ATTENTION – EFFECTIVE March 2023 (please read):
The Notes to Pharmacist field usage has changed. These changes are designed to improve workflow and efficiencies in e-prescribing. These changes are suggested by the E-prescribing network and Pharmacies who have determined that an overwhelming majority (greater than 95%) of “notes to pharmacists” entered by users are redundant, confusing or contradictory to the rest of the prescription; this can contribute to errors in dispensing.
As a result, the Notes to Pharmacist field now primarily allows for selecting a CODIFIED note to send. Sending information in a clear, codified fashion reduces the potential for error by reducing the reliance on a human to identify, transcribe, and respond to the information.
Below is the new list of Codified Notes that can be selected. The language below will capture additional language when selected and present on-screen to the user.
The Notes to Pharmacist field is optional. The Notes to Pharmacist field is intended to allow prescribers and pharmacists to communicate information that is relevant to the prescription AS LONG AS THE INFORMATION ENTERED IS NOT CONTAINED in a designated field that is already on the prescription. It is crucial that all key prescription information be entered into the designated fields. This helps improve patient safety by reducing the amount of unnecessary information healthcare providers review, reduces human touchpoints, and helps leverage e-prescribing technology to increase efficiency in the dispensing workflow.
What can you do now with the Notes to Pharmacist Field?
You can now easily select from a drop-down list a standardized set of notes. Click the drop-down and select the standardized note to add to the prescription.
Can you enter a free-hand text note of your own?
Yes, you can still enter a text note at any time, but this should be used infrequently and should NOT contain:
- supervisor info
- change in dose info, strength, quantity, days supply
- insurance info
- diagnosis
- patient demographics
- picking up medications information
- any other information that has a designated field on the prescription preview screen.
Text entry of notes should be done only for data or communication needed that is outside of the available fields on-screen and pertinent to the prescription.
Default comments – Can you use them and what happened to them?
Any existing default comments added to your system have been removed from March 1, 2023 on. You can create and store new default comments, but please only store defaults that are in compliance with the terms and recommendations contained herein.
Examples of Unnecessary Notes:
Below are examples of commonly added Notes which are unnecessary because the data is either ALREADY sent with the prescription, unnecessary to communicate or there is a defined field on the prescription creation screen that the data should be entered in.
| Sample Unnecessary Notes | Reason this note is not necessary or appropriate in the Notes to Pharmacist Field |
| “New med from ABC CLINIC-Call w/questions: 555-555-555." | Information is not needed as the name & phone number are on the prescriptions |
| "Days supply." | Should not be entered in notes field; not required to be on prescription |
| “Discontinue 15mg dose and refills.” | The proper workflow would be to find the previous medication & send cancellation prescriptions for the past order |
| “DX: E78.5 Hyperlipidemia.” | User should click ADD Diagnosis in the designated Diagnosis area |
| “Fill today 1/1/2023.” | Pharmacists will always try to fill same day - also, there is a checkbox on-screen to mark prescription as Urgent |
| “Hospice responsible do not use patient insurance.” | This information should be entered in Insurance area on prescription |
| “Increasing dose to 20 mg.” | Information not needed to send on prescription |
| “Patient DOB 01/01/1980.” | Not needed in this field as DOB always sends with all prescriptions automatically |
| “Please blister pack and deliver today.” | Users can enter the blister pack info in the SIG (directions) area and check off Urgent prescription setting |
| “Supervising Physician DEA: AA1234567.” | Supervising physician information can be added to setup of users and should not be added as text notes |
| "Collaborating Physician is Dr. X." | Collaborating physician information can be added to setup of users and should not be added as text notes |
| “Use patient coupon and BIN and GROUP #.” | This information should be entered in Insurance area on prescription |
| "Patient in renal failure and terminally ill." | Diagnosis section should be used to select “N26.1 Atrophy of kidney (terminal)” |
| "Discontinue (D/C) all previous scripts." | Individual prescriptions should be cancelled and/or notify pharmacist through alternative methods |
| "Cash Pay - Do not bill insurance." | Reflect in insurance area |
| "Change from the immediate release tabs." | Not appropriate for notes field; this should be reflected in the form of the medication and directions line |
Thank you for your cooperation in increasing efficiency in the dispensing workflow and compliance with electronic network best practices.
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