The Rouse Estate

Challenges: Inefficient Prescribing; Compliance with State Law

The Rouse Home, our skilled nursing facility, had PointClickCare® in place for a while, but we were not using it to its full capabilities. We still had many paper-based processes in place that no one knew how to streamline. Within PointClickCare itself, the were a lot of features that staff didn’t know existed.

After taking advantage of the online learning portal and becoming familiar with PointClickCare, I took a much more detailed look at the Integrated Medication Management (IMM) solution and found ePrescribing for Controlled Substances (EPCS).

EPCS is a special instance of ePrescribing that provides pharmacies, hospitals and practitioners a mechanism to use technology for controlled substance prescriptions. This replaces the paper, fax, email and phone processes for placing prescription orders.

Before, when our physicians came in every day, they were greeted with a huge stack of papers to address, many of them prescription requests for our skilled nursing facility patients. Prescription orders were entered into PointClickCare but our process was time-consuming and inefficient because we had to:

• Wait for physician to fill and sign paper order
• Fax order to pharmacy
• Follow-up with a call to pharmacy to confirm receipt
• Re-send fax if not received

The cumbersome, multi-step process increased the potential risk of missing or misplaced prescription orders, which might mean that residents could experience delays getting the medications they need.

In addition, there was another big benefit to adopting EPCS. In 2019, Pennsylvania passed a law that mandated that all Schedule II, III, IV and V controlled substances be prescribed electronically—no more paper prescription pads or faxes.

Solution: Implement ePrescribing and EPCS

I pitched the idea of implementing EPCS to our leadership team. Once they saw how the solution could improve our process—and ensure we were compliant with the new law—they were on board.

There are no added fees for EPCS since it is included with IMM. There is a one-time payment for professional services, and you don’t have to worry about it again. In the long run, that adds up to significant cost savings.

Training primarily consisted of showing our nurses how to enter the right order type on these controlled substances. Implementation was surprisingly easy, and I continued to monitor the controlled substances to verify that the orders entered the previous day were done correctly.

Outcomes: Compliance and Time Savings

Moving to EPCS has saved us time and improved workflows for doctors, nurses, and even pharmacists. During times of low census, we can average 20 to 25 prescriptions each day, which can include up to 5 controlled substances. We now save at least five minutes per prescription, which can equate to 125 minutes per day. This means that our use of EPCS has easily saved over 60 hours each month that our staff can use for patient care.

In addition to time savings, EPCS helped us achieve more benefits, including:

• Confidence that once the physician signs the prescription, the pharmacist sees it without checking faxes or deciphering handwriting due to the standardized format
• Automatic checks for medication conflicts and potential allergies, which adds an extra layer of safety for our patients

Thanks to EPCS, the Rouse and our providers are fully compliant with the Pennsylvania state mandate. I expect that a similar act will eventually be implemented on a federal level, and once it is, the stakes will be a lot higher. In the meantime, we don’t have to worry about signature forgeries for prescriptions or manual mistakes that could delay the delivery of medication.

Making the move to EPCS was necessary, not only to improve the workflow for nurses and physicians, but to move our organization forward on the path to modernization. Eliminating manual processes greatly reduces the risk of error and eliminates one more administrative task, allowing our staff to do the work they love most. By adopting PointClickCare’s solution, we’ve ensured our residents are as comfortable as they can be, thereby improving their quality of life.