not an AC issue. I have saved a few prescriptions in NewCrop which makes it faster, plus the new authentication app in my iphone is pretty fast and reliable.

Just found the orientation videos in the NewCrop admin section--very helpful!

It is pretty irritating that sometimes the prescription in New Crops menus is added to the medication list in AC and sometimes not. That should be a priority fix. Also the prescription history in AC is just not reliable for this reason. The prescription history from the pharmacy benefit managers is nice but it doesn't have an interface to reconcile with the AC med list. The reconciliation screen from the Patient Health Information screen is nice for allergies, problem lists and medications, but the other essential information in the PHI is ignored (labs, procedure notes, radiology results, etc.). It's like everything is half developed, nothing is checked for errors or usefulness. Why?

Hi Kevin,

There are a number of issues with eRx and NewCrop. With eRx, I have suggested making the two places to inactivate different. The actual button below the list works and right-clicking works, but both bring up the Reason for Inactivation window. Most of the time I don't add a reason, i.e. Zithromax.

I wish the transcription record in the plan would say the pharmacy. I also think the transaction record could be much better.

In Oregon we still have an option to prescribe controlled substances with written prescriptions.
This works out much better for me.

Of course, I am trying to completely eliminate controlled substances from my practice. I'm sure that will never happen, but now that pain is no longer the 5th Vital Sign, I don't have to beat myself up about being a bad doctor if I can't guarantee that every patient's life can be completely pain free.

I still don't know what to do with "adult ADHD" but I have a few patients who really have functioned much better long term with relatively low-dose Adderall, and never abuse it. Not many, but enough to make me wary of absolute rules about anything

Hi Tom,

Just interested in why paper scripts work better for you? Just wondering.

Also, I was going to start a new thread, but I guess I can put it here. I had no idea that NewCrop had AI. If you put the word generic or brand in the pharmacy message, it will read that and not allow you to send it. It will tell you that you have to put it in the DAW box. Sometimes, it isn't about indicating that. Like today, it was simply Medicaid requires the brand name for Concerta and not the generic. But, the patient has MC and private. Let me know if you need me to write for the generic.

Now, I have to use the word "bran_" and "generi" It's not smart enough to figure those out. Of course, then the pharmacist thinks you can't spell. Maybe I should write geNERi.You know so it doesn't get confused with generality or generals.

HaHa.
But the laugh is on us.
We spend the time and effort.
They pick up the chips.

The thing about paper scripts is it forces the patient to be part of the transaction.
They have to come in to the office to get a piece of paper.
They have to safeguard it -- I won't rewrite it if they "lose" it.
If the pharmacy doesn't have or won't fill the prescription, they can take it somewhere else.
It doesn't cost me anything for additional software and the headaches involved in that.
It doesn't frustrate me waiting for the program to execute and the various identity checks to occur.
It doesn't fail when the internet goes down.

The thing about paper scripts is it forces the patient to be part of the transaction.
They have to come in to the office to get a piece of paper.

They have to come in every three months for a one-minute med check for $75

They have to safeguard it -- I won't rewrite it if they "lose" it.

They can't lose EPCS scripts. All three are there. And, I can't rewrite it, because the pharmacy has them on file.

If the pharmacy doesn't have or won't fill the prescription, they can take it somewhere else.

Yes, sometimes we do have to send it to another pharmacy. But, they can't go to this pharmacy this time and a different one next time without our knowledge.

It doesn't cost me anything for additional software and the headaches involved in that.

You already have AC. You must have eRx? So, clicking on NewCrop isn't that hard. No headaches here.

It doesn't frustrate me waiting for the program to execute and the various identity checks to occur.

Send the script. Then click on Approve on your phone. If you want, you can see that all scripts were sent to pharmacy A and were verified successful at pharmacy A.

It doesn't fail when the internet goes down.

When the Internet is down we are allowed to use paper and write Internet down. Then we print to tamper-proof paper on the Star printer. Three sent. Three more. In seconds.

Advantages:

Complete "paper" trail.
Patients can't lose script, say dog ate script, flush it down the toilet, give it to someone else, change it, etc.
MAs usually don't fill out your paper scripts. But, they do set up all controlled scripts, so it is just click, click and tap approve.
I think the big difference is I think you are talking about a script for oxycodone. One script. Or a script maybe for Ativan.
But out med checks are usually three, six or nine scripts.

Concerta 54 mg ER
Concerta 54 mg ER
Concerta 54 mg ER
methylphenidate IR 10 mg in afternoon
methylphenidate IR 10 mg in afternoon
methylphenidate IR 10 mg in afternoon

And, sometimes a 5 mg at noon so three more.

So, that patient would require me to write nine separate scripts (unless you are printing them to paper -- then maybe not as big an advantage)

But, it is nice to have the nurse set up those six as pending. And, send all three or six or nine in one click. Pharmacy puts 1 of 3, 2 of 3 and 3 of 3 on file.

Three months. Med check. One minute. $75 Rinse and repeat.

I guess just different styles. eRx was the greatest thing to happen. And, EPCS was the second. And, pretty cool to send Adderall XR to Pennsylvania where the patient is at college.

I think one of the best features of EPCS is being able to write a script when away from the office, such as vacation. I use to always hate having the doc on call write scheduled med scripts for me while I was away on vacation, which I tried to plan and avoid but it would seem to always occur.

That's a good point. When I would have Wednesdays off (no more) my FNP wouldn't touch the controlled substances. I just did them from home.

@Tom

Sorry, I was just giving the other side. I had asked you for your reasoning. I didn't mean to come across as then debating you.

To avoid entering it twice, I first prescribe using the regular script writer, this is much easier to navigate than the newcrop screens anyway. Then after hitting "prescribe" I then hit the close button on the send screen (if one hits send, you just get an error saying that Controlled scripts cannot be sent electronically). I then go back to the script writer, open the "manage via newcrop" option and send the script through the newcrop screens. Seems to work best for me.

Aaron Way, D.O.

I do exactly the same as Aaron. Once you get into the routine it is not too bad.

Gene

@ Burt: No offense.
I know all the rationales advanced for using electronic prescribing, and I use it -- mostly.

I prescribe lots of controlled substances -- I have a lot of elderly patients with intractable pain, cancer, as well as kids (and adults) with ADHD. For all of the reasons that you obviously know, I want to see people regularly if they are using those drugs. It's too easy for them to go astray.

I buy tamper resistant paper in 8x11 sheets that are scored into quarters and feed them into a standard laser printer
I set up the printer driver so it prints the prescriptions one-quarter size, and so I send people home with normal-sized prescriptions instead of notebook pages. I don't have a STAR printer.

Repetitive prescriptions come out of the prescription writing software (like those situations where you can write for 3 months at a time) -- just use the old one and change the date.

I could certainly figure out how to use EPCS, but I will quit before complying with another "mandate" to use anything. Besides, I don't see why we have to pay to write prescriptions