Home Forums Discussions Problems Prescribing problems

So my NP found a workaround if the Authy app doesn't popup when you use EPCS. Go to your Authy app on your phone, press the bell icon, opens a new screen of Pending, Accepted, Denied and the request to authorize will show up that way. Sometimes clicking there works. Another workaround is to select the Authy app radio button after you give it your 4 digit PIN. Sheesh.

I remember when the PIN wasn't there. But that is a brilliant workaround.

A friend is using another EMR that unfortunately uses NewCrap and she has the same issues. One friend uses one with DrFirst and has few issues.

Ozempic came out with a new pen size,
3ml instead of 1.5ml
NO WHERE TO BE FOUND IN AC, this was announced at the 1st of the year, rolled out in March and now causing issues, this is the sort of thing that is frustrating, I know AC does not do the prescriptions, it is surescripts, but would think they would be better about the new meds coming to market

Heard from one of the local reps last night about the new Ozempic Pen size and Amazing Charts is the last of the EMR's to add in the 3ml pen for prescribing. She has a list of about 20 EMR's all showinf the change in February or March but Amazing Carts shows to be an automatic update between 4/30 and 5/30! Why is Amazing Charts that far behind???????

Just got off of chat with tech support. Started getting an error, "unhandled exception" pop up box. Marc from tech logged in and took off the user preference for "participate in patient copay assistance and education program". This seems to have fixed the issue. My question is why did htis just start yesterday? Started first on one machine and now on this one? I did not get a clear answer. "I've been aware of that glitch since I started with AC tech support. Not sure when it began" was the response. I am not faulting him but still wonder why all of a sudden the program would glitch.

Probably due to a Microsoft update. Go back a few updates and remove them and see if the problem resolves. But other than that, it's a computer. The glitch has to start some time. Between updates on the machine, updates on Windows, not the greatest code in the world, these things are bound to happen.

Agree, 2nd Tuesday of month (June 13) is Microsoft update day. I start getting pdf printing problems after they are downloaded and prepped. Then fingers crossed after updates applied.

You can delay these at least 1-2 weeks in Server group policy. Let someone else "discover" the worst bugs.

Had this one today: "A technical error has been automatically reported to your EMR/PM vendor. Contact them for more information. MSG 3 - RxInput XML parse error:
Please check the specified element name and value below for unusual characters and leading or trailing spaces.
Unexpected end of file has occurred. The following elements are not closed: dosageLong, OutsidePrescription, NCScript. Line 428, position 73."

This error messaged locked up the EPCS system and would not allow me to refill a controlled substance. The offending medication was not the controlled substance I was trying to refill! the offending medication turned out to be the pt's thyroid medication. The last electronic refill from the pharmacy came in with the instructions changed from 0.5 tablet to 1/2 tablet. Apparently the " / " caused the whole system to bug out. I am not sure why the electronic refill request changed the directions I had in the chart to begin with. I had to get AC Tech to help me figure out the problem and when I mentioned this change all I got back was "Have a good evening." Thankful for the help but wish we could get these bugs fixed!

Hi Chris,

I can't explain all of your error messages. And, I could be way off as I tend to not understand the electronic requests either. But, maybe, only maybe you are not understanding how it works.

When the pharmacist asks for the refill, they want to not only have you let them know it is OK, but that your prescription matches in name and directions even if they are different. What the pharmacist will ask you for will ALWAYS be what they have changed your prescription instructions to be.

So, if you wrote Augmentin 250 mg, 1 po bid for 10 days, They are automatically going to ask you to approve what they changed that to. A pharmacist is never going to write Augmentin 1 po bid for 10 days -- they are going to change that to:

amoxicillin-clavulanate 250 mg tablets, TAKE one tablet by mouth twice daily times 10 days.

Unless you specified Brand name only, they changed it to the generic and when you go to match them up, it will accept your script again, but it is the same. If you wanted them to write Augmentin even if they are going to change to a generic, you will have to write "please list as Augmentin in the script."

I am guessing, although I haven't looked that no pharmacy writes 0.5 mg (because one-half of America doesn't know what 0.5 is). We write 0.5 because we have been taught to start with a leading zero to let other doctors and health care providers know it is one-half. But, likely, all pharmacies' computers or a self-typed sig is going to change 0.5 to 1/2 for that other half of America who understand 1/2. They certainly are not going to keep po in your script. All of the red is going to indicate that the pharmacist changed what you wrote but they still want to know if you want to refill this medication even though we wrote it differently.

So HTH and IAPW (I am probably wrong).

One interesting thing that can cause one to go crazy is when Walgreens changes your script from amoxicillin 400 mg/5mL, 1 tsp po bid for 10 days to:

Please give JOHNNY 1 tsp of amoxicillin twice daily times 10 days. If they write it this way and it ends up in AC, the NewCrop window will NOT open no matter how many times you try. It is because they wrote "give Johnny." So, you have to rewrite it so JOHNNY isn't in there.

When I do medication reconciliation, AC prints out the med list for the patient to review. Invariably I am asked about our antique abbreviations, "what does q mean, bid, tid, hs?" So it really makes sense for the "royal we" to forget how we used to hand write Rx'es and use quick abbreviations and put them into plain English since the pharmacy will change it anyway. I wonder if I'd have to double-click on pharmacy refill requests to match the med if we both spoke English?

Not a bad idea.

Over the years I have changed to write more descriptive prescriptions. I include what the medication should be taken for if it is a ling term medication, 1 tablet by mouth for diabetes. This way the patient knows better why they are taking a certain medication. I try to reconcile the med list with the other providers. I like to print a med list for pts but this is a little time consuming in AC. My problem is that the refill request from the pharmacy, when matched, change my directions from 0.5 tablet to 1/2 tablet which is not allowed with the EPCS. Just like his problem of the pharmacy adding Johnny in the prescription but AV rejected it and he has to go in and correct. I don't think that that the directions should be changed in AC even if matched to the pharmacy.

Agreed. Weird thing is you don't get an error message for having the name in the sig. We get that with Walgreens. Says it is safer for the parent and it is. And, it's not Walgreen's fault. It is NewCrop's. And, it won't even open up. But that is still not my #1 complaint. And, it isn't even a complaint. Not a bug. Just would make things better and I wouldn't get two calls a week with patients' asking why their med isn't at the pharmacy.

I know a lot of people wouldn't show up, but I think it would be a great idea (well in a smaller area like Bangor) to have a pharmacists-doctor breakfast and talk together. There are just a lot of things they don't know about our prescribing and a million things we don't know from their perspective.

If I were president, second thing I would do would be to make all pharmacy audexes the same.

I have breakfast, lunch and dinner with a local pharmacist as often as possible, but she is my wife. She has been a pharmacist for a long time but not on the retail side, she is hospital based. I tell her stories of the retail side and she just listens.......

That is quite awesome. Who makes more money?

The hospital.
Always the hospital.

The wife! Has been with the same hospital for 30 years. You are correct JBS, that is why so many sell the practice.

Noticed a new problem recently.

I will prescribe a medication and then go back to the chart and the medication is not documented. It looks like I never prescribed anything. Has anyone else seen this issue?

No issue with prescribing except the shortage of pediatric antibiotics.

Seems like a shortage of lots of stuff! We are having a hard time with ADD medications. I noticed this problem of missing scripts a while back but didn't post, thought it was something I was doing but nope happened this morning. I thought someone else was having this problem as well. I emailed AC about beta testing 11.4 but have not heard anything. I am cautiously optimistic it will solve some of the mysterious prescribing problems I have.

I think I found the way to avoid the refill request changing my sig:
"match" each refill med via right click even if it is auto-matched.

Nope, it will still change it at times, or at least that has been my experience.

When prescribing I noticed recently the DRUG INFORMATION drop downs no longer work very well. The PDR Search takes you to a generic home page instead of the med you want to look up, as does the epocrates and Additional Drug Info links. The Merck Manual Profession link just doesn't seem to work at all.

Chris, have you thought that ePrescribe just hates you?

Bert, I feel that way every day!

Am I the only one that used the drop down for the PDR and it worked great until recently?

I think you just need to have AC on your laptop, go to a nice restaurant and have a talk with him/her. Obviously, your script writer just doesn't like you. But, he/she does help with your being top poster of the month. As long as I can remember to reply, lol.

I replied a lot this morning but need this one to make me top for the month so here you go Bert.

My wife says she likes me but we still argue so maybe it is the same for AC?