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NeHII Pharmacy Stakeholder Use Cases

 

Today during training at one of the pharmacies, a beautiful thing happened.  Several use cases were readily identified by the NeHII users - a pharmacist and the tech that were accessing the VHR following training.  The NeHII users were able to secure necessary information to improve patient care, dispense medical supplies/medications and improve customer service through decreasing the turn around time for reimbursement processing.

Use Case 1:  The pharmacy tech had worked for 20 days without success to secure documentation from the prescribing physician on the need for a walker for this patient.  By using the VHR Report tab, the NeHII user was able to locate the chart note stating patient unable to ambulate without use of assisted devices which supported the dispensing of a walker.

Use Case 2:  The pharmacist/NeHII user needed documentation to support the use of diabetic test strips.  By using the VHR Report tab, user was able to secure Discharge Summary documentation which stated the discharge directions for regular and periodic blood sugar testing and supported dispensing diabetic test strips.

Use Case 3:  In the file documentation, the primary care provider was not known to the pharmacist.  The provider signature on the script was not legible.  By accessing the VHR report tab, the pharmacist/user was able to access a report which identified the primary care provider.  In addition, the pharmacy benefit manager (PBM) was not disclosed.  The user accessed the pharmacy query to determine the PBM.  This particular pharmacy was not a preferred provider, but the pharmacist secured information to assist him in managing the prescriptions dispensed with the care provider.

Use Case 4:  The pharmacy tech had been working for more than 6 months to determine if a patient's walker was reimbursable by Medicare.  To this point, they had not been able to get medical records verifying the medical necessity from the provider.  A query was made by the pharmacy tech to the VHR Report tab.  In the report tab, the discharge summary note had documentation by the discharging physician that the patient was able to walk around a city block.  Although the patient had other medical conditions, there was no documentation to support the walker.