Surescripts inefficiencies?

If I share a database with another person, and I want to send a particular record to another person, I send them the primary key which might be say 40 chars if it's a UUID.

Surescripts maintains a database of prescribers and pharmacies which I presume everyone is supposed to use.  Yet, according to the XSD, if I want to send a script to a pharmacy, not only do I have to send their unique ID ( or primary key ), I have also send their address information etc, as well as the prescribers name, address, and contact information along with the prescriber's unique id.

Don't they trust that their system is working correctly or not to require all this redundant information??

So, counting characters, a simple script for Aspirin balloons out to over a 5000 character XML message.

 

gchiu:

Don't they trust that their system is working correctly or not to require all this redundant information??

If Surescripts does not find the pharmacy in their database, they will fax the script. That is why you need to send everything over, so they can reconstitute the prescription.

I don't know where they get the prescriber name though, because we receive renewal requests with different name for the same doctor (i.e. Richard Jones, Rick Jones, R. Jones, etc....) and they all have the same SPI.

Go figure.....

That accounts for the pharmacy .. but not the prescriber But perhaps they should not even display pharmacies that are not in network so that the physician can fax to those directly.  Or indicate that this is the case ...

If everyone goes e-prescribing, it seems to me that Surescripts will have a nationwide network that can be used to send secure physician to physician messages much as we have in NZ.

 

gchiu:

But perhaps they should not even display pharmacies that are not in network so that the physician can fax to those directly.  Or indicate that this is the case ..

They are not displaying pharmacies that are not on their network, but most ePrescribe software doesn't make the distinction and sends everything to Surescripts.

gchiu:

If everyone goes e-prescribing, it seems to me that Surescripts will have a nationwide network that can be used to send secure physician to physician messages much as we have in NZ.

I think that is the biggest advantage Surescripts has. They will have a ready to use network. If you think about it, so do the claim clearinghouses. I wonder who's going to monetize this incrredible treasure first.

My father has the best idea I have heard yet. Providers should not have to deal with this at all. We should be able to e-prescribe scripts to a central database/repository from which the pharmacies then pull the scripts. Patients can go anywhere they want. Pharmacies can call or if able inquire electronically. If done as envisioned, the advantage would be that providers could access the database to know what other providers have prescribed and eliminate the hassle factor for the prescriber.

This is the Australian model

http://www.erx.com.au/Demos/eRxInAction.aspx

A key is bar code printed on a paper script which the patient takes to the pharmacy.  The script is then downloaded from the Rx Script Exchange using that bar code key;

 

This allows a patient to take the RX to any pharmacy they choose.   Pharmacies prefer this method.

I wonder if the Rx Script Exchange is setup such that every pharmacy has access to the patient's entire medication history ?

 

I think one resonably look at e-prescribing as an example of the fact that not everything is better done electronically. Having a central repository of a patients medication history is one facet of their medical history. Seems to me we could print a scriptwith a bar scan that any pharmacy could use to effectively enter it into such a repository -- kinda like taking inventory.

I was thinking about doing this a couple of weeks ago .. printing out all my scripts using a barcode font and let the pharamacist scan it all in ...

 

elidan:

gchiu:

Don't they trust that their system is working correctly or not to require all this redundant information??

If Surescripts does not find the pharmacy in their database, they will fax the script. That is why you need to send everything over, so they can reconstitute the prescription.

As I progress thru their API, I find that this doesn't explain why these fields are needed for other messages eg RxFill, RefillRequest etc which are clearly originating from pharmacies in their network!

 

gchiu:

As I progress thru their API, I find that this doesn't explain why these fields are needed for other messages eg RxFill, RefillRequest etc which are clearly originating from pharmacies in their network!

Well.... if the pharmacy system is temporarily down or otherwise unavailable, they will still have to fax the script. If all the fields are already there in the message, they can just drop it to fax without having to do a match, wich may have legal implications if done incorrectly.

There are plenty of other interfaces where you have to pass seemingly redundant fields. For example, in a claim interface, if I send ICD9s or CPTs, why should I also have to send the description? Or if I send the insured ID why should I send the name? Same for the physician.... I guess, it helps with validation