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Annual Prescription RenewalSave Time and Improve Medication Adherence

Learning Objectives:
At the end of this activity, you will be able to:
1. Summarize the process of synchronized prescription renewal;
2. Identify advantages of utilizing synchronized prescription renewal;
3. Describe the three key steps to effectively implement the synchronized prescription renewal process.
0.5 Credit CME
How will this module help me implement annual renewals?

  1. Describes strategies to simplify implementing a new annual prescription renewal process.

  2. Provides answers to questions that your staff may have about an annual prescription renewal process.

  3. Shares advice on what you may encounter when implementing annual prescription renewal.

Introduction
What is annual prescription renewal?

Annual prescription renewal is the process of renewing all of a patient's stable medications for the typical maximum duration of 12 to 15 months. This does not change the frequency of your patient's office visits.

How much time and money per year will an annual prescription renewal process save my practice?

Consider a hypothetical scenario of an internal medicine practice that has not implemented an annual prescription renewal process. This practice has 1,000 patients with chronic illness with an average of five medications per patient. Every year, each patient makes an average of two calls per prescription. Each call lasts about two minutes. These factors result in more than 300 hours of physician and staff time spent on prescription renewals per year.

Interactive Calculator: Annual Prescription Renewal

The calculators below will generate the estimated amount of time saved per year and the estimated annual savings that could be gained by implementing an annual prescription renewal process.

Interactive
Calculate time and money saved per year
Calculate time and money saved per year
Three STEPS to annual prescription renewals

  1. Quiz Ref IDAt a dedicated annual comprehensive care visit, renew all medications for chronic illness for the maximum duration allowed by state law.

  2. Include instructions for the pharmacy on all prescription modifications and renewals as applicable.

  3. Take the opportunity to renew all of the patient's prescriptions for chronic conditions when you receive a prescription renewal request.

Step 1 At a dedicated annual comprehensive care visit, renew all medications for chronic illness for the maximum duration allowed by state law.

The annual comprehensive care visit is a good time to renew all medications for chronic illness because during this visit the patient's medical history is thoroughly reviewed, including past and present conditions and medications. Quiz Ref IDDuring this visit all medications for chronic illness should be renewed for the maximum duration (12 to 15 months in most states). When a patient has received prescriptions for their chronic conditions for the upcoming year, they will not need to call the office for refills, and they will not have any unanticipated gaps in medication adherence.

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Step 2 Include instructions for the pharmacy on all prescription modifications and renewals as applicable.

A standard notification indicating that a medication is being discontinued or a new dose replaces a previous one can accompany the electronic prescription submitted to the pharmacy. This allows the pharmacy to update its list of the patient's current prescribed medications. This will also lessen the chances that the patient continues to fill both the old and the new prescriptions.

Quiz Ref IDAs a courtesy, we recommend alerting the pharmacy that the patient may not need to fill the renewed prescription right away to avoid dispensing the medication before the patient needs it.

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Step 3 Take the opportunity to renew all of the patient's prescriptions for chronic conditions when you receive a prescription renewal request.

During a busy workday it may be tempting to renew only the requested medication. However, renewing all prescriptions at the time of one medication request will reduce the subsequent number of calls for prescription refills, especially during the first year.

Quiz Ref IDThere is no need to calculate the number of refills necessary to last the patient until the next annual visit. It is easier to renew prescriptions for the maximum duration (i.e., 90 days and 4 refills). You should synchronize all of the prescriptions at the next annual comprehensive care visit, by renewing all for the maximum duration, whether or not there are refills remaining on the old prescription.

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Conclusion

Annual prescription renewal can help your practice function more efficiently and save time. To put this approach into action, use the step-by-step guide provided in this module and the corresponding implementation checklist.

Glossary

standing ordersstanding orders: A protocol-driven approach for providing care, such as established procedures for renewing prescriptions and ordering laboratory tests and health screenings. State laws and regulations may address to whom and what can be delegated by standing order.

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Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.5 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Successful completion of this CME activity, which includes participation in the activity and individual assessment of and feedback to the learner, enables the learner to earn up to 0.5 MOC points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn their required annual part II self-assessment credit in the American Board of Otolaryngology – Head and Neck Surgery’s Continuing Certification program (formerly known as MOC). It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of recognizing participation.

Successful completion of this CME activity, which includes participation in the activity and individual assessment of and feedback to the learner, enables the learner to earn up to 0.5 MOC points in Lifelong Learning (Part II) of the American Board of Pathology’s (ABPath) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABPath MOC credit.

Article Information

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this enduring material activity for a maximum of .50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Target Audience: This activity is designed to meet the educational needs of practicing physicians, practice administrators, and allied health professionals.

*Disclaimer: Individuals below who are marked with an asterisk contributed towards Version 1 of this learning activity.

Statement of Competency: This activity is designed to address the following ABMS/ACGME competencies: practice-based learning and improvement, interpersonal and communications skills, professionalism, systems-based practice, interdisciplinary teamwork, quality improvement and informatics.

Planning Committee:

  • Christine A. Sinsky, MD, FACP, Vice President, Professional Satisfaction, American Medical Association*

  • Marie Brown, MD, MACP, Senior Physician Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association & Associate Professor, Rush Medical College, Rush University Medical Center

  • Renee DuBois, MPH, Senior Practice Transformation Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Brittany Thele, MS, Program Administrator, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Julia McGannon, Segment Marketing Manager, Member Programs & CME Program Committee, American Medical Association

  • Kevin Heffernan, MA, CME Program Committee, American Medical Association*

  • Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Sam Reynolds, MBA, Director, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Rhoby Tio, MPPA, Senior Policy Analyst, Professional Satisfaction and Practice Sustainability, American Medical Association*

Content Reviewers:

  • J. James Rohack, MD, FACC, FACP, Senior Advisor and former President, American Medical Association

  • Renee DuBois, MPH, Senior Practice Transformation Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association

  • Brittany Thele, MS, Program Administrator, Professional Satisfaction and Practice Sustainability, American Medical Association

  • William Bush PA-C, MMS, Internal Medicine, Lawndale Christian Health Center*

  • James R. Deming, MD, Palliative Care Physician, Mayo Clinic Health System, Northwest Wisconsin Region*

  • Blair W. Fosburgh, MD, General Internist, Internal Medicine Associates, Massachusetts General Hospital*

  • Michael Glasstetter, Vice President, Advocacy Operations, Advocacy Planning & Management, American Medical Association*

  • Amy L. Haupert, MD, Family Medicine–OB, Allina Health, Cambridge Medical Center*

  • Thomas Healy, JD, Vice President and Deputy General Counsel, American Medical Association*

  • Jeffrey Panzer, MD, Medical Director, Oak Street Health*

  • Mary H. Parsons, MD, Medical Director, Redstone Health Center, University of Utah

  • Ramin Poursani, MD, Medical Director, Family Health Center Clinic, University of Texas Health Science Center at San Antonio*

  • Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Sam Reynolds, MBA, Director, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Rhoby Tio, MPPA, Senior Policy Analyst, Professional Satisfaction and Practice Sustainability, American Medical Association*

  • Michael M. Wall, MD, Family Physician, Decatur Memorial Hospital Medical Group*

  • Rachel Willard-Grace, MPH, Research Manager, Center for Excellence in Primary Care, Department of Family & Community Medicine, University of California-San Francisco*

About the Professional Satisfaction and Practice Sustainability Group: The AMA Professional Satisfaction and Practice Sustainability group has been tasked with developing and promoting innovative strategies that create sustainable practices. Leveraging findings from the 2013 AMA/RAND Health study, “Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy,” and other research sources, the group developed a series of practice transformation strategies. Each has the potential to reduce or eliminate inefficiency in broader office-based physician practices and improve health outcomes, increase operational productivity and reduce health care costs.

Disclosure statement: Unless noted, all individuals in control of content reported no relevant financial relationships.

ABMS MOC: Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Maintenance of Certification (“MOC”) Activities, this activity has met the requirements as an MOC Part II CME Activity. Please review the ABMS Continuing Certification Directory to see what ABMS Member Boards have accepted this activity.

Renewal Date: February 2, 2018; April 25, 2019

References
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Wieczner,  J. (2013).  The doctor won't take your call.  Marketwatch. Retrieved from http://www.marketwatch.com/story/the-doctor-wont-take-your-call-2013-07-16Google Scholar
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