The Pharmacy Chick

Flying the coup in retail

The reminder call conundrum.

Filed under: Uncategorized — pharmacychick at 7:36 pm on Wednesday, June 6, 2012

Technology has a way of being the eternal double edged sword.  We love our computers but become slaves to Facebook, games, YouTube, and email.  We love the convenience of  cell ( now smart) phones, but as I have written before, I felt naked one day when I  left home without it, and fretted until I had it back on my person.

We love technology in the pharmacy a  point.  I would never want to go back to typing labels on the typewriter, and hand pricing every prescription.  And, CERTAINLY would never want to go back to the Universal Claim Form to which most contemporary pharmacy graduates have never heard of. I would bet decent money that if you have a Pharm-D after your name, you have never typed a label on an IBM Selectric ( the best in the biz) nor filed a UCF….and if you are a B.S, you may remember them both! ( and, if you work in a pharmacy over 20 years old, you may have one or both buried in your store room somewhere.

The cash register is a wondrous invention but even it has become so complicated a device that it takes days of TRAINING to understand and use it.

One of the newest technologies that PC Pharmacy has instituted is the “reminder call”.  Hailed as a wonderful device to improve compliance ( choke-cough-laugh) its main purpose is to nag  notiify patients that they have a prescription to pick up, in the feeble attempt to reduce the amount of return to stocks we have to process–which thru the new technology of AUTO-FILL has quintupled since its inception.

The Reminder Call goes out twice in  a period of  a week to the phone number of record and leaves a very generic message to the recipient that they have a prescription to pick up. Because of HIPAA, it does not state the actual patient’s name, nor the drug on the shelf. This leads to many issues…such as…

1) the inevitable call back:  generally starting about 15 minutes after the bulk calls go out, we get some back..  ” I just got a call saying I have  script…WHAT IS IT?” If we didn’t have auto fill, I could just tell them to quit being a doofus and pick up what ever they ordered…but thanks to auto fill, I have to trapse over to the shelf and find out what ever the Doe/Smith/Jones family has on the shelf.

2) the wrong phone number:  ” I just got a call saying I have a script there…I dont use your pharmacy!”.  We have to then do a search on the phone number , find the offending number, delete it, apologize and then accept that whomever’s RX is really there is NOT going to get that reminder call.

3) ” I dont need that”.  If I had a dime for every rx I put back because they dont need or want it, I could probably take a great vacation someplace.   ” Im not out”  ( compliance issue).  ” I quit that”  ( thanks for telling us)  “The doctor changed it” ( again, THANKS for telling us)  this becomes more common with certain drugs over others.  I personally would remove every single topical from autofill.  I would also stop most anti-inflammatories, eye drops, rescue inhalers and nose sprays.

4) ” I already picked it up”…of course they did..they picked it up about 2 hours ago and those calls were generated a 6 am in a corporate server go out at some determined time.  Once generated they cannot be stopped, even if they pick up the rx that very day.

5) ” quit calling me already”.  Well, here’s how this works.  If  you order a rx on monday, then order something else on wed…you will get reminder calls on EACH script you have filled on any given day. If you have all the scripts filled on ONE day, you get ONE call for the bunch. but if you get rx’s filled over a period of days, those calls add up.  I can’t help it…actually I can…PICK THEM UP.

But probably the most potentially awkward issue I face is when somebody physically comes in after receiving a call.  ” I received a call from the pharmacy to pick up a rx..Here I am ( big smile).  They have NO idea what they are picking up so we grapple with deciding how much information we have to collect/divulge in order to serve the patient…and preserve privacy.  This can be dicey in mixed families who share a phone number…  I will usually ask ” who do you pick up for”..and they will  say  “we have Sue, John, Mary and Mike Jones, and my mother Martha Doe  living here”.  So I go to the shelf and peruse for whomever meets this category. Nearly all HIPAA bets are off when somebody physically comes in to pick up an order.If they as for a patient’s rx by name, we can legally retrieve it, sell it and counsel the agent picking up the rx. They dont have to know WHAT it is…they basically only have to know that there is actually an rx here.

Dont think it can’t get exciting:

Sue comes in after getting the phone call and gets wide eyed when the pharmacist goes over to counsel on John’s new viagra rx…that she didn’t know he was on.  ( John, may I make a suggestion… pick up your prescription elsewhere or use a different phone number…or at least tell your wife you are ON viagra before she picks up your rx ok?…she wasn’t very happy when she left)  

Sometimes  a customer will lead us on like they just got the call today and when we can’t find it, they get all pissy.  It only takes a moment to discover the rx they were looking for was returned to stock 2 days ago…their ” reminder call” was tuesday…today is Thursday…of NEXT week!  People have such a warped sense of time. “You can’t have put it back, I just ordered it the other day..having been 2 weeks ago..

Occasionally we have the honest person to admits they just blew off our reminder calls but somehow thinks we are like a RX storage facility and keeps rx’s on the shelf like it was POD storage….” yea my doc called in something for me a few weeks ago. You still have it right?”  well. not exactly my friend…

But more often we get the indignant hand-on-hippers who piss and moan when we have restocked their drugs and deny to our faces that they ever received 1, both or any calls. You may not have listened to your messages, but the calls go out. Because the calls are automated, Ive learned a lot of people hang up as soon as they hear its a machine…and dont listen to its message.

Sadly, all rx’s are automatically opted  in to this phone notification system.  You dont opt IN, but you can opt OUT.  If you fill a rx at PC Pharmacy and do not pick it up after x days, you WILL receive that call.

Ahh technology…the creators of new problems for a new generation!



Comment by murgatr

June 6, 2012 @ 10:32 pm

What’s worse than the Viagra blunder? Manual reminder call to pick up Rx’s for someone who passed away #awkward

Pharm. Tech. RDC’06haha, quick story. We used to get a list of people ( printed on the computer) who were due for a reminder call for certain vaccines…I made the call one day only to get a furious woman whose husband had died a few months before. ” He doesn’t need any shots does he?!?!?” I guess I was supposed to just divine from the heavenly realms that her husband had taken up residence elsewhere. I have since decided that these calls take up more time than the cash they generate is worth…

Comment by PharmacyTechPOV

June 7, 2012 @ 3:59 am

Sadly, our automated system also generates “refill reminders”. It goes something like this: This is My Pharmacy, you have a prescription ready for refill. If you would like to refill this prescription follow the prompts. All the patient hears is “you have a prescription ready”. They then show up to the pharmacy wanting to pick it up. Then they get mad when we don’t have it ready. That, of course, is in addition to the ready-for-pick-up calls.yup, that sucks even worse. PC pharmacy sends out written reminders on certain meds ( subsidized of course by the manufacturer) if they become late on meds. Ive never seen them until a few customers brought them in.

Comment by lil abner

June 7, 2012 @ 6:39 am

”The doctor changed it ( again, THANKS for telling us)”

You really expect every patient to call you every single time their doc changes a prescription?Yes I do, wanna know why? Because you are on AUTO fills AUTOMATICALLY based on the days supply of the prescription. if you stop the med or half the dose it will refill way to early. If you double the dose it wont fill in time and you’ll be pissed because its not ready and the insurance will refuse to pay because you should still have half the bottle…THATS WHY. Auto fill takes YOU out of the loop, the computer has no idea that you have changed your meds..therefore its YOUR responsibility to keep us current so autofill works properly for YOU.

Comment by joanj

June 7, 2012 @ 8:07 am

I hate autofill and refuse to use it. Here, if you have an early refill due to a vacation, it refills early ever after.

The reminder to refill calls are trying to comply with HIPPA as they now request the birth date of the person they are calling before they give the message that prescription X needs to be refilled.

Comment by ndenunz

June 7, 2012 @ 9:25 am

Question about auto-fill: Do you have to opt in (sign up for it) or are you automatically put on it?you enroll. We never automatically put anybody on auto fill.

Comment by Loren Pechtel

June 7, 2012 @ 9:35 am

I’m afraid you have a blame problem here.

If the patient opted in to auto fill then you would be right in blaming the patient for not telling you things changed. However, it’s your corporate HQ that did it, don’t blame the patient for errant results from auto-fill.

Also, it’s a poorly implemented system. It should recognize that it’s trying to call about two scripts for the same patient and make only one call. The patient is right to gripe about this.

The problem of calls for scripts that have already been picked up is technically a bit more complex to handle but assuming you have a broadband connection it could be handled. Without knowing the link I can’t say for sure that it’s the fault of the system but it most likely is.

Comment by pharmacychick

June 7, 2012 @ 11:11 am

Loren, the system calls based on the date the script is filled not how many. If you fill one one Monday and something else on Wednesday you will get calls for each one. Auto fill is a optional program you enroll in. Nobody is auto filled without an enrollment. You can also opt out of reminder calls…but if you opt calls ever goes out.

Comment by JS

June 7, 2012 @ 10:47 am

No system is perfect! I opt out of auto fill because my medications/doses change so often! As a “train wreck” patient it’s my responsibility to inform my pharmacy of any changes in medications, doses, or anything that pertains to my pharmacy needs. It’s no different than letting them know if I develop a new medication allergy. It’s also important when the medication you are taking is expensive. Most of my medications are VERY expensive. Two, in particular, would cost me WELL OVER $2000 a month w/out insurance. In an effort to help (and work with my pharmacy) they don’t order them until I need them. This helps for them to not have the added inventory on their shelf until I need the medication. I don’t have to do this. But I know it helps them. And having a good working relationship with your pharmacy is an important thing! So, I will call them about ten days in advance for certain medications. That will give them time to make sure they came with their weekly order and not have the inventory sitting on their shelves (they won’t run them through my insurance until we know we won’t get a “refill too soon message”). If I am compliant, do what I am supposed to, keep them aware of changes, etc., it makes for a positive experience for all involved! Also, if I am ever to run out of a medication (has happened twice in eight years; there were extenuating circumstances; but still my responsibility) they are more likely to give me a few days’ worth to allow time to contact my doctor. They do not have to do this. They are not obligated by law, and it’s truly not their fault or problem. If I was talking 8 mg of a medication, and the doctor decided to have me take 2 mg instead my now one month supply has become a four month supply. To the pharmacy that looks like I am not being compliant, when really I am. So, now I have run out of medication, they look at my profile and see that I should have run out three months earlier and tell me I am out of luck. Had I told them three months prior that the dose had changed; they would know that I was compliant and note my file! We as patients need to take responsibility of our own health care and not assume that someone else is going to be there to “baby sit” our profile. If you are someone who can’t handle this, than you need to delegate the responsibility to someone who can. JMO!

Comment by The Candid Pharmacist

June 7, 2012 @ 12:48 pm

Well written and exactly like the system I am forced to deal with. Now being measured on how many calls are completed, wrong numbers, etc. and given benchmarks to hit.

Just another metric to get nailed on. No added value to public health or safety. HIPPA violation waiting to happen as you stated.

May God have mercy on all of us poor retail pharmacists. Our employers will not!

Comment by marc b

June 7, 2012 @ 8:26 pm

I so hate autocall, I had one elderly jerk call screaming at me and a tech because the auto-fill program dropped like 8 scripts into fill for him and his wife and the system does not batch them together so as I finish the scripts and bag them, the system generates a call for each one where if they were bundled, only one call goes out. The jerk though screamed at us that he only wanted one call and we needed to stop calling him right now but keep him on autocall so he would know when to pick up the rx. I can’t only turn the autocall on for a certain RX, it is all or nothing. He kept screaming at the tech and I through the phone and was threatening to have us fired for harrasing him with phone calls.

I am also not a fan of autofill for alot of our customers but some it is great for as the adult children know what meds the parents take and have us kill any old rxs so they don’t keep filling and makes it easier to just come and pick up the meds to fill the pill boxes with instead of trying to remember what meds need refills when each parent seems to be on at least 5 or more. Of course we still get the “just fill all that I need” line and get people pissy at us when keep asking what they need as we at the pharmacy don’t have a clue the doctor took you off the metformin unless you tell us. People need to know what they are taking and not just keep demanding we fill everything and then throw a fit at the pharmacy about how they don’t want X, Y, and Z medications for (insert random reason here).

Comment by Paul Trusten

June 8, 2012 @ 11:35 am

Hi, PC. I’ve been away from your site awhile, but I am on vacation, so I’m looking up old Internet haunts. Yours I should never have considered a haunt, but a home.

Technology story: When my mother was receiving home healthcare, the aide was going out to pick up her prescriptions. This lady relied almost completely on her GPS device to drive. She set her GPS to “Cambrldge Street.” Well, in my old home town, there are two streets named Cambridge. She wound up on the other side of town!

If she had asked me for directions, I would have said:

1)right turn out of driveway
2)right turn onto the main street. Drive one mile.
3)sharp right at the 99 restaurant.
4)first left after the Shall gas staion.

Four turns. ETA 10 minutes. No GPS required.

I don’t own a GPS. I want to continue to use a map and my wits to find places.Welcome back!! missed you!

Comment by Loren Pechtel

June 8, 2012 @ 2:56 pm

In your comment you say it’s opt-in, but the original says: “Sadly, all rx’s are automatically opted in to this phone notification system.”

Furthermore, the technical problems I mentioned could be dealt with. Just because the system is flawed doesn’t mean it has to be flawed. This is a case where the developer did it as easy as possible rather than doing it right. This is quite understandable as the burden falls mostly on someone who has little say about it but that doesn’t make it right.Loren, re read the comment and the post. Auto fill and reminder calls are two separate entities. Auto Fill is an enrolled program only. NObody’s rx are auto filled without their expressed enrollment. Reminder calls go out to everybody UNLESS you request otherwise.

Comment by bcmigal

June 10, 2012 @ 10:07 am

In our chain, not only do folks receive robocalls (at least 2 per rx), they also receive calls from our “adherence” and “new script pickup” list. Every employee who makes the calls gets tracked by call rate, reach rate, and pickup rate. Calls are made 6 days per week. Some customers get up to a half a dozen calls. Customers who want to opt out must call the 800 number themselves. Otherwise, we must “hide” their phone numbers.
We are also required to have a certain percentage of folks on autofill. The system tracks if we enrolled them at drop off or pick up.
Technology has provided new ways to gauge employee “performance”. Candid Pharmacist is right. Heaven help those who can’t keep up.

Comment by Stacey

June 14, 2012 @ 10:29 pm

Like JS, I am a medical train wreck (rare disorders and their ‘friends’), one side aspect of my main disorder is that I become tolerant to ALL medications easily (even meds where tolerances should not happen). I was wondering with the autofill, but more along the lines of telling your pharmacist (of which the two I deal with are absolutely amazing!). Because of the tolerance issue, I have to rotate a handful of my medications in order to maintain the level of treatment I need. As an example – I suffer from dysautonomia and take a beta blocker twice a day (yes I know they are 24 hour meds). Say I am on atenelol and come in with a script for metropolol, would this ‘cancel out’ the atenolol on my file? I know my pain medications work this way. Also at the pharmacy I go to the have a rule that news scripts over ride old ones. Like if my file shows that in have 5 refills of med#1, if I bring in a new script with no refills on med#1, that trumps the old one and I no longer have refills on med#1. Is that common? It doesnt bother me but I could see how it could turn confusing!

Sorry for the long comment, was just curious how your system works ( I am Canadian btw). Again I am a medical train wreck and deal with many members of the medical community and love being able to get a glance of things from their side. Love the blog btw, keep up the great posts!

Comment by Chris

July 17, 2012 @ 7:39 am

Glad I just found your blog… Love retail pharmacist’s blogs… a friend of mine is one but refuses to write his daily horrors.

Anyway, this is what I stopped using CVS and their auto-fill madness. I understand the concept behind it and for patient *cough* compliance but there were instances were my doc would write me a 30 day supply of “migraine away” with instructions to take 1 or 2 by mouth daily. So I would get a 45 or 60 count of “migraine away” but would never use that much in 30 days but good ol doctor primary care was doing me a favor so I wouldn’t have to play 2x co-pay…I guess

So, around day 28 or 30, I would get the reminder calls that my local CVS has refilled my rx even though I still had enough left. Since I knew the dreaded “RTS” from my friend (waste of time and money) I would oblige and pick it up. I asked several times to stop the auto-fill on that medication but it happened for several months in a row. Now I’m stockpiled with “migraine away” that I use sparingly and it will probably expire before I use it all. I’m sure ENDO Pharmacuticals made a fortune off their newest triptan from my insurance co…

Comment by Chris

July 17, 2012 @ 7:41 am


Forgot to mention that I switched to a local pharmacy with two locations and is a non-profit org that helps & subsidizes costs for people that otherwise could not have access to quality healthcare.

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