Friday, January 31, 2014

GADGET FRIDAY: A Smart Blood Pressure Monitor

Withings Smart Blood Pressure Monitor

The first blood pressure monitor for iphone, ipad and ipod touch

Measure your blood pressure in one gesture and all your tracking is automatically done

Detailed results are displayed and the application will provide recommended values, using the iphone display capacity at its best

Compatible with iPhone 5 using the Apple Lightning to 30-pin Adapter

Thursday, January 30, 2014

YOU Gave her Endocet, not Oxycodone!

A lady with her two daughters approaches the window with a bottle a medication.

"I'm here to exchange these. We were given the wrong medication."

I look at the bottle. It says "Endocet 5/325." I look up the Rx number on the computer and pull the hard copy. The hard copy says "Percocet 5/325." I wanted to make sure we didn't make a mistake. Mistakes seldom happen, but when they do it's because we're overwhelmingly busy and do not have proper technician coverage. Proper technician help is definitely a problem at Goofmart Pharmacy.

"I'm sorry, you can't 'exchange' medication. It looks like you were given the generic for Percocet and,"

She cuts me off, "Last time we were given Oxycodone! This time you gave my daughter Endocet. Endocet don't work" [sic].

I sigh. "Endocet is Oxycodone with Acetaminophen and a generic of Percocet."

The mother looks at me angrily. One daughter whispers something into the ear of the other daughter. I'm sure she's saying something about how handsome I am. Good looks like mine are rare.

Mom says, "Nuh uh. You gave us Endocet instead of Oxycodone. That's YOUR error!"

I go and get the bottle of Endocet off the shelf. I show the mom on her daughter's vial the NDC and show her how it matches to the bottle of Endocet in my hand. Then I show her how it says "Endocet" on the bottle and below that how it says, "Oxycodone and Acetaminophen 5/325."

I get a blank stare. Apparently I am unable to convince the jury.

"Well! All I know is my daughter is still in pain and it's because you gave her Endocet instead of Oxycodone!"

At this point I've had enough. "I didn't fill this prescription. You'll have to come back tomorrow and talk to Mickey the manager. I'm sorry."

She snags the bottle of meds out of my hand and says, "So my daughter has to suffer another night?"

"I'm sorry, there's nothing I can do for you."

Three angry ladies exit, stage left.

The technician on duty comes up to me. "You're going to love this, Crazy..." she says.

"Medicaid, isn't it?"

"Yep," she replies.

Wednesday, January 29, 2014

Hope had even more Hope

Last year I posted a story about Hope

Hope always has hope that her narcotic prescription will process early. And because I will not give in to her demands, she has made complaints about me to the Goofmart managers. One of the complaints is that I will not fill her narcotic prescriptions two days early even if it will process on her insurance. She thinks that just because it will process on her insurance that means it must be legal and ok. It's not ok with me.

Hope has made other complaints about me with some really outlandish claims. When the truth isn't good enough, why not spice it up a little bit with some exaggerations and outright lies, right? One of the complaints was that one day she asked me to refill a compound for her, which I did. I had it done within minutes and it was sitting by the register. I then went back to eat the rest of my sandwich. The technician wandered out of the pharmacy to help someone find something that was right in front of their face. Hope came up to the register and saw me sitting eating my lunch and assumed that I never bothered to make her compound, got mad, and left. Yep, that was her complaint... that I failed to refill her prescription. 

Management came to visit me about these complaints and despite my explanations for EVERY SINGLE ONE of the complaints, I'm assumed guilty SIMPLY because a complaint was made. So much for innoncent until proven guilty -- at Goofmart, you're guilty. If you receive a complaint, you're even MORE guilty.

And now the best part. Because of the way the schedule worked out, last week I was off four days in a row. On the day I was back, Hope saw me and stopped by the pharmacy with a truly unhappy look on her face. 

"I didn't see you for several days and I thought you might have been transferred or something..."

Yeah... "something" -- you were hoping I was fired, you nasty old woman.

No, Hope, I'm still here. You haven't convinced the managers to fire me yet. 

Game Over. Please insert another token.

Tuesday, January 28, 2014

Where's the Tums?

I'm getting older and I admit I have hearing loss. But this guy definitely said, "Where's the Tums?"

So I tell him they're behind where he's standing on the aisle on the left. He heads that way and I go back to my business of saving lives one person at a time. A few minutes later I look up and see him headed over to where my technician is standing.

She takes him out on the floor and down another aisle. I figure he asked her where something else is located. We get that a lot. People are completely helpless and can't find anything on their own. They probably lost every game of Hide and Seek as a child. It's sad when you think about it.

So the tech wanders back in and I asked, "What was he looking for this time?"

Tech: "Condoms. He said you sent him down the wrong aisle."

Me: "He asked for TUMS."

Tech: "I know. I heard him when he asked you."

ConDUMS... Tums... might sound alike, a little I guess, but both me and the 25 year old technician heard him say TUMS the first time.

Oh well. One thing I know for sure: Tums will not prevent pregnancy of the spread of STDs.

Monday, January 27, 2014

Stop the Madness!

Please ask your pharmacist if manufacturer coupons are right for you. Because they're a real pain in the ass and we're going to tell you NO.

FreshKote is an eye lubricant that is now available OTC. So Focus Laboratories says, hey, let's issue a coupon so that people can get the medication half off! But instead of a bar code to scan at the register, we'll just put in billing information with a BIN, group, and ID number so that the pharmacist has no way of getting reimbursed unless they have a prescription!

That's what happened with Mr. Dryeye a few days before the end of 2013. He raced in with this Manufacturer Coupon which allows him to save a whopping 50% off a bottle of the product and tells me, "One bottle, please."

I looked at the coupon. It has billing information like usual for a prescription, so I ask him for the prescription. He says his doctor refused to write one because it is over the counter now. (Why would a doctor refuse that? Maybe what Mr. Dryeye isn't telling me is that HE refuses to go back and see the doctor... you know, with those pesky office co-pays and all).

So then I look at the fine print so I can show Mr. Dryeye that he needs a prescription. And what does it say:

To Pharmacist: Submit a PRIMARY claim to PDM using BIN: 610020. This card is valid for prescription and over the counter use.

Nice, Focus Labs... tell the patient they can use this for the product when we can't use it.

Mr. Dryeye is now panicking because it's almost the end of the year and unless he gets his 50% off he's going to have to pay $17 more for a bottle of eye lube. Cry Havoc! Let slip the Dogs of War! Mr. Dryeye immediately dials up the 800 number on the coupon and starts in on whoever answered the phone, right there, at the register, in the middle of the store. He's not yelling but he's pretty loud and I know within moments he's going to try and hand me his cell phone.

Whoever he's talking to doesn't understand why there is a problem. Maybe at other pharmacies you can just enter BIN, group, and ID information at the register and get 50% off, but not at Goofmart or any pharmacy that I know of in the tri-state area.

He says, "I have the pharmacist right here... Sleazy. You want to talk to him? Ok?"


He hands me the phone and I immediately change it to speaker phone mode. HIPAA be damned! I tell the lady that I have no way to bill it because I don't have a prescription and I can't run it as a prescription without a prescription and if pigs could fly we'd have flying bacon sandwiches.

I hand the bacteria-laden phone back to Mr. Dryeye. I've become Howard Hughes but at least I don't spend the Christmas holidays whining about having a cold like some bloggers. Mr. Dryeye walks off still talking to the lady and the tech and I go back to work to try and make up for the lost time for this little misadventure.

Ten minutes later, Mr. Dryeye walks by the pharmacy and I hear him say, "Let me talk to your supervisor!" in a loud tone.

Twenty minutes later Mr. Dryeye walks by the pharmacy in the other direction. I can hear he's STILL talking to Focus Labs about this manufacturer coupon crap.

Thirty minutes later he's back at the register. "Well," he says, "They're going to extend the expiration date until the end of March and I'm going to have to get a prescription. Please order it for me."

I nod yes and click the order button on the computer.

I tell you, if $17 ever, ever becomes that important to me, please euthanize me. Please.

Saturday, January 25, 2014

Friday, January 24, 2014

GADGET FRIDAY: Scale with Cool Features

Withings WS-50 Scale will measure more than just your weight

Checking your weight is something we all do (especially around this time of year). Most scales will tell you a simple number, and leave you to your own devices past that. Seeing that there are now all sorts of fitness and health apps, gadgets, and gizmos, it seems only fair that bathroom scales pick up the pace.

The Withings WS-50 Scale will do far more than just tell you a number. This will tell you weight, BMI, and your body fat. It can store information for up to 8 different people, and can pair up with over 60 different apps, so you might be able to use one you’re already acquainted with. Of course, this isn’t all it can do.

Having fresh air in your living space can do a lot for your health, so this scale is constantly checking the the quality of the air you’re taking in. It will also tell you if you favor leaning on one side rather than the other, meaning you need to improve your posture. This is also capable of checking your resting heart rate, and can tell you if you’re doing any better over time. It does have Bluetooth and Wi-Fi capabilities, and will cost you around $150. This will work on Android or iOS, so no one should be left out (well, mostly everyone anyhow). This is a great first step in tracking your fitness improvements, and will hopefully make the process a little bit easier.

Thursday, January 23, 2014

What's Up with That?

Lady: "I'm here for my prescription. It was emailed over earlier today. My name is Ms. Lowque."

Me: "Yes, I have it here. I didn't have any insurance info on the computer for you but it is on our $4 list. It may not even be worth trying to run it on insurance."

Ms. Lowque: "I have insurance. Here's my card."

I begin putting in the information. Lines start forming at the drop off and pick up window. This makes most pharmacists nervous. I'm no exception.

I send off the claim. It comes back "PHARMACY MODEL NOT ACCEPTED."

Me: "Your insurance says you have to go to a specific pharmacy to use this insurance."

Ms. Lowque: "I know."

What?! She let me put in her insurance info while people are lining up for service knowing that it wasn't going to work anyway? What's up with that?

Seriously... I really, really worry about our species. The average IQ must be dropping dramatically all around the globe, or at least in my neighborhood.

Wednesday, January 22, 2014

Your birth date?

Lady: "I want to fill a prescription."

Me: "Ok, what is your birth date?"

Lady: "August 25, 1971."

Me: "Ok, I have no one with that birth date on my computer. I'll have to add you in..."

Lady: "Oh, it's not for me. It's for my husband..."

You have absolutely NO IDEA how often this happens.

Tuesday, January 21, 2014

Clarifying Expectations

A recent email from corporate:

"We were recently made aware that a few of our customers have been disappointed because the pharmacist on duty was not comfortable filling a prescription for a partial C2. We want to take a moment to clarify what our expectations are going forward so that we do not continue to disappoint our customers."

"The best way to prevent disappointment is to have the proper medication on hand. If you will follow the inventory policies once a week, the majority of your out of stock issues will go away."

So... on top of everything else, Quake-N-Zap, MTM, Flu shots, Zostavax, keeping the healthy rooms spotless, Loss Prevention, Transfers for coupons, and everything else in addition to just filling prescriptions... NOW our focus is not disappointing the customer?

Corporate, please listen up. You're out of control. Inventory management has become a nightmare now. Our new fancy computer logic system tells us to send off inventory we want to keep and packages arrive from other stores for things we didn't order nor do we need. We dispensed Zyvox ONE TIME in 2013 but the supply management algorithm told another store to send us a big box of the stuff. Thanks. How are we supposed to manage our inventory when you're managing it for us? Please explain that to me?

Nobody wants to disappoint the customer, but that's where this whole thing starts. YOU don't understand that our customers are PATIENTS and that changes the entire landscape on how they're handled. This isn't about not having a box of their favorite cereal or a shank of veal.

The law in this state is very clear on how C2s are to be handled with partials. There's no getting around that. Either get off our backs about the inventory and let us stock what we need without a computer telling us how to handle it OR expect some patients to be disappointed. That's just life.

While we're at it, let me tell you what disappoints me:

1. A company that values profit over patient safety. When YOU fart around with tech hours, you're messing with patient safety. That's a fact.

2. A company that is more concerned about someone seeing a chair in the pharmacy instead of a pharmacist or technician taking a break every now and then and not making an error.

3. A company that is more concerned about stupid things like Quake-N-Zap and expensive remodels than patient care.

4. A company that hires regional managers from other companies rather than promote from within.

5. A company that looks at any complaint as "valid" no matter what the complaint is about.

I can go on, but there isn't enough gigabytes to hold all my disappointments....

Monday, January 20, 2014

Fun with Insurance

Recently I had to call the insurance company for a patient.

Dealing with automation can be lots of fun:

"If this is a Medicare Part D member, please press 1. Otherwise, please press 2."

Me: "Representative."

"Ok, you want to talk to a representative. First, I need to get some information. Is this for a Medicare Part D member? Please answer 'yes or no.'"

Me: "Yes or no."

"I'm sorry, I didn't understand that. Are you trying to process a claim? Please answer 'yes or no'."

Me: "Yes or no."

"I'm sorry, let me transfer you to someone who can help. But before that, I need to get some information. Please say or type the ID number of the person you are calling about."

Me: "Six one one eight five seven one two three."

"Did you say, 'six one nine two seventeen one-hundred-eighty? Please answer yes or no.'"

Me: "Yes or no."

"I'm sorry, let's start over. If this is a Medicare Part D member, please press 1. Otherwise, please press 2."

Me: "May I please just talk to someone? I don't have time to fuss around with an automated system that doesn't understand a F----ing thing I'm saying, my patient is bleeding on the floor and my technician is busy doing Quake-N-Zap. Now let me talk to someone, NOW!"

"Please hold."

<pleasant music plays>

"Hello, this is Insanity Insurance, what is the nature of your call?" said by a human, finally....