When it comes to filling prescriptions, staying abreast of the latest market developments is vital to pharmacy business continuity. The trends we are seeing today in the legislature around pharmacy compliance point to the tightening of the rules around prescriber verification requirements.
One example of that is the state-specific requirements on the handling of the deceased provider rules. Another one is the limited reciprocity around prescriptive authority for in-state and out-of-state providers. And, to add even further complexity, the state-specific controlled substances registration and varying drug scheduling make the verification process even more cumbersome and extensive.
What does that mean for the pharmacies?
Well, it definitely places an additional burden on the workflow that has to be responsive to incorporating these changes as soon as they take place. For pharmacy technology solution providers, supporting pharmacy compliance means the continuous implementation of product enhancements to address the ever-changing compliance landscape.
Pharmacy Compliance Pain Points
Let’s look at some specific examples. Currently, over twenty states limit how many times a prescription can be refilled once the prescriber’s license becomes inactive. For valid prescriptions written by deceased providers, rules become even more complex.
Previously, our clients could determine a grace period based on the number of days. However, in the light of some states passing laws that require specification of the number of refills, not days, remaining, this becomes the new rule that the pharmacy prescriber verification system has to be configured upon.
This is exactly the pain point that one of our latest VerifyRx enhancements – Provider Deceased (PDCN) feature – addresses. Once the mandated limit of refills has been reached, the edit will invoke. We made this feature available as an option – it can be turned on or off to fit specific workflow needs – knowing that is only applicable for the clients residing in the states where the above-mentioned legislature is active.
Another area of continuous regulatory change is the pharmacy state rules. Guam pharmacies, for example, can only fill controlled substance prescriptions from in-state licenses – a pharmacy behavior that is unique to Guam; out-of-state credentials are allowed to write these prescriptions elsewhere.
Nurse Practitioners in Georgia cannot prescribe schedule II controlled substances, but can prescribe schedules III through V. Naturopathic Physicians in Washington may only prescribe codeine and testosterone products which fall under schedules III, IV, and V.
The examples of state-specific variations can go on and on, but the point here is clear. To stay compliant, a pharmacy workflow must be backed up by a robust verification system. It must allow for applying the multitude of state-specific rules to each and every prescription fill with a single point of compliance control that allows for the rules to be set by the legal experts on the corporate level covering both in- and out-of-state prescriptions.
Another VerifyRx enhancement addresses that. Provider Prescriptive Authority by Pharmacy (PPAP) allows state-specific customization of the prescribing rules set per the company-wide policy. The PPAP feature is also optional and can be turned on or off at the client’s discretion.
Enhancing the Pharmacy Workflow
Now, let’s look the operational side. Speed is one of the key KPIs in pharmacy workflow. Knowing that a large national chain may fill as many as 300-400 prescriptions per day per location, the economies of scale come into play.
To be able to sustain the accuracy at such high workflow speed, especially on the initial fills, large pharmacy databases require to be powered by fast and agile data APIs that can check a prescription against all of the earlier mentioned rules and tell the pharmacist if it is OK to fill a script in matter of milliseconds.
Needless to say, such speed cannot be derived from a static, infrequently updated database. This is why we continuously work on increasing the speed of our verification system as we know that pharmacist time is highly monetized.
As the changing pharmacy market landscape continues to impose additional demands on workflow and operational efficiency, dependence on the agility of pharmacy technology takes center stage. This the reason behind LexisNexis Risk Solutions Health Care team continuously improving ways in which we support our clients’ business needs – from ensuring pharmacy compliance to driving down costly dispensing errors for a better, faster, more responsive and patient-centric pharmacy of tomorrow.