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Prescriptions

– Prescriptions are sent to pharmacies electronically which is integrated into the telemedicine software using RXNT. On a new patient that has never been with us before, do not end your encounter until you click on the e-prescribe button (and select a mock medication), or the e-prescribe token will expire and you will have to create another admin-scheduled encounter to e-prescribe. IIf you were to create a manual profile in the e-prescription software, it will not be associated with a specific encounter and will not be reflected in the encounter summary (so try to avoid that).  

– Once a Rx has been sent for a particular patient, now even outside of an encounter you will be able to prescribe something for the patient (i.e. during follow up emails or if you were initially unable to reach the patient during the encounter.  

– The only controlled substance we prescribe is buprenorphine (+/-Suboxone), a schedule III controlled substance (and gabapentin, as in some states it is considered controlled). Never prescribe other controlled substances to QuickMD patients.  

– It’s good practice to look up a pharmacy information (in a different tab of the browser) while still in communication with the patient (in the later hours about a quarter of the time patients believe that a pharmacy is still open, when in fact it is not. This confusion comes from the fact that the store hours shown in the google results are often not the same as the pharmacy’s hours within the store). 

– if the patient did not provide the pharmacy name or you forgot to ask for it and the encounter is over, then go to the patient’s ‘Visit summary’ (Encounter history > click on ‘visit summary), or check their ‘Patient file’ (menu > patient records > search for the name > enter patient file) and look up their preferred pharmacy. If you cannot find it, call the patient’s phone number provided in the ‘Patient file’ 

– Remind the patient that many pharmacies may take up to 45 minutes to an hour to process the prescription, and at least an hour for Suboxone prescription.  

– Quantity: You can prescribe up to 90 days worth (no refills if 90 days are prescribed, but up to 2 refills 30 day-prescriptions). The exception is Suboxone (starting or restarting a patient on it the first prescription will be 1 week, after that on a monthly basis). If patients have been on Suboxone by a different prescriber and are staying at the same pharmacy, up to a one-month supply is appropriate. The other exception to the 90-day rule is gabapentin, for which the maximum is a 30 day supply with no refills. In Alabama, Kentucky, West Virginia, Virginia, Tennessee, and Michigan gabapentin is considered a controlled substance, so be mindful of that. 

– For new prescriptions: use your clinical judgement. Examples of medications that are higher risk and that should not be prescribed are. Example are abortion medications, fertility medications, unproven medications for COVID-19, Isotretinoin (Accutane), high risk biologicals, cancer medications–but of of course use your clinical judgment.  

REFILLS of regular medications for higher risk conditions (including heart medications like nitrates, beta blockers etc) is permissible if the patient has been on these medications before and if in your clinical judgment they are deemed safe for refill for that patient. 

Again, we NEVER prescribe controlled substances (that includes tramadol) with the exception of buprenorphine.  

– Other medications (some of which QuickMD advertises): Malaria prophylaxis (Malarone), essential tremor (propanolol), male enhancement (Sildenafil vs Tadalafil–know the contraindications), male-pattern hair loss (finasteride), Suboxone, smoking cessation (Wellbutrin), Permethrin, toe fungus (terbinafine), post-exposure prophylaxis (PEP) with Tenofovir disoproxil fumarate-emtricitabine (300/200 mg once daily) plus dolutegravir (50 mg once daily) or Tenofovir disoproxil fumarate-emtricitabine (300/200 mg once daily) plus raltegravir (400 mg twice daily). 

– To prescribe an oxygen concentrator you need to type in “oxygen”, click the “Favorites” radio-button, and then create the custom sig, and change to O2 flow rate to whatever you deem appropriate. On the pharmacy screen click the “No Pharmacy” button, and under “Print Options” click “Patient Original > Plain Paper”. Then save it onto your computer, and email or fax it to the supply store. If the patient was referred to us by the oxygenconcentratorstore.com (= AMSR = American Medical Sales and Rentals)  email the PDF to 18666511261@faxaway.com  (saved as oxygenconcentratorstore.com contact) which will fax it to their fax number (866-651-1261). Make sure to delete the footer and everything else in the email except the attachment of the prescription in PDF format.  

– The pharmacy has a toll-free number (800-799-6101)  they will call for issues with prescriptions, the pharmacists can select to connect to you, in that case it will ring on your phone. Note that the pharmacies do not have your actual direct number. When you receive a call, make every effort to pick up pharmacy calls, even during consultation, as it will take much longer to call back the pharmacy if you miss their call, and you might be on hold for minutes. Patient’s understand if you tell them that you need to take a call from the pharmacy real quick.

-no cancer drugs, no biologicals/immunomodulators, no immunosuppressants (other than corticosteroids), no injectable medication (other than insulin), no antibiotics for TB treatment, no initiation of HIV treatment (needs tons of labs etc–but PrEP ok and PEP okay)

  • Medications we cannot prescribe – https://quick.md/knowledge-base/medications-we-cannot-prescribe/
  • Medications we cannot prescribe – https://quick.md/knowledge-base/medications-we-cannot-prescribe/

r Restiffic prescriptions, please send to orders@mediusa.com

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