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Tuesday, December 8, 2020

Dear Board Of Pharmacy

I have a question for my BOP.
Perhaps you too will share this question.
CP: Dear BOP, do you have to approve pharmacist license applications?
BOP: Yes.
CP: Do you have to approve companies that do business with the State BOP?
BOP: Yes.
CP: Do you have to certify e-script providers and other vendors that do business with the State BOP?
BOP: Yes.
CP: Okay. Do you suspend licenses of pharmacists in the State?
BOP: Yes.
CP: If a pharmacist was asked to complete something as part of her registration, and told you "NO", could you revoke their license?
BOP: Yes.
CP: If a vendor said "NO", could you do the same thing?
BOP: Nope.
CP: Why not? You know that you have approved over 200 e-rx systems in the State. You know that one of the providers has refused to fix a known issue with their software.

(Here's the background. If an e-rx is sent by a prescriber, it passes from the office system to another processor who passes it on to Emdeon. They in turn pass it to a switch who is responsible for passing it to the pharmacy. IF, at any point it does not make it to Emdeon, whether due to a system outage or a "glitch", the e-rx is routed directly to my fax machine. This comes complete with no signature by the prescriber. My state has mandated that these Rx's are, in fact, not legal. We are required by the State BOP to call on each of these Rx's. They even have a disclaimer at the top that reads "Warning. This is not a valid Rx until called to verify by the pharmacist." What's even better is, we then have to transcribe it as a verbal order instead of an e-rx, thereby circumventing the intent of the e-rx in the first place.)
Still with me? Good. Now, despite repeated conversations between the company and the BOP, the company has refused to take the action that the other two big e-rx players have and that is to change their software to allow signatures to be printed on the faxes. They also contain a disclaimer that essentially reads "this started as an e-rx but due to a system error or glitch, got routed to your fax instead. It is totally valid so feel free to dispense it. Approved per State BOP", or something to the effect.
BOP: What's your question again?
CP: Why can't you just revoke their approval? Like you would a license?
BOP: Because.
CP: Oh. Okay. What do you suggest?
BOP: Call the offices that use this software and speak to their office managers. Explain the situation and why you have to call all the time, even though they get frustrated with you, and have them complain to their software vendor. Maybe, once enough offices complain about all the phone calls, the company will relent.
CP: Or you could just give them 90 days to be in compliance or threaten them with the loss of their license.
BOP: The Board of Medicine wouldn't go for that. Too many doctors would complain.
CP: Gotcha. So you approved a system that basically tells all the pharmacists to piss off, makes more work for us, then you tell us it is OUR responsibility to call on something you could fix, because you, the Board of Phrickin Pharmacy, are afraid of what a group of prescribers will do?
BOP: Yes. Pharmacists have no backbone and won't stand up to us. We only approve the systems.
CP: I got nothing. I need to relocate.

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