In 2017, PCC released the all-new PCC eRx. Since that time, PCC has rolled out dozens of updates, medication adjustments, and fixes to bugs that you helped us find.
Below is a log of the most prominent PCC eRx updates and fixes. In addition to the issues noted below, our PCC eRx partner (First DataBank) continues to optimize and improve their library of drugs, dosing statements, and pharmacies.
Recent and Upcoming Updates
Improved behavior with Prednisolone liquid: We have identified and resolved the issue where entering 5 or 10mLs into the per-dose field would inappropriately change the default strength from 15mg/5mL to either 5mg/5mL or 10mg/5mL. Changes included in this set of fixes now prevent this behavior from occurring. This change applies to all other liquid medications as well, as this issue was not specific to prednisolone. Selecting either the 20mg/5mL or 25mg/5mL strength will now ensure the per-dose Unit of Measure remains set to mLs and no longer prompts the user to “Choose Units”.
Rare cases of Inactive Medication Allergies incorrectly displaying as Active in PCC EHR: During a specific series of infrequent events, Medication Allergies that were successfully marked as Inactive or Resolved in PCC eRx may not have been properly updated back in PCC EHR. Changes have been made to prevent this issue going forward. The small number of patients affected by this bug were programmatically resynced to ensure proper Medication Allergy statuses are displayed in PCC EHR.
Additional 'PCC eRx is unavailable' Error Resolved: You may recall that we squashed a number of issues triggering the “PCC eRx is unavailable” message early in 2018 – we found one more! Certain workflow involving approving a Renewal Request from inside the patient-specific Rx Task queue, followed by an attempt to return to the individual’s eRx chart would result in a white screen including the “PCC eRx is unavailable” message. Changes have been made to prevent this error.
Preparation for eRx Code Transition: PCC’s eRx partner, FDB, has a significant software version transition coming soon. PCC is preparing our underlying infrastructure for this update, which will result in a variety of feature improvements in prescribing.
PCC will test all fixes and patches until we are satisfied that they improve performance and the user experience. We often announce updates on the PCC Newsfeed. For more information about PCC eRx, visit PCC’s library of PCC eRx training videos and documentation. We add new eRx videos and materials every month.
PCC’s eRx team continues to monitor and troubleshoot errors, large and small, and we will update this article to reflect the latest news. If you are experiencing any issues with PCC eRx, chat with your client advocate and let us know!
2018: Second Half
Improved Searching for Drug Lists and Dosing Statements: When a prescriber searches for a medication and then selects a dosing statement, the lists they see will now be based on your practice’s common prescriptions. You’ll find medications that you use more quickly, and you will no longer have to scroll through long lists of unwanted dosing statements. If at any time you wish to search the entire list, just click “Full Product Search”.
FDB Drug Database Update Including Methylphenidate: In June of 2018, FDB’s periodic drug database update included dramatic improvements to drug searching and dose selection for Methylphenidate. Each of the biphasic formulations of methylphenidate ER capsules (30-70, 40-60, 50-50) are now split out into separate options, and the Metadate CD suggestions will no longer include the incorrect biphasic 40-60 and 50-50 entries. Included with the update were additional clarifications regarding the biphasic preparations for both Ritalin LA and Aptensio XR entries.
Improve eRx Open Times: New data processing optimization, installed to all PCC clients in May 2018, improves PCC eRx opening times. Users may experience an improvement of up to 2-3 seconds, especially for complex charts.
2018: First Half
Optionally Display Indications on Printed Prescriptions: Your practice can now optionally configure indications to print on paper prescriptions. Contact your PCC Client Advocate to activate this feature.
When a Pharmacy Closes: When a patient’s preferred pharmacy became inactive, PCC eRx would display an error message, “PCC eRx is Unavailable: API Error Code 4020”. This prevented access to eRx for that patient. Now you will be able to access PCC eRx even when a patient’s preferred pharmacy no longer exists.
Albuterol Renewals Not Sending Electronically: Under certain circumstances and workflows, Albuterol AEPB Inhaler 90mcg/actuation prescriptions that were created from an existing entry in a patient’s history or with a Favorite could not be sent electronically. FDB has fixed this error. They are currently researching a submission problem with HFA inhalers.
Strength/Dose Form Now Required on All Prescriptions: Electronic prescriptions need to know the dose form of all medications in order to select the correct NDC. If you create or renew a prescription without a dose form, PCC eRx will now warn you with a pop-up message (“Medication is incomplete. Please select dose form.”) and highlight the appropriate field in red. This new requirement will fix confusion or errors with drug forms or dosing statements that don’t automatically select a default strength, such as Prednisolone.
Prednisolone Oral Solution Strength: With an upcoming PCC eRx patch, Prednisolone Oral Solution will have a default form of 15mg/5ml, and the default will also appear when creating an Instruction Only medication. This default, along with the overall requirement for a strength, will prevent prescribers from unintentionally sending a Prednisolone prescription without a strength.
Sodium Fluoride Chewable Tablets: A recent patch corrected multiple problems with Sodium Fluoride Chewable Tablets. Your practice can now create orders for 0.25mg (0.55mg of Sodium Fluoride) tablets, and 0.5mg (1.1mg of Sodium Fluoride) and 1mg (2.2mg of Sodium Fluoride) tablets can now successfully be sent electronically. The descriptions of the dosing statements for these medications has also been improved.
Ciprofloxacin Oral Suspension: The dose field labels for Ciprofloxacin now appear correctly and will be included in the prescription when it is sent to the pharmacy. This also fixes a problem with volume calculation for this drug.
DUR 070-03 Invalid Content Error: When adding a PRN reason to a prescription, the system automatically adds that reason as an indication. If there was no clear ICD-10 mapping, and the pharmacy used the EDIFACT format, PCC eRx would display an Invalid Content error. For example, prescribers may have seen this error when using an indication for an inhaler such as “cough/wheeze” or “shortness of breath or wheeze”, which do not have an ICD-10, and when they were sending the prescription to a smaller, local pharmacy. The error has been corrected and this no longer occurs.
'Currently Editing a Medication' Pop-up Error: When a weight-based dosing medication is renewed but there is no valid weight for the dosing calculation, PCC eRx needs to display the Prescription Edit window. This is not working properly. An upcoming patch will fix this issue. In the meantime, you can right-click and select “Reload PCC eRx” and rewrite the prescription.
Review & Sign Component Not Displaying Pharmacy for App-Approved Prescriptions: When you finalize a prescription with the Authy software token on your mobile device, the pharmacy may not appear correctly in the PCC eRx queue. The pharmacy information is safely captured and used, it just does not always appear in the Review & Sign component. An upcoming patch will correct this.
Update To Comply With Surescripts Single-Strength Rule: PCC eRx has been updated to comply with Surescripts requirements: A new prescription order can no longer include multiple strengths of the same drug in the same prescription.
Budesonide Strength Confusion: When renewing a Budesonide prescription from an old (DrFirst) prescription, options for strengths could appear in the Dose Form drop down that contradicted the strength listed in the medication description. A planned update will remove the dose strength from the drug description for these prescriptions, making it impossible to accidentally send contradictory strengths on a prescription renewal.
Renewing a Prescription from Hx Sometimes Did Not Display as Active: Under certain circumstances and for certain prescriptions that were part of short-term treatments, renewing a prescription from the history would not cause the medication to appear as active in the Medication Hx component. Instead, the new prescription appeared under the “Active & Inactive” option. After a patch this March, renewed medications of this type appear correctly with other active medications.
Unintentional Duplicate Prescriptions: Sometimes a prescriber creates multiple prescriptions for the same drug, spaced out over time or for other clinical purposes. Occasionally, when renewing prescriptions from the Prescription History, it was possible to create unintentional duplicates as well. This has been resolved in a recent patch.
Updating the Ordering Provider: Triage nurses, provider agents and other users reported having trouble changing the ordering provider on a prescription, and needing to change it multiple times for the change to take affect. A recent patch resolved this issue.
'Date To Fill' Improvements: When you create multiple, future prescriptions for a maintenance medication, you might adjust the “Date to Fill” field. Under certain circumstance, if you edited that field from the final Prescription Review screen, it could result in the updated date not saving or transmitting to the pharmacy. A recent patch fixes this problem.
Invalid Dose Range Safety Alert Warnings: For some medications, prescribers encountered inappropriate Dose-Range alerts. A recent update has corrected this for many medications. Please report to PCC if you encounter any illogical dose-range alerts so we can track them down and correct the dose database.
2017: November and December
Highlights from patches delivered at the end of 2017 include:
Improved Wording During Weight-Based Dosing: When a prescriber picks a weight-based dosing statement, the wording on the screen that shows the per-dose amounts is now clearer and easier to understand. This improvement was delivered in a recent patch to all clients.
Audit Records for Controlled Medications: Under certain circumstances, the audit logs for controlled medications did not indicate that a prescription was sent with 2-factor authentication. The prescriptions were sent correctly, but the logs did not record the correct details. This issue has been fixed with a recent patch to all clients.
Make PCC eRx Load Faster: Some prescribers experience a per-patient delay when they open PCC eRx for a patient. The result is that PCC eRx can take several seconds to load and impact performance. PCC has two fixes for this issue that we are testing in practice offices now.
Asynchronous Error When Adding PRN Reason: When you add a PRN reason to a duration-based dosing statement, it sometimes results in an “Asynchronous Error Has Occurred” message. PCC delivered a patch to fix this issue in December.
Support for new EPCS and Opiate Requirements in Ohio: In December, PCC and FDB updated PCC eRx to help Ohio practices comply with new requirements. For more information, read Meet Ohio Prescription Verification and Indication Requirements in PCC eRx.
Highlights from patches delivered in October 2017 include:
An Asynchronous Error Has Occurred: Users sometimes saw a pop-up error message with the text “An asynchronous error has occurred while processing your request.” This error did not impact prescriptions, but it definitely interrupted your day. PCC and FDB have developed fixes for two of the reasons this error occurred.
PCC eRx is Unavailable: Under certain circumstances, users could see a “PCC eRx is unavailable” message, and need to close and reopen a patient chart or PCC EHR to continue. This bug may also relate to problems with the Rx Queue. PCC and FDB developed a fix to this error and rolled it out to all practices.
Improved Rx Queue and Rx Queue Hx Query: For some practices, filtering the Rx Queue by provider was very slow, and performance and responsiveness for the Rx Queue Hx tool made it difficult to use. PCC and FDB redesigned the software queries to optimize performance. This may also help resolve the above two error messages.
2017: August and September
Highlights from patches delivered in August and September include:
Prescription Errors Could Cause a Backlog of Updates: If a prescription was unsuccessful for some reason, prescription information could stop synching back to the patient’s chart in PCC EHR. This will no longer happen.
Inaccurate 'Patient Record Modified By Another User' Message: Prescribers would occasionally see an error message in PCC eRx stating that, “Patient record has prescriptions that have been modified by another user. Click Ok to reload the page.” This message was appearing when it should not. This issue has been fixed.
Renewal Requests with Unspecified Quantity: Renewal requests for prescriptions marked PRN, or with a dispense quantity of “Unspecified”, could result in incomplete prescriptions in the Review and Sign component that can not be completed. This issue has been fixed.
The Sleepy Search: Repeating a Search for a Medication Appeared to Freeze: If a prescriber searched for a medication and then repeated the search, under certain circumstances the search would appear to hang or freeze, unless they typed a different search. This no longer occurs.
Improved Pharmacy Search Results: Some practices had problems searching for pharmacies, due to a set of missing zip codes. We have added the new zip code information to PCC eRx’s zip code library, which will improve pharmacy searching.
Norvelt Pharmacy Rejections: Under certain circumstances, a code error caused Norvelt (and possibly other pharmacies) to reject electronic prescriptions. This no longer occurs.
Duplicate Strengths When Renewing From History: When a user renewed a prescription from the patient’s Prescription Hx or Medication Hx, it was possible to click on options in such a way that the strength appeared twice in the prescription. This will no long occur.
Incorrect Dispense Quantity: For certain medication forms (such as inhalers, patches, and pumps), conversions between dosing forms could occasionally cause the wrong dispense quantity to be sent to pharmacies. This no longer occurs.
Highlights from the 7/10 and 8/1 PCC eRx patches include:
Improved Support For Imported Allergy Records: Under certain circumstances, allergy data from the prior eRx system (DrFirst) was not appearing correctly. In addition, due to DrFirst’s data format, manual updates to those allergies might not sync to PCC EHR. PCC fixed these problems and updated affected clients.
Printing EPCS Prescriptions in Ohio: For a brief period after a previous patch, EPCS prescriptions could not be printed in Ohio. This issue was resolved with a quick patch.
Renewal Requests and the SurescriptsRejectionValidationFailed Error: Some renewal requests from pharmacies could not be approved, accompanied by a “SurescriptsRejectionValidationFailed”. This issue has been fixed.
Pharmacy Name Missing from Review & Sign Component: Under certain circumstances, the pharmacy name was not available when hovering over a prescription in the Review and Sign component. Now it is.
Improved Rx Queue Refresh: PCC has improved how the Rx Queue counter and list refreshes.
Retail Rx Hx Results: Due to a mismatch in identifying a pediatric practice’s location NPI, Retail Rx histories sometimes showed very few results, particularly for Provider Agents and Clinical Staff. This has been corrected.
PCC eRx 'asynchronous error': When a laptop’s internet connection failed, users would sometimes see a “An asynchronous error has occurred while processing your request” message. This has been corrected.
Formulary Info Absent: PCC eRx has improved eligibility and formulary matching and will now display formulary information when available.
Dispense Quantity: Under certain circumstances, incorrect dispense quantity could appear on a prescription. This no longer occurs.
Prescription Component Update Improved: Under certain circumstances, a patient’s prescription component would not update immediately due to a logjam of interface requests. This no longer occurs.
Prescription Interface Restoring After Down Time: If a practice’s connection to the eRx service was interrupted for more than an hour, it could encounter problems dealing with the message backlog afterwards. This process now works better.
Improved Prescription Audit report: Under certain circumstances, the Rx Audit and Audit Log reports would fail to run. This no longer occurs.
Improved Pharmacy Searching: The pharmacy search field is now more responsive. The search field also now accepts unusual characters.
2017: May and June
Highlights from PCC eRx patches delivered in May and June include:
Faster: After the PCC 8.0 release, we tracked down many performance issues, including a “slow typing” effect and slow Rx Queue performance. We were able to improve PCC eRx performance without a full update.
Renewal Requests for Controlled Substances: Authorized prescribers can now approve or deny EPCS renewal requests. They will appear on your Rx Queue.
DNTF: The “Deny, New Request to Follow” feature for renewal requests now works as expected for electronic renewal requests on your Rx Queue. Note that DNTF does not yet work for EPCS renewals, so for now please deny and then create a new Rx instead for controlled substances.
Rx Queue History Update: When you review the Rx Queue history, you can now see more information. You’ll see details for denials or DNTF, including the patient, provider, action, and denial reason. You can also review the date a renewal request was made and responded to, and any notes to the pharmacy.
Patient Mismatch for Renewals: PCC eRx prompts you to find a patient whose name doesn’t quite match a renewal request. This process now works better and allows you to approve a pending refill prescription.
Better EPCS Token Validation: The EPCS ID-Proofing process was improved with better token ID validation.
Editing Finalized Prescriptions: It is now impossible to accidentally edit a prescription that has already been finalized and sent.
New Configuration Option for Discontinuing Medications: Your practice can decide whether you want to be prompted for the “reason for deleting” a medication, a message that appears when you delete a medication from a patient’s record. Contact your PCC Client Advocate for help with this option or other PCC eRx configuration options.
Support of Ohio Drug Reporting Requirements: Ohio pediatric practices can now generate a Daily Prescription Report from the RxQueue. They can use this report to meet Ohio’s 2-factor identification requirement.
Fix for eRx Allergies Migrated from DrFirst: If a patient had an allergy listed in the previous prescription system, and that allergy was updated or changed, under certain circumstances those changes would not appear on the patient’s Medical Summary screen. This no longer occurs.
Improved Support for Pharmacy-Initiated Renewal Requests: Under certain circumstances, it was not possible to approve a renewal request. PCC has improved how this function works.
Printing: PCC made numerous improvements to printed prescriptions between the 8.0 and 8.1 releases, including alignment and placement of practice name and margins.