Why Do I Like Working In Pharmacy Again?

[Shalom]

When I worked in the chains (Chain of Very-large Stores, previously Aid of Rite) we could say that we were calling from a pharmacy about a prescription. That's as far as we went. If I ever got a machine, it would depend on what the recording said. If it said "You have reached the Johnsons, we're not in right now," I would say, "This is See Vee Ess Pharmacy calling for Mrs Johnson, please call us back regarding your prescription." However, if it was one of those generic machine voices saying Hello, we are not available right now, please leave a message, then I'd just say "This is See Vee Ess Pharmacy, please call us back at $NUMBER." Reason being, if their tape didn't give me a name, I'm not leaving one either, just in case it's the wrong number.

Regarding spouses, we were especially not permitted to discuss a person's meds with his/her spouse. This was because back before I started working for them, and even before HIPAA was passed, someone came in to one of their stores asking for their spouse's list of meds, which the pharmacist gave him unhesitatingly. Turns out they were in the middle of an acrimonious divorce, and the husband used the list against the wife in court. (I don't have the details. Maybe she was on psychotropics and he wanted to claim that she was an unfit mother because of that (Which is ridiculous: I have a cousin who is a perfectly fit mother as long as she takes her psychotropics, but when she stopped them because she wanted to breastfeed, watch out!) Maybe she'd taken certain antibiotics and he was claiming this was "evidence" she'd had an STD, something along those lines.) The wife promptly turned around and sued the Chain, who wound up paying out, and they then put policies and procedures in place to prevent this happening again. We can give anyone their own profile; we can give either parent their children's; but we can't give one spouse's profile to the other, we have to mail it to their house. Of course who knows who's gonna open that envelope once it gets there, but that's not our problem.

(Regarding corporate not understanding HIPAA: One time I got a call from the local jail wanting a copy of a prisoner's meds. I called the Privacy Office at corporate and they said that under no circumstances was I to fax over the list without a signed release from the patient, but I was allowed to discuss the meds over the phone. I relayed this to the medic at the jail. She said "So you can't fax them, but you can tell them to me and I write them down? Isn't that kind of stupid?" I said "You know, that's exactly what I said to them when they told me this, but that's what they want me to do and I don't want to get fired. Got a pen?")

(edit: one See Vee Ess that I worked in did stock some veterinary meds, like Frontline and the like. Never saw that at any other stores, but they all could order them if they wanted. Not all of the stores were aware of this either.)

[Whiskey]

(Regarding corporate not understanding HIPAA: One time I got a call from the local jail wanting a copy of a prisoner's meds. I called the Privacy Office at corporate and they said that under no circumstances was I to fax over the list without a signed release from the patient, but I was allowed to discuss the meds over the phone. I relayed this to the medic at the jail. She said "So you can't fax them, but you can tell them to me and I write them down? Isn't that kind of stupid?" I said "You know, that's exactly what I said to them when they told me this, but that's what they want me to do and I don't want to get fired. Got a pen?")

I hope that store got the shit sued out of it again. If they wanted a copy of his medicines, they should have contacted his doctor.

[trailerparkmedic]

I hope that store got the shit sued out of it again. If they wanted a copy of his medicines, they should have contacted his doctor.

Doctors aren't at the jail 24/7. Some small jails don't even have RNs 24/7. I'm under the impression that doctors only see patients in the jail VERY occasionally, and depending where you are, patients are more likely to be taken to the ER to see a doctor. Therefore, it is probably way more difficult for the medic at the jail to contact the doctor than to contact the pharmacy.

Besides, HIPAA pretty much states that any member of the healthcare team who needs the info should be able to get it. If you're my patient, I can get info on you from the pharamacy, your doctor, your previous nurse, etc. so I can take care of you.

[Sapphire Silk]

Doctors aren't at the jail 24/7. Some small jails don't even have RNs 24/7. I'm under the impression that doctors only see patients in the jail VERY occasionally, and depending where you are, patients are more likely to be taken to the ER to see a doctor. Therefore, it is probably way more difficult for the medic at the jail to contact the doctor than to contact the pharmacy.

Besides, HIPAA pretty much states that any member of the healthcare team who needs the info should be able to get it. If you're my patient, I can get info on you from the pharamacy, your doctor, your previous nurse, etc. so I can take care of you.

Almost all jails have a nurse at least part time, and a doctor that does sick call. Prisoners have a constitutional right to health care (I'm not going to get into the pros and cons of that lest this be banished to Fratching). CO's will get a list of meds from a prisoner, and then the doc figures out what the inmate needs to be taking. I used to work as a correctional nurse, and I have called pharmacies and doctors offices to confirm what medications inmates are taking because some inmates just don't know beyond "blood pressure pill."

HIPPA does allow health care providers to discuss protected information among themselves, which is probably why corporate thought it was OK for a pharmacist to verbally give information rather than fax it. However, the error in this thinking it that it is communication; verbal or faxed HIPPA affects all communication regarding patient information.

The corporate of that chain should simply require a HIPPA consent to release information and let the pharmacist fax the information over. That's what my local pharmacies required, and this was pre-HIPPA.

[RxBoy]

HIPAA does not prevent two healthcare professionals from sharing information about a patient if it is necessary to provide care for that patient. For example, a doctor who calls a pharmacy to get a list of meds currently being taken by someone they are treating would certainly be allowed to have that information. Of course, that doctor is then also required to follow HIPAA with regards to how he/she uses that information.

My chain had an incident several years back where a technician called a man's home about his prescription. His wife answered the phone and asked if it was in regards to a prescription. The technician proceeded to discuss the prescription with his wife. It turned out that she didn't know he was taking the medication and she was pretty angry to find out that he was. I don't need to go into details, but let's just say that he wasn't using the medication with her and the whole situation ended in a divorce. That might explain some of the reason my company is so scared about privacy of patients.

As far as medication profiles, we cannot release them to anyone other than the patient. The patient has to come to the counter and show ID. Otherwise we have to mail it to their house. If someone else happens to open it, that person has just committed a federal crime. If a parent or guardian requests a profile of their minor child, we are required by law in my state to remove certain types of medications from that profile before giving it to the parents.

The only way we can release info to a third party is if we have a court order or other legal document authorizing it. But whenever someone brings in something such as that, we are required to take it from them and forward it to our legal department. We then inform them that our legal department will contact them within two business days. Lots of times they don't like that, they expect their subpoenia or power of attorney will get them what they want then and there. But we have to let our legal department review everything first.

[jedimaster91]

What do you do in the case that you get an answering machine? Are you allowed to leave a message stating that you're calling from a pharmacy and you need the customer to call them back?

In this age of cell phones, sometimes you can get away with things if the person's voicemail greeting says their name. So you have a little more leeway if you get "This is John Doe, please leave a message" instead of "Can't answer my phone right now." I'm not sure where I heard this though, so use at your own risk.

You certainly know HIPPA better than I do, but I can't imagine how it would be a violation to tell somebody you're calling them from a pharmacy and their prescription is ready.

I would certainly think it would be a violation if you named the pharmaceuticals involved ("O hai Mr. Johnson, your boner pills are ready."). I think your employer is just being paranoid.

When it comes to HIPAA, you're definitely better off being overcompliant and paranoid than undercompliant and having to deal with HIPAA lawyers. *shudder*

I'm always paranoid about getting busted for a violation when I have elderly patients who can't hear thunder and I have to scream at them. There's no way other people can't hear me say "MR SMITH, HERE'S WHAT I'M GOING TO DO TODAY. CAN YOU VERIFY YOUR BIRTHDAY FOR ME?" All I need is for the compliance officer to walk by at the wrong time and be in a really pissy mood.

Also, your pharmacy fills animal prescriptions? We just get ours from the vet every month or so....

Depending on what it is, a vet might not stock it, or it might be cheaper to get it from a regular pharmacy. Not stuff like flea and tick and heartworm preventatives necessarily, but antibiotics like generic amoxicillin or something.

I had to go to a specialist pharmacy last year to get an antifungal for my cockatiel. The regular pharmacies carried it, but the suppliers wouldn't split a bottle to sell such a small amount. A bird weighing 3oz doesn't need a people-size bottle.

[RxBoy]

I've wondered that too about elderly people who have bad hearing. At what point does it become of a violation of HIPAA when I have to yell so loud into the phone that the customers three aisles over can hear me?

Another big problem is when patients can't speak English. We have a lot of that at my store. We will often bring an employee over from another department who speaks their language to translate. I don't know if that is a HIPAA violation, but if the person can't understand English there's nothing else we can do. Sometimes too when we call them at home a relative who speaks English will get on the phone. I don't think HIPAA explicitly states what to do in these situations. But we can't refuse to serve people who don't speak English so there's not much else we can do.

[Whiskey]

I would have the employee translating get explicit consent to translate the call before proceeding. That's what the census did if someone had to

[Grrrrrrr]

...We got it all set for her and did she thank us? Nope, she bitched about how long it took and threatened to start using another pharmacy. Please do, LOL.

If I live to be a hundred, I will never EVER understand why SC's think "I am never coming here again" is supposed to hurt my feelings and/or be a negative. O NOES! There goes my 25% commission!

[protege]

Hey guys, can we keep this to the post at hand? Some of the HIPPA stuff is in danger of going into Fratching-land. Thanks

[RxBoy]

If I live to be a hundred, I will never EVER understand why SC's think "I am never coming here again" is supposed to hurt my feelings and/or be a negative. O NOES! There goes my 25% commission!

Apparently they don't think that they are being jerks to us. To them the fact that every employee is either combative or doesn't want to wait on them is because the employees don't care. They obviously have no idea what it's like to work in retail if they truly think we care when they tell us they aren't going to shop at our store anymore.

[ExRetailDrone]

Apparently they don't think that they are being jerks to us. To them the fact that every employee is either combative or doesn't want to wait on them is because the employees don't care.

I also love it that if they always get such shitty service and bad attitudes no matter where they are, they don't stop and think that the common denominator in all of those experiences is them. But, that would take some logic, thinking, and the ability to admit they are wrong, none of which a typical SC possesses.