Patient Safety/Risk Management Tips
In-Office Dispensing
As the first medical professional liability insurer to establish a patient safety department, The Doctors Company sets the industry standard with innovative tools that can help you reduce risk and keep your patients safe.
Because of pressure to increase revenue and patient satisfaction, the practice of dispensing prescriptions in-office is becoming more common. Done safely, an in-office dispensing system can be a win-win situation for patients and the practice.
In-office dispensing saves the patient time and increases convenience because there is no need to make another stop to pick up medications. Because many prescriptions remain unfilled, the physician can feel more confident that the patient will take the medication when dispensed during the office visit. An in-office dispensing system also reduces pharmacy call backs and provides additional revenue for the practice.
If you are considering in-office dispensing, the following tips can help you decrease your risk.
Be sure the system or vendor you select has certain essential capabilities.
If you have an electronic medical record system, be sure the in-office dispensing system interfaces with it.
- Choose a system that interfaces with your patient database and has the capability to check for allergies, interactions, and contraindications on the Web.
- Select a system that provides patient education information that is similar to the information sheets from a pharmacy.
- Be sure that the system provides patient information in a format and at a reading level that the majority of your patients can understand.
- Ensure the selected system produces a medication label that includes the patient’s name, physician and practice names, dosing information, and the name of the medication.
- Select a system that also offers insurance/billing interface and has bar code or similar technology.
Know your state laws regarding dispensing.
In-office dispensing is legal in most states; however, Arkansas, Massachusetts, Montana, New Hampshire, New Jersey, Texas, and Utah have certain prohibitions or severe restrictions.
- Proceed with caution in these states.
- Note that most states restrict in-office dispensing to the practice’s patients only.
- Know and follow the Board of Pharmacy regulations for your state, as many regulate who must actually hand the medication to the patient. Many states require that the physician “hand” the medication to the patient and that it is not given by staff or “left at the front desk” to be picked up.
Be aware of the potential risk issues.
- Do not dispense beyond your specialty.
- Be extremely reluctant to stock controlled substances, as this can raise multiple concerns—from placing the office at a higher risk for break-ins to increasing the possibility for employee theft or robbery.
- Recognize that in-office dispensing takes the pharmacist out of the loop and that it is often the pharmacist who alerts the physician to issues, such as multiple prescriptions of controlled substances from other providers.
- Make sure that medication education is provided to the patient at the time of dispensing.
We encourage physicians to discuss concerns about in-office dispensing with their Patient Safety/Risk Management representative. Please call us at (800) 421-2368, extension 1243, if we can assist you.
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By Susan Marr, MSA, CPHRM, Patient Safety/Risk Management Account Executive.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.