CONTACTS
SUBJECTS
VA Pharmacy Denial of Service Omeprazole Refill Order Fill Date Sche
3703 -
3703 - ..
3704 - Summary/Objective
3705 -
370501 - Follow up ref SDS A8 0000. ref SDS A7 0000.
370502 -
370503 - There is enough Omeprazole for 8 days at current prescription taking 2
370504 - pills per day, so need to order refill in time to avoid running out.
370505 - VA Pharmacy online refill system shows 3 refills for Omeprazole, 3 for
370506 - Atorvastatin and 1 for Ezetimibe. The system reports "Refill in
370507 - Process" with fill date of 140725 for Omeprazole. ref SDS 0 4O6H If
370508 - refill is mailed to customer on 140725, then it may be received OA
370509 - 140730. ref SDS 0 HX5O Since there is no evident procedure to update
370510 - the VA processing schedule to fill the prescription, will take 1 pill
370511 - per day until refill is received. ref SDS 0 IP6K
370512 -
370513 -
370514 -
370515 -
370516 -
370518 - ..
3706 -
3707 -
3708 - Background
3709 -
370901 - EGD on 101210, seems to show progress recovering from esophagitis; the
370902 - doctor dilated the LESV from 11 to 14 cm, reported on 101210 0930,
370903 - ref SDS 51 XG6J
370905 - ..
370906 - Follow up EGD planned for February, ref SDS 51 L94L.
370908 - ..
370909 - Doctor Lee prescribed doubling dose of Omeprazole to increse recover
370910 - from esophagitis, reported on 101210 0930. ref SDS 51 ZN4M
370912 - ..
370913 - On 101216 appears Doctor Lee ordered refill for omeprazole. ref SDS 53
370914 - 8785
370916 - ..
370917 - On 110320 0750 ordered refill Omeprazole to treat Achalasia,
370918 - ref SDS 60 5N3O,
370920 - ..
370921 - On 110626 0721 ordered refill Omeprazole to treat Achalasia.
370922 - ref SDS 64 5N3O
370924 - ..
370925 - On 110913 2238 ordered refill Omeprazole to treat Achalasia,
370926 - ref SDS 65 5N3O
370928 - ..
370929 - On 120326 1549 ordered refill Omeprazole to treat Achalasia,
370930 - ref SDS 73 5N3O
370932 - ..
370933 - On 120330 1439 received refill Omeprazole to treat Achalasia.
370934 - ref SDS 74 5N3O
370936 - ..
370937 - On 120906 1100 Doctor Egan reduced dose Omeprazole 20 mg from 40 mg,
370938 - which increased effective treatments with current prescription.
370939 - ref SDS 77 W165
370941 - ..
370942 - On 120925 1300 Doctor Lee increased dose Omeprazole 40 mg from 20 mg,
370943 - which decreases effective treatments under current prescription.
370944 - ref SDS 78 K37G
370946 - ..
370947 - On 120927 1214 could not order refill prescription for Omeprazole.
370948 - ref SDS 79 3Z4M
370950 - ..
370951 - On 121001 0820 VA ordered new prescription Omeprazole with 3 remaining
370952 - refills, ref SDS 81 5N3O, VA also ordered Fluconazole 200 mg, which is
370953 - not explained in the record, ref SDS 81 EO5H, and further which
370954 - increases side effects for Rosuvastatin, ref SDS 81 0450, but on plus
370955 - side Fluconazole resolves electrolytes abnormalites, in this case
370956 - Total Bilirubin is nearly 100% over healthy range, causing peripheral
370957 - neuropathy. ref SDS 81 ZH6J
370959 - ..
370960 - On 121003 1438 received in the mail Omeprazole with incorrect dose
370961 - prescription. ref SDS 82 5N3O
370963 - ..
370964 - On 121003 1438 received in the mail RX # 10864663B which conflicts
370965 - with RX #10864663A, ref SDS 81 5N3O and dose instructions to take 2
370966 - pills twice a day, ref SDS 81 MH65, conflict with the doctor's order
370967 - to take 1 pill twice per day.
370969 - ..
370970 - On 130416 1100 Doctor Lee reported the VA placed hold that prevented
370971 - patient from ordering any of 3 refills of Omeprazole; the doctor
370972 - cancelled the prior order and placed new order for current
370973 - prescription with 3 refills of Omeprazole. 130416 1100, ref SDS 84
370974 - RG9K
370976 - ..
370977 - On 130423 1140 received refill for Omeprazole. ref SDS 86 5N3O
370979 - ..
370980 - On 131115 0800 meeting Doctor Lee EGD Dilation, continued prescription
370981 - for Omeprazole to aid digestion. ref SDS 89 R74M
370983 - ..
370984 - On 131121 1604 ordered refill for Omeprazole. ref SDS 91 AG9I
370986 - ..
370987 - On 131205 1448 received prescription for Atorvastatin 20 MG,
370988 - ref SDS 94 5N3O, ordered by Doctor Alba during the meeting at the VA
370989 - on 131121 0930. ref SDS 90 6H6K
370991 - ..
370992 - On 131219 0930 Doctor Alba ordered Ezetimibe 10 mg to take with
370993 - Atorvastatin 10 mg, during meeting at VA. ref SDS 95 6H6K
370995 - ..
370996 - On 131230 1450 received Ezetimibe from VA to combine with
370997 - Atorvastatin. ref SDS 96 5N3O
370999 - ..
371000 - On 140127 1821 ordered refill Ezetimibe from VA. ref SDS 97 5N3O
371002 - ..
371003 - On 140201 1353 received refill Ezetimibe from VA.
371005 - ..
371006 - On 140226 2035 ordered refill Atorvastatin and Ezetimibe from VA.
371007 - ref SDS A0 5N3O
371009 - ..
371010 - On 140311 1730 received prescription refill for Atorvastatin and
371011 - Ezetimibe, delivered by neighbor because mailman delivered to the
371012 - wrong mailbox; treatment resumed. ref SDS A6 YS4O
371014 - ..
371015 - On 140401 0734 ordered refill Ezetimibe from VA. ref SDS A7 5N3O
371017 - ..
371018 - On 140404 1328 received refill for Ezetimibe, ref SDS A8 5N3O and for
371019 - Omeprazole. ref SDS A8 ZZ9M
371021 - ..
371022 - On 140715 1614 have 8 days supply of Omeprazole at current
371023 - prescription taking 2 pills per day, so need to order refill in time
371024 - to receive Omeprazole before running out of pills. Opened VA Pharmacy
371025 - online medication refill system. ref SDS 0 5N3O VA system shows 3
371026 - refills for Omeprazole, 3 for Atorvastatin and 1 for Ezetimibe. The
371027 - system reports "Refill in Process" with fill date of 140725 for
371028 - Omeprazole. ref SDS 0 4O6H If refill is mailed to customer on 140725,
371029 - then it may be received OA 140730. ref SDS 0 HX5O Since there is no
371030 - evident procedure to update the VA processing schedule to fill the
371031 - prescription, will take 1 pill per day until refill is received.
371032 - ref SDS 0 IP6K
371033 -
371034 -
371036 - ..
3711 -
3712 -
3713 - Progress
3714 -
3715 -
3716 -
371601 - Omeprazole Order Refill for Achalasia Blocked by VA Automated Ordering
371602 -
371603 - Follow up ref SDS A8 ZZ9M, ref SDS A7 G54N.
371604 -
371605 - Have 16 Omeprazole pills, from last refill on 140404 1328. ref SDS A8
371606 - ZZ9M That is enough for 8 days treatment taking 2 pills per day
371607 - prescribed by Doctor Lee in the meeting on 140509 0900. ref SDS A9
371608 - JG4K
371610 - ..
371611 - Plan to confirm prescription from Progress Notes, has been disrupted
371612 - by ROI Department delaying submission of Progress Notes for past 2
371613 - months for the meeting with Doctor Lee on 140509, that shows the
371614 - current prescription.
371616 - ..
371617 - VA prescription refill website is at...
371618 -
371619 - https://www.myhealth.va.gov/mhv-portal-web/anonymous.portal?_nfpb=true&_nfto=false&_pageLabel=mhvHome
371621 - ..
371622 - Customer....
371627 - ..
371628 - VA's pharmacy website listed today...
371629 -
371630 - Refill
371631 - Submit Fill Refills
371632 - Date Date Remaining Prescription
371634 - ..
371635 - Active 140620 3 RX # 5786152
371636 - Atorvastatin Calcium 20 MG
371638 - ..
371639 - Active 140521 1 RX # 5787670
371640 - Ezetimibe 10 MG
371642 - ..
371643 - Refill 140401 140725 3 RX # 24515139
371644 - in Omeprazole 20 MG
371645 - Process
371646 -
371648 - ..
371649 - Omeprazole showing 3 refills pending resolves issue reported on 140401
371650 - 1659, ref SDS A7 G54N, and aligns with planning during the meeting at
371651 - the VA in Sacramento of 140509. ref SDS A9 RG9K
371653 - ..
371654 - VA system reports prescription for Omeprazole is not scheduled to be
371655 - refilled until 140725, which is 10 days from now. This may indicate
371656 - the customer will receive the refill on that date or a few days later,
371657 - when delivered in the mail. Since no refill has been ordered, Refill
371658 - Status of "in Process" for Omeprazole may indicated the VA is
371659 - attempting to increase efficiency by automatically estimating when
371660 - refills are needed and execute processing without support of the
371661 - customer.
371662 -
371663 - [On 120101 0900 did not receive Omeprazole refill from VA.
371664 - ref SDS 70 T56H
371666 - ..
371667 - Automatic refill worked well last month on 140626, when Atorvastatin
371668 - was received in the mail on the day when supply on hand required
371669 - ordering refill in time to maintain continuity of treatment, reported
371670 - in letter to Doctor Alba.
371672 - ..
371673 - Need link to letter to Doctor Alba on VA automatic prescription refill
371674 - system.
371676 - ..
371677 - Denial of service to VA prescription refill system provides no evident
371678 - process to update scheduled prescription refill date of 140725.
371680 - ..
371681 - This is the third denial of service (DOS) that delays prescription
371682 - refills...
371683 -
371684 - 140715............................ ref SDS 0 HX5O
371685 - 130406............................ ref SDS 83 5N3O
371686 - 120927............................ ref SDS 79 YK6F
371688 - ..
371689 - Seems similar to denial of service (DOS) problems accessing Internet,
371690 - reported on 101031 1719, ref SDS 48 6D5H, and previously on 071127
371691 - 1509. ref SDS 6 X95H
371693 - ..
371694 - Customer currently has 8 days supply under the current prescription
371695 - for taking 2 pills per day, as understood during post-procedure
371696 - meeting with Doctor Lee on 140509 0900. ref SDS A9 JG4K
371698 - ..
371699 - If the refill is shipped in time for delivery on 140725, treatment
371700 - will be paused for 2 days.
371702 - ..
371703 - If the refill is shipped on 140725, which seems likely, and takes 3+
371704 - days for delivery in the mail, then treatment may be paused for 5+
371705 - days.
371707 - ..
371708 - There is no communication with the VA EGD Department in Sacramento to
371709 - reconcile adjustment to prescription taking 2 pills per day, so will
371710 - reduce treatment to 1 pill per day until new prescription refill is
371711 - received sometime after 140725.
371712 -
371713 - [On 140718 1017 planning for notifying VA to update current
371714 - fill date for Omeprazole. ref SDS B0 U88L Kathy visited VA
371715 - in Sacramento, and requested changing refill date for
371716 - Omeprazole to 140718. ref SDS B0 OL5K VA representative
371717 - called customer, and said Doctor Lee would call back later
371718 - that day to consider action on updating scheduled refill
371719 - date of Omeprazole to 140718. ref SDS B0 U76M
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