Part 4 Flashcards
What is ACO stand for
Accountable Care Organization
What does and ACO do?
Group of physicians hospitals and other health care professionals who come together voluntarily to commit to provide high quality of coordinated care to Medicare patients
What is an ACO attempting to minimize
Excessive care and ultimately save money
3 main purposes of ACO
- Improve quality of care
- Improve cost effectiveness of care
- Improve total overall Care
What does IRB stand for
Institutional Review Board
What does the IRB review (amr)
Used to
1. Approve
2. Monitor
3. Review
BIOLOGICAL RESEARCH
What does the IRB protect
The rights and welfare of human research patients
What does the IRB review
Informed consents
Patient education
Proposed study
If doing an FDA regulated study, who does the IRB need to register with
Health and Human Services
What is expedited review in regard to the IRB
To approve and review minor changes in already approved research
Is informed consent needed when doing biomedical research on children
No, but they still usually get it from older children
An IRB should be composed of at least how many members
At least 5 with varying backgrounds
When selecting an IRB, what should be considered (5 things)
- Cannot contain only one profession
- Should be a mix of men and women
- Needs to have one member who works in scientific areas
- Needs one member who does not work in scientific areas
- Must have no conflicts of interest
What does someone who has a conflict of interest involved in drug research need to do
Need to disclose conflicts prior to involvement in research
Examples of personal health information phi
Information about
1 patients health
2 care provided
3 payment
What is MUE
Medication Use Evaluation
What does MUE analyze
- Prescribing
- Ordering
- Preparing
- Dispensing
- Administering
- Monitoring
POPDAM
What is MUE useful for
- Supporting and identifying ideal med therapy
- Preventing errors or adverse events
- Ensures best practices are followed
- Continuous improvement
- Standardization
- Identifying weaknesses
- Minimize cost
- Satisfying regulatory requirements
What is a Pharmacy and Therapeutics Committee (P and T)
A committee in an institution that is responsible for creating, editing, and managing a formulary
Who makes up a multidisciplinary p and t committee
Pharmacists
Physicians
Nurses
Admin
Advanced practice providers (NP and PA)
What does the DEA do
Enforces rules/laws on the use of controlled substances
Prevents/reduces
1. Drug smuggling
2. Drug abuse
3. Unauthorized use of controlled substances
Schedule 1
No acceptable medical use
Ie meth, LSD, Haroin, Marijuana
Schedule 2
Medical use but high potential for abuse
Schedule 3
Moderate to low potential for psychological and physical dependence
Schedule 4
Low potential for abuse and low risk of dependence
Benzos, tramadol, phenobarbital
Schedule 5
Lowest risk
Ie lomotil, pregabalin, robitussin ac
In the DEA number, what does the 1st letter represent
Kind of provide
Physician pharmacy manufacturer mid level practitioner
What is the 2nd letter in the DEA
1st letter of the providers last name
How to calculate DEA number
Add 1st, 3rd, and 5th
Then add the 2nd, 4th and 6th and multiply by 2
Then add step one and two together
The 7th number is the second number in the sum
Which other DEA may a provider use
The Hospital DEA number
(May contain additional number to indicate who prescribed a cs)
Military providers exempt from DEA registration
- Army
- Navy
- Air Force
- Marine corp
- Coast Guard
Exempt from DEA number requirement who are not military
- Public Health Service
- Bureau of Prisons
If no DEA number what must be stated
Type of service that they work under
Ie us army
Also need their service id number
What is the service id number for public health workers
It’s their ss#
What is acceptable transmission for electronic controlled substance prescriptions
Computer to computer
What is NOT acceptable transmission for electronic controlled substance prescriptions
Computer to fax
What is the process of faxing a controlled (not c2)
- Sign
- Fax
What are the 3 situations when you can fax a c2
- Hospice (needs to be noted on the fax)
- LTC/nursing homes
- Home infusion
(Not acceptable for home care unless patient is on hospice)
What may a prescriber do to get a c2 filled more quickly
They can fax it in for the pharmacy to get it ready, but it may not be dispensed until the hard copy is given to the pharmacy and it is verified that they are the same. Paper copy becomes the original
Who has to approve of the program that is being used to send the controlled electronically
DEA
What should the physician not do if they send a controlled electronically
They should not print a backup copy of the rx for the patient
(Printing for clinic record keeping is ok)
What should happen if the electronic controlled rx transmission fails
Office needs to document failed send
Time, date and pharmacy must be noted
If a pharmacy receives a controlled rx with a note that the escribe failed, what must they do
They need to do their due diligence to ensure that the e-rx was not filled
(Remember the Time Date and Pharmacy need to be on the rx replacement)
What needs to be in place in order to send electronic c2 rxs
Two factor credentialing
Ie password and fingerprint reader
How many days worth can multiple c2 rx be sent for
Up to a 90 day period
The DEA allows electronic records. What I for must be kept in the electronic record for a controlled substance (7 things)
- Rx #
- Written Date
- Name and ADDRESS of patient
- Name Address and DEA # of prescriber
- Drug info - drug, strength, dosage form, and qty (dispensed and remaining)
- Refills remaining
- Pharmacist who dispensed each fill
Federal law of how long to keep electronic DEA records
2 years - need to review if different per state
Requirements for a controlled prescription (8 things)
- Patient’s name, Address,
- practitioner’s full name, DEA number
- Drug Name
- Strength
- Dosage Form
- Qty
- Directions
- Refills (if appropriate)
- Date
Two requirements for prescriber to be able to write for controlleds
- Licensed within the State
- Registered with the DEA
Can provider write a controlled substance for research purposes?
No
Can a prescriber have a controlled delivered to them for dispensing to a patient
No
