Verona - Rx Authorization
This type of In Basket message does not always mean that a patient has called clinic asking for a medication. In fact, often it means that a request has been automatically generated by a patient’s pharmacy because the medication refill is due and then faxed to clinic, translated into a “Rx Authorization” encounter, and routed.
In first year, you will get a lot of prescription reauthorizations for patients you don’t know. Don’t be afraid to review their chart to see, is their blood pressure controlled? Have they had an appointment in the last year? Do they need labs?
The two buttons you should use here are:
“Enc” – This takes you into the encounter itself, just like is pictured above for patient calls. You can modify the prescription, add additional orders, write notes, etc.
“Approve All/Rt” – This approves the prescription exactly as the nursing pool has pended it, and then gives you a space to write a quick note for the encounter and specify who to route to. For example, for lisinopril, you should check to see that their BP was controlled, that they had had labs done recently, and that they had been seen in clinic in the past 12 months, and then you could “Approve All/Rt” with a message explaining the refill. The pharmacy will call the patient for e-prescribed medications. If nursing needs to call the patient (i.e. if there is a question about the medicine use before refilling it) route it to “P DVN FM RED/YELLOW (or BLUE/GREEN) RN TEAM” pool. Phone-in medications will automatically be routed to the nursing pool. If a patient does not meet a criteria for a refill (i.e. hasn’t been seen for 1 year) it is usually okay to do a 1 month refill and make a note for reception (“P DVN Schedulers”) to call the patient saying they need to schedule an appointment.
“Edit Rx” would be used to make a change to the prescription before signing it, although it may be easier to go through the “Encounter” as above.
For filling controlled substances when you are not in clinic, a good workflow is:
“Enc” button to enter the encounter
Write a quick note explaining who the patient is and why they need a controlled substance, when they were last seen in clinic, whether their contract and UDS are up to date (within the past year), and if there are any issues on the PDMP
Route to “P DVN FM PROVIDERS” (which is the staffing pool) for prescription.