J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):e341-e348. doi: 10.1016/j.japh.2020.07.006. Epub 2020 Aug 3.
To describe the implementation of a centrally located certified pharmacy technician (CPhT) team to streamline the process of approving medication refills for chronic disease state management within a multisite physician network.
Primary care (PC) offices within a large physician network.
Incoming medication refill requests from patients and community pharmacies were typically received at each PC office and processed by medical assistants, nurses, or providers.
A centralized team of CPhTs managed medication refill requests for 9 PC offices. Standardized protocols for 14 drug classes were built into the electronic medical record (EMR) system. Incoming medication refills were shifted from PC offices to the centrally located CPhT team.
The implementation process was assessed through pharmacists' random audits and feedback from providers, office staff, and patients. Refill reports from January 2020 through March 2020 were obtained. Refill requests' characteristics were summarized and evaluated to determine the volume of refill requests, approved or denied requests, and requests requiring further PC staff analysis.
Changes to the protocol process and EMR documentation included modifying or removing laboratory test value parameters, adjusting "grace period" refill quantity on the basis of the scheduled office visit date, and expanding the CPhT role to include communicating with patients and pharmacies regarding denied refills. Data showed that the CPhT team processed 81.7% of all refill requests. This averaged 215 requests per CPhT per day. Of the refill requests approved, 22.5% passed the protocol for the maximum quantity and refills permitted, and 17.3% were granted grace supplies until office visit protocol criteria were met.
A CPhT team processed 81% of the medication refill requests for 9 PC offices with institution-approved EMR protocols and ambulatory pharmacist supervision. There were many barriers identified and addressed, but through continuous evaluation the workflow and protocol continue to improve.
描述一个位于中心位置的认证药剂师技术员（CPhT）团队的实施情况，以简化慢性病管理多站点医师网络中药物续方的审批流程。
大型医师网络内的基层医疗（PC）办公室。
患者和社区药房的药物续方请求通常会被各个 PC 办公室接收，并由医疗助理、护士或医生处理。
一个由 CPhT 组成的中央团队管理 9 个 PC 办公室的药物续方请求。14 个药物类别的标准化协议已被纳入电子病历（EMR）系统。传入的药物续方已从 PC 办公室转移到位于中心位置的 CPhT 团队。
通过药剂师的随机审核和来自医生、办公室工作人员和患者的反馈来评估实施过程。获取了 2020 年 1 月至 2020 年 3 月的补充报告。总结并评估了补充请求的特征，以确定补充请求的数量、批准或拒绝的请求以及需要进一步由 PC 工作人员分析的请求。
对协议流程和 EMR 文档的更改包括修改或删除实验室测试值参数，根据预约就诊日期调整“宽限期”的续方数量，并扩大 CPhT 的角色，包括与拒绝续方的患者和药房进行沟通。数据显示，CPhT 团队处理了所有补充请求的 81.7%。这相当于每个 CPhT 每天处理 215 个请求。批准的补充请求中，22.5%通过了协议规定的最大数量和允许的续方数量，17.3%获得了宽限供应，直到符合就诊协议标准。
在机构批准的 EMR 协议和门诊药师监督下，CPhT 团队处理了 9 个 PC 办公室 81%的药物续方请求。尽管存在许多障碍，但通过持续评估，工作流程和协议不断得到改进。
