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Who can electronically rx controlled substances??

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  • Who can electronically rx controlled substances??

    I do have a few chronic pain patients (this includes essentially pain meds stronger than Tylenol 4, also testosterone and adhd meds) and I use epcs (electronic prescribing for controlled substances). However it becomes a pain in the rear when I’m not available to order the rx because “prescribers” are the only ones allowed to enter the order. So if I’m off I have to get to my laptop and put in a special code that changes every 60sec in order to send it to pharmacy. And these meds can’t have refills on them so the scripts have to sent monthly-i see most of these monthly but have some on every 2 mth follow up. I get we have to be careful to prevent abuse/misuse however this seems to me to be undue hardship for us docs. Why did someone not fight against this? Or is there a work around I’m missing?? I heard I can ask for a waiver to continue using paper scripts but then I’d have to leave a few signed scripts around the office and have my ma write in the sig which I don’t like either.
    all I want is for the ma to send me a text “ hey can I send pt x this refill?” And i text back “yes” . That’s it

  • #2
    Seems like a perfect job for a PA. We have a PA in clinic who does this when the docs aren’t physically around (in the OR or hospital, for example).

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    • #3
      Do you carry a smart phone? We use the Authenticate app on our phone for the code. I hate e-prescribing for other reasons. Namely, it seems that the nurse never updates the patient's preferred pharmacy or (at least in the ED) the patient decides they want their script sent to a 24 hour pharmacy.

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      • #4
        Originally posted by CordMcNally View Post
        Do you carry a smart phone? We use the Authenticate app on our phone for the code. I hate e-prescribing for other reasons. Namely, it seems that the nurse never updates the patient's preferred pharmacy or (at least in the ED) the patient decides they want their script sent to a 24 hour pharmacy.
        Yea I Have an app for the code but I can only send rx via laptop

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        • #5
          These are not urgent, so how often are you actually "unavailable" and it can't wait a day or two? You just need a policy that these refills need to be requested 5 business days in advance to give yourself time to check database and e-scribe the Rx. The MA can collect the refill requests and you do them all at once at the end of a clinic, or whatever time is convenient for you.

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          • #6
            Originally posted by climbhigh View Post
            These are not urgent, so how often are you actually "unavailable" and it can't wait a day or two? You just need a policy that these refills need to be requested 5 business days in advance to give yourself time to check database and e-scribe the Rx. The MA can collect the refill requests and you do them all at once at the end of a clinic, or whatever time is convenient for you.
            We do 28 day scripts, so refill dates will always be during the week. We also have a policy to not handle controlled meds over the phone which helps mitigate much of what OP mentions. While I agree PRN meds arent typically urgent, a patient on higher daily MME opioids chronically could go into significant withdrawals if not dealt with quickly.

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            • #7
              The best way to get around this is to stop writing for controlled substances, as harsh as it may seem and you may get a few patients mad and leave, but over all it makes your life much better. You can't fight an uphill battle. Our state government requires electronic controlled substances with no exceptions. I toted a laptop around for a while , even paying for good wifi on a cruise so I could be the good doctor and take care of my patients. It got old after a while.

              The choice for me was to either ruin a perfectly good vacation doing refills and getting annoyed or just saying no.

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              • #8
                I understand you may not be able totally stop writing them but it does make your life much easier. I have refused to sign up for electronic RX controlled meds for this reason. If they call after hours I have an excuse that I cant write the RX and fax it in after hours. I am sure my state will move to mandatory at some point.

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