Scenario: Refill request received by phone or by fax before e-prescribing
| Step No. | Step | Performer | Step Type | Description | Documents | Key information |
|---|---|---|---|---|---|---|
|
1. |
Retrieve renewal request message(s) | Office staff | Retrieving | Take or retrieve fax or phone message from a pharmacy or patient to request medication renewal; if phone, transcribed message to a note; calls pharmacy to clarify request as needed | Request fax or phone message | Telephone message transcribed to notes |
|
2. |
Retrieve patient information | Office staff | Retrieving | Pull record and/or look up in practice management system; confirm that patient is seen in the clinic | Patient record | Patient identification confirmation on fax sheet or transribed phone message and clipped to the record to pass to authorized office staff for renewal approval |
|
3. |
Deposit message with record for staff authorized for renewal approval | Office staff | Handoffs |
|
Patient record, request | Patient ID, date of request |
|
4. |
Authorized staff retrieve message with record | Authorized office staff | Retrieving |
|
Patient record, request | Medical records, details of request |
|
5. |
Check whether request meet protocol for authorization vs. needing physician review | Authorized office staff | Decision | Staff person checks protocol criteria for approving request without physician review and routes request to physician or to be approved per protocol | Patient record and protocol for staff renewal | Details of request, match to protocol |
|
Protocol-approval pathway (a) |
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|
6a. |
Document protocol renewal | Authorized office staff | Processing | Document renewal on patient record | Patient record | Details of request |
|
7a. |
Inform physician | Authorized office staff | Communication | Inform physician verbally or in writing | Note paper | Details of request |
|
8a. |
Give patient record and prescription to office staff | Authorized office staff | Handoffs |
|
Patient record, prescription copies | Details of request |
|
Physician-review pathway (b) |
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|
6b. |
Deposit message with record for prescriber approval | Authorized office staff | Handoffs |
|
Patient record, request | Details of request |
|
7b. |
Prescriber retrieve message with record | Prescribing physician or nurse practitioner | Retrieving |
|
Patient record, request | Patient ID |
|
8b. |
Prescriber approve or decline request or change medication | Prescribing physician or nurse practitioner | Decision | Decide if prescriber has approved request by looking up information such as last visit, lab results, current medication list, insurance coverage; complete prescription | Patient record, request | Approval or denial |
|
9b. |
Give prescription and record to office staff | Prescribing physician or nurse practitioner | Handoffs |
|
Patient record, prescription copies | Patient ID |
|
All renewals (pathways a and b rejoined) |
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|
10. |
File patient record | Office staff | Filing |
|
Patient record, prescription copies | Patient ID |
|
11. |
Transmit to pharmacy | Office staff | Processing | Transmit to pharmacy via fax or phone | Prescription | Pharmacy information including name, address, phone number |