The Pharmacy Chick

Flying the coup in retail

What I would like to see in my pharmacy: my technology wish list.

Filed under: Uncategorized — pharmacychick at 7:16 pm on Wednesday, September 28, 2011

Technology is an amazing thing.  We can so many things today that even 5 years ago seemed an impossiblity.  And was WE can do with a cell phone in the US pales in comparison to what is being done with cell phone in Europe.  You can use your phone as your wallet, your computer, your phone, and your store.  You can send a message to a vending machine and purchase something from it.  You can “scan” s bunch of squiggly black dots on a page and get more information on a subject than you can shake a stick at.  I have a smart phone and I only use a small percentage of its capabilities.

In the pharmacy, we still do a lot of things the “old fashioned way”, not because I choose to do so, but because the company hasn’t invested in cutting edge technology.  I am sure that technology is expensive, and for a company who is all about cost cutting at the moment, the idea of investing cutting edge technology is abhorrent to them. While we do not type on a typewriter or hand price drugs anymore, we certainly aren’t using our imagination to make the business of pharmacy more 21st century. I only work for PC Pharmacy so I cannot speak for what technologies exist or dont yet, but here are some of the things I would like to be able to do .

1.  Automatic refills should REALLY be automatic.  when I come to work on any given morning, the computer should just have automatic refills done.  Why should I just have to hit enter, enter, enter, enter…print?  I would like to come to work with a stack of labels printed and ready for filling after some pre-determined  ( like 3 am) start time for the days auto-fills.

2. Online profiles:  I am sure this is already being done, but we dont have it. I would like to see the consumer order and check the status of their refills by computer or some smart phone app. I would like to see a customer see and print their refill history, see and print their tax reports, order prescriptions, enroll or cancel autofills, etc.

3. Rx tracking. we already have a workflow program. I would enhance that by enabling a real time notification process.  As soon as the script has been fully  completed, a quick scan by a device would launch a txt to an enabled device ” a prescription for you has been completed and is ready for pickup. Rx must be picked up by xx/xx/xx or will be returned to stock”.

4. Automatic payments:  I would like to see our computer credit card enabled so that a prescription that is filled is also CHARGED. I would bet the customer would be less inclined to ignore our phone calls or txt notifications if they had already paid for the prescriptions.  I would also like to see a restocking fee charged to the cards.  If we return a prescription to stock, only 90% of the price shall be refunded, and once its returned another message would be sent out ” A prescription has been returned to stock, your credit card has been returned $x.xx minus a 10% restocking fee”

5. A better process to determine what is new or what is refill.  Everytime we get an escript, it is called a “new” one, despite that is , in fact, just a refill authorization sent electronically.  I would like to see an option to choose “refill” . Just because it gets a new number doesn’t make it “NEW”, but because its “new” I get dragged over for a counsel over and over on what is truly a REFILL.

6. I would like to ELIMINATE having to document if its written, phone in, or fax, or electronic.  WTF moron thought this  up?  Its just another way to hose a pharmacy in a predatory audit, and who friggin cares?

7. I’d like to see E refills simplified. When I send an e-refill , I want to bring up the number and hit SEND.  currently I have to run thru about 6 key strokes and 6 windows before I can send my request.

8. E scripts should go into a batch file so I can pull them as I want to NOT as a frickin irritating pop up every time I clear a screen!!  Do I really need to be asked ” 1 E-script in queue, process Y or N?”  every time I clear a screen? NO.  put an icon on the bottom tray that indicates I have a script and let ME handle it. 

9.  I would like the refill history to print on every refill request I send to the doc, not just the LAST one.  I dont have that on my computer and it would come in handy, especially on controlled substances.

10. I would like responses from  insurance companies transmits to be in easy to read format instead of some weird company code.  If Joe McCrack has filled 5 narcotic scripts in the last 30 days, show me what he had not ” Multiple controlled rx…..30/90-45 DE88…WTF? How can I do a proper DUR if I can’t understand the messages?

11. MedGuides should print as part of the epistles of patient info that comes out with my label.  Nobody can be as sick as I am of trying to find and keep up with every med guide.  the MG has become the proverbial Manufacturer COP OUT.  ” whups we f’d up!  lets make a med guide to tell people our drug may make their skin turn green, hair fall out and teeth turn black! and make the pharmacist do our dirty work FOR us! They can take the blame for all these side effects if the customer gets sick”

What other techy touches would you like to see happen in YOUR pharmacy!  Speak!


Comment by Anonymous RPh

September 28, 2011 @ 8:38 pm

The chain I work for already has a lot of these things already in place. 1, 2, 3, 4, and 6 are covered either somewhat or completely.

The main thing I’d want to mention is that you probably *don’t* want credit cards being auto-charged as prescriptions are filled. That used to be protocol when that technology was first unveiled, but I had a patient once claim that they hadn’t picked up their Vicodin (or some other controlled RX) and …. We couldn’t be sure. We couldn’t find the RX, it was sold in the system, but the patient swore up and down they didn’t have it. They weren’t a regular “problem” patient that sets off our alarms (and I don’t really remember how we handled it, since it’s been 3-4 years), but that was a unexpected complication. A restocking fee would be great, but I don’t realistically see that ever happening.

So far as 5 goes, I usually X out the “new” mention on what I know are refills and circle the “new” mention on what I think are new scripts. Yeah, I don’t always have time to do that, but – in the long run – it saves me the time of walking over to counsel and realizing that it’s a Concerta “refill.”

I’d love to have #9 available – or to have a “report” that could be printed for a patient on all controlled drugs. (Perhaps a program that lets you select all the drugs from their profile that you want to incorporate into said report, so you could add in Soma or Tramadol …. )

My latest frustrations at work have been more of the “What? Our printer is jamming *again*?!” variety. It would be nice if the technology we already have would start working. (Of course, that’s far too much to ask for, I’m sure.)

Comment by mb

September 28, 2011 @ 8:41 pm

I’ve worked in places that have the autonotification and the autopay and I have mixed feelings about it. It is nice that the patient gets told the RX is filled and ready for pick up, though telling them you have so many days to pick it up would be nice. The autopay is nice for some elderly or places like rehab places that autocharge small copays. Otherwise it is a pain in the rear explaining to patients why the card on file was declined and they still need to pay a copay. Or the morons bitch about not wanting one script after they looked through it and signed off on the total amount being charged.

The Autonotification also is not great with the elderly or those who keep changing phone numbers as then someone else gets the call, calls up at us bitching that they got the call, ect. I also use to get the elderly calling wanting to know why “someone from your pharmacy is calling me” even though all it says that it is XYZ pharmacy, not which location which just happens to have 5 locations in the city.

I also agree with the DUR nonsense, I really hate having to have myself or one of my techs call to figure out what the hell one of the rejects mean. Some we’ve seen enought to figure out but some are just a “WTF!” moment of just seeing a jumble of letters and numbers, only to get the snotty call center helper when you call to figure out why the reject is happening. It ranks up there with rejects saying you need to submit the prescriber NPI, which is in the prescriber profile but either the computer on my end is not sending it or the insurance company computer is not recieving it. And to make matters worse, the 3rd party help desk is closed as it is 8pm on a saturday and they aren’t open sundays.another thing that would be cool would be the ability to mark rx as mail out…then when the rx is filled a mail out label is automatically generated and a call tag to Fed Ex generated. toss in the envelope and DONE!

Comment by used up rph

September 29, 2011 @ 5:30 am

I too have several of these features at my box pharmacy, most just create another call from the customer….”I got a call that my prescription is ready for $4, is that right????”…duh, no. April Fools!

What I dream of having is an insurance card reader and insurance cards w/magnetic stips that can scan pt info into my computer include drug allergies, health conditions, etc. That would really save time.

Oh, right…”I forgot my card.”

Comment by Stonegiant

September 29, 2011 @ 9:00 am

I work for a pharmacy software company. We do most of that stuff already.
1. We can do this via Post-Date refills.
2. We can do all of this, plus if you have LTC business, the LTC can order refills for all their patients.
3. We do Text and Email notifications, free of charge (to the pharmacy).
4. We aren’t certified to store credit card numbers and that is getting trickier every day. PCI is making things more difficult.
5. We put Escripts in the a queue. You can highlight as many as you want to fill at once. We track Escripts as New or Refill Authorizations. If the doc just sends a new one instead of authorizing refills, we link it back to the original Rx.
6. This is a CMS regulation. Nothing can be done about this.
7. We ask if you want to send to the same or different doctor and then any notes. Then it goes.
8. Again, ours go into a queue. You see a notification on the main screen that you have eScripts in the queue.
9. Ours doesn’t do that either. Would be nice, yes.
10. That’s more of a request from the Processor.
11. Agreed.

Comment by another pharmacist

September 29, 2011 @ 12:43 pm

I too have many of the features available that you describe. At a past job, I had the Express Pay feature. However, believe me, you only want the patient to be charged if he picks up the Rx. Otherwise, the return to stocks are a nightmare. One of my happiest retail pharmacy days was throwing all of the medi-guides into the re-cycle bin. They automatically print out for drugs on which they are required. The only exception are some drugs (i.e. Advair) where they are packaged in the medication.

Comment by dan

September 29, 2011 @ 10:34 pm

The chain I work for also has several of these. As far as number six, a bar-code is embedded on our pads and refill papers. Then the system is programmed to read those, if it is sent electronically or has none of the above it knows it is a new hardcopy.

Comment by Erin

September 30, 2011 @ 5:46 am

Medi-guides are a total nightmare. Ugh.

Comment by Jade

September 30, 2011 @ 7:51 pm

In the agency jobs I’ve picked up in the last five years, I’ve seen some of these ideas in effect already. Other than a universal patient data-base, and prescriber bank, as well as standardization of insurance information reporting, I’d like for patients to be able to get the whole amount of their refills at once, for myself, and spend the minimum amount of time in the pharmacy drive-thru.

Synchronizing forking over new scripts with requesting refills is a hassle; then singly leaving refill request on voicemail for each of six prescriptions, amounting to six or seven trips to the pharmacy each month is ridiculous, so I vote against a restocking fee, as well as putting away my filled script on the sixth day it’s been waiting for me to pick it up.

I would like a one-way sound barrier like the technology that created privacy windows, to be able to work in silence but be able to see all that’s going on. (And, also to put incoming phone calls on a hands-free loudspeaker system while maintaining confidentiality.)

I’d like to see more automated perpetual inventory of controlled substances in retail utilizing automated dispensing cabinets. The paper book is usually in shreds by the end of the year, and it’s irritating when the pharmacist ahead of you ‘forgot’ to record something important.

I’d like someone to invest time into coming up with a few more ideas about comfortable flooring, and I notice that in many stores of one particular chain, the pharmacist only has a high four-legged stool with which to sit on. I’d like to see more thought in this respite than picking up something cheap in the furniture department.

Comment by CPhT

September 30, 2011 @ 7:58 pm

I said today that my chain’s loyalty card should be able to be programmed into the patient’s profile so if they are picking up and we scan the script first, it registers to the card. That would be especially helpful at the drive-thru where it’s even harder for someone to come up with theirs!heck yea! like that one. I get sick of asking every single you have your customer card?…Um sure hang on ( as they dig thru their purse/wallet whatever…)

Comment by smartTech

September 30, 2011 @ 11:03 pm

8. Our E-scripts also sit in our queue until selected. Thank goodness! Pop-ups would drive me batty!
11. We have some ad software that prints basically spam when one of the targeted drugs are ran through (we get paid some random cents each…) but the plus side is it prints all meds guides. Makes tracking down and keeping and using med guides one less issues.

***Question: Here is Kansas we have K-TRACS. (through our board of pharmacy) It moniters all controls and “drugs of concern”
A. (1) any product containing all three of these drugs: butalbital, acetaminophen, and caffeine;
(2) carisoprodol; and
(3) tramadol.
It is updated weekly and can be searched to moniter drug seekers and pharmacy shoppers. It is fantasic. It even alerts us when someone is being naughty. Any other states using similar technology?

Comment by JJ

October 10, 2011 @ 2:56 pm

all good suggestions, and I would recommend you passing them to your software company. my computer geeks are wonderful and very open to new ideas and suggestions. love your blog.

Comment by Stonegiant

October 24, 2011 @ 7:36 pm

Some states are moving along the same lines as the K-Tracs site. I know Oklahoma supports this. As of now, all schedule drug Rxs are reported to Ok Bureau of Narcotics nightly automatically (or manually if your software doesn’t support it). It will soon be required to be submitted automatically at the time of Pickup (if you have a POS system of reporting to the Pharmacy system the status of Rxs) or at the time of input (if you don’t have a POS capable of flagging the Rx as picked up).

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