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Refill alerts on a medication list - help reduce unnecessary work

What if the doctor and patient took care of all the necessary work at a visit for managing chronic disease?

Disclosure: I hate getting calls and faxes for refill requests. It seems totally avoidable. I’m not winning this battle.

It’s fairly common for primary care physician offices to get dozens of phone calls or faxes a week about medication refills.

    It might be about a patient I just saw last week.
  • These calls take time and money: mine and the staff.
  • This is unreimbursed work.
  • I get whiney about it.

If there is a discrepancy between the pharmacy (or patient) request and my records, it gets a lot worse.

Then calls go back and forth, trying to reconcile the difference, and the outcome is not always satisfactory.

So, what can we do about it?

How about adding a little alert to the medication list?

  • Don’t make me think (that is, don’t make me “sort by last refill date”, figure out the interval since last refill, count the meds and remember their names), just show me!
  • Dark red (or gray) could mean “due for refill in <3 months”.
  • Pink (or lighter gray) could mean “due for refill in <6 months”.
  • These intervals (3 and 6 months) match the numbers for “frequency of diabetic lab tests” and “limit on controlled substance refills”.

With this information right in my face, it would be easy to see if, and which, medications need to be refilled today. That avoids an extra call for the patient, an extra fax/call or two for my staff, and a headache for me.

That makes me happy!

(special thanks for the idea to Phil Vinyard at University Physicians Family Medicine Clinics)

What's Your Phone Number?

How can I, a physician user of an EMR, give feedback or enhancement requests to the someone who can make a difference?

As the EMR Champion in my medical group, I hear my partners come up with excellent suggestions all the time. Most of these gems are never recovered.

All EMR corporate websites need a “Contact us” page that includes a link to feedback for product improvement.

  • It shouldn’t require me to log in to a secure website.
  • It should give me an email address for support, suggestions, or to report problems.
  •          That way, I can grab a screenshot, type a few words or lines, and shoot off the message while I’m still hot.
  • The sorting (support, enhancements, issues/bugs) can be done at the corporate end.
  • It should ask if I want to get feedback or not.
  •         Feedback can be simple ("We got your message" or more nuanced "We forwarded your suggestion to the enhancement team" or "You should also notify your local support team").

Developers benefit by getting fresh feedback. A focus group done weeks or months later will yield only the most egregious problems.