Larry King, Surescripts Manager of Clinical Informatics

Coronavirus disease 2019 (COVID-19) has significantly expanded pharmacists’ roles and duties—and their workload is about to become even greater. For more than 6 months, pharmacists have been administering COVID-19 tests and documenting each patient encounter. Now, as administration of COVID-19 begins, pharmacies are preparing to vaccinate millions of people, not only once but 

Pharmacists’ day-to-day work of filling prescriptions, counseling patients, and communicating with prescribers remains critical and won’t stop. As such, this is an important moment to examine pharmacists’ routine workload and identify ways to reduce inefficiencies and streamline work ahead of COVID-19 immunizations.

The continued adoption of the new National Council for Prescription Drug Programs (NCPDP) 

—specifically, its standardized language and expanded use of enhanced transactions, such as RxChange&mdash;can help reduce administrative burdens for pharmacists and increase patient safety.

The first NCPDP SCRIPT standard was introduced in 1997 and has become the backbone of nationwide electronic prescribing. It has been updated since then to ensure that information is presented in a standardized way for patient safety and proper medication dispensing.

The newest standard, which went into effect this year, includes standardized patients’ directions that support greater automation and reduces rework. The standard also expands the use of enhanced transactions, which lets pharmacies electronically request changes or clarifications to prescriptions, as well as request a prior authorization.

Wires can easily get crossed without standardized language. Patient directions are prone to quality issues due to prescribers’ wide variance in styles when using free-text. For example, “Take 1 tablet by mouth 2 times daily” can be written more than 

. And medication comes in various forms—tablets, pills, packages&mdash;so it can be difficult for a pharmacist to know what the prescriber intends.

A recent Minnesota Pharmacist Workforce Survey found similar issues. Practicing pharmacists identified patient directions as a leading factor of incorrect prescription data, interruptions to workflow and potential risk to patient safety.

These top issues included critical risks such as 2 different sets of patient directions, conflicting patient directions, and incorrect quantity prescribed compared with the written directions. This lack of explicit instruction can result, at best, in patient confusion and, at worst, in a patient taking the medication incorrectly—such as the wrong dose, frequency, etc.

Standardized language (also known as Structured and Codified Sig) helps patients avoid adverse health events and reduce the administrative burden for prescribers and pharmacies. It standardizes the way prescribers enter patient instructions; creates clear, accurate and fillable prescriptions; and minimizes disruptive phone calls for pharmacists and prescribers. This allows for clear directions and increased speed to therapy.

 that e-prescriptions with Structured and Codified Sig language take 10 seconds less to fill each time (a 33% time savings), allowing more time for patient care.

We are so fortunate that pharmacists have willingly and successfully stepped into the COVID-19 front-line role. With this expanded workload, pharmacists need robust technologies and standardization that allow them to spend more time with patients and less time on the phone with prescribers attempting to clarify instructions.

The codification of messages to a standardize Sig clarifies prescriber intent with clear and accurate directions, which reduces confusion and increase patient satisfaction and safety. Utilizing the tools available today can cut down on workflow interruptions, improve overall prescribing experiences for prescribers and pharmacists, and ultimately enhance patient care.

2019 Minnesota Pharmacist Workforce Survey

Articles

As administration of COVID-19 begins, pharmacies are preparing to vaccinate millions of people, not only once but twice.
 