Avoid the Pharmacy Rants with ePrescribing


There's a posting at Musings of a Dinosaur that's deserving of a comment or two. Mine is that the whole thing could've been avoided with ePrescribing.

I just came across a May 28, 2008 posting at Musings of a Dinosaur (warning, lots of cursing) in which the author goes on about a prescription mix up:

"I hate:

  1. Idiot, moronic, too-stupid-to-live patients whodon't bring all their meds in, even though they say that all their medsare in the bag.
  2. #*$&ing @$Ihole gastroenterologists who can'tbe bothered to drop me a line after scoping said patient, giving themProtonix and then changing it to some other PPI; again, without everletting me know.
  3. *$^-burbling trout-@#&ing (thanks again, CrankyProf)chain-store pharmacists who send me requests to preauthorize PrilosecWITHOUT EVEN &%$#ING NOTICING THAT THE PATIENT ALREADY HAD A SCRIPT FORANOTHER PPI-- complete with refills -- ON FILE!!!

So what endsup happening is that I spend forty-five minutes of my life that I'llnever get back on the phone with a West Virginian who tells me that:

  1. Prilosec will never be covered because it's available OTC (even though he needs 40 mg. BID) but that,
  2. Another PPI will go right through.

SoI call the patient -- who doesn't answer, of course, so I leave amessage -- to let him know I've changed the Prilosec to somethingthat's covered for him; only then, upon calling the pharmacy to call inthe other PPI, TO DISCOVER THE SCRIPT ALREADY ON FILE!!!"

Here's my question: Couldn't this have all been avoided with the use of ePrescribing and connected EMR systems? Red flags would have come up, a month wouldn't have passed before the script was in the pharmacist's hands, the primary care physician would've know about the scoping performed by the gastroenterologists, the gastroenterologist would know about any medications the patient was on, and most importantly, the pharmacist would have seen the duplication. Right?

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