Magazine article Drug Topics


Magazine article Drug Topics


Article excerpt

PPAs and CPPs

Re: "The Pharmacy Physician Assistant" [June 4,]:

PPAs already exist. They are called Clinical Pharmacy Practitioners (CPPs) and work under a collaborative practice agreement with their physicians. Their role is not exactly as described in the article about PPAs, but it could easily be expanded.

North Carolina is one state that recognizes CPPs.

E-Rxs - Oh, yeah

At, articles by the Cynical Pharmacist ("Electronic prescriptions: Return tosender, " and reader Tom Hanson ("E-prescribing: The end of prescription errors? Hardly, " http:// set off a round of cheers and catcalls. The following are some of the comments you 'll find posted.

Got their number?

This is a hideous problem. Are we by law expected to find and solve physicians' mistakes?

My biggest problem is the physician phone number listed on the script! I call to correct the prescription and the secretary says, "I'm sorry, this is the billing office. We didn't send you any electronic scripts." Totally ABSURD.

It should work both ways

Since the evolution of e-scripts, I have been so frustrated that I do not have a "Return to Sender" option. The doctors and their agents are so hard to get hold of by phone or fax. I consistently leave messages that are not returned.

I'm not a programmer, but it seems to me that if the e-script communication can go in one direction, it should be easy to open the channel to communicate in reverse.

The other thought I have had about decreasing errors in e-scripts is that doctors' offices should start employing experienced pharmacy technicians to either enter or review the orders before sending them to the pharmacy.

Back to the future

I understand your frustration. I've worked in both hospital and retail settings for the government for almost 40 years. We had problems with "physician order entry" in the institutional area back in the 1970s and went back to hand-written orders.

The software providers must use simple directions and provide matching entry fields.

Start with NDC

I highly doubt that any of the software providers that write this defective code are willing to hire the team of pharmacists needed to correct and maintain their software. Pharmacists are just too expensive when compared to offshore coding mills.

Further, even if an e-script vendor were willing to invest in the necessary resources, the data is coming from a third-party "drug database" solution that often contains numerous errors.

One thing that might help is if the FDA would correct their useless NDC system. Every vendor has to "translate" data fields because the FDA allows manufacturers to enter strength, size, quantity every which way, then cry about the cost of relabeling if anyone brings up the concept of a real national standard. …

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