Anatomy of a Great Prescription Renewal Protocol
To ensure efficiency, safety, and consistency, many healthcare organizations have protocols in place for various tasks that staff regularly encounter. Prescription renewal requests are one of those tasks. When built well, a prescription renewal protocol will tell the individual completing the request if the medication is safe to renew or not, and will identify if other care measures need to be addressed.
Unfortunately, many renewal protocols are missing key data elements or are too broad in scope to fully determine the safety and viability of the renewal. Thus, to avoid medication errors or unsafe prescribing, staff may ignore protocols entirely and revert back to individually handling each request. Not only does this render your protocols useless, but it takes up significant staff time to manually review each request. This contributes to inconsistency in practice across providers and clinics, as well as increased costs.
To get a comprehensive understanding of whether a renewal request meets all requirements, protocols should contain the following information:
Medication Rx Information
The requested medication and all of its attributes (e.g., strength, frequency, route, etc.) should be checked against the patient’s active medication list. Further, renewal requests are often sent to a clinic multiple times via automated pharmacy interfaces for exactly the same prescription. Renewals should be reviewed to ensure they are not a duplicate request of a recently completed or requested prescription.
Based on the type of medication being requested, regular office visits may be needed quarterly, yearly, or somewhere in between. The protocol should note the frequency so the staff completing the request can ensure patients are seeing their provider regularly as part of their health maintenance and disease management.
Monitoring criteria include all the related activities, other than visits, that can impact safety and compliance. Activities that may need to be reviewed in a patient’s chart include:
- Lab tests
- Vital signs
- Procedures or imaging
- Questionnaires or patient assessment tools
- Controlled substance agreements
- Health maintenance activities
It’s not enough to just note whether these items have been completed. A protocol should also include acceptable ranges for elements like labs and vitals, as well as how frequently they need to be performed. Protocol criteria should be medication specific, or at a minimum, medication class specific since different medications have different monitoring criteria.
If your organization delegates prescription renewal requests to non-provider staff, this should also be included in the protocol. Identify who is approved to process the request based on an organization’s workflows and state statutes. For example, often a nurse, pharmacy technician or other non-provider can approve renewals if all protocol criteria are met. Be sure to also note on the protocol when a provider needs to review the request, such as for controlled substances or in more complex patient scenarios.
If you’re struggling with creating comprehensive prescription renewal protocols, consider working with a vendor like healthfinch. Using the criteria listed above, our base protocol library contains over 250 evidence-based renewal protocols that cover almost 1,000 medications. And, we integrate them directly into your EMR so that protocols details are presented right in existing workflows. This saves providers and staff significant time, while also ensuring patients receive the recommended care and monitoring. Contact us for a demo!