Appropriate and Inappropriate Use of the 'Notes to Pharmacy' Field

Within the National Council for Prescription Drug Programs (NCPDP) SCRIPT v10.6 standard for e-prescribing, a custom note can be sent to the pharmacist/ pharmacy personnel using the Notes field. This field is designed to convey information to the pharmacist/ pharmacy personnel only and should not contain redundant or conflicting information that has already been entered in any of the other designated fields within your prescription writer software.

 The receipt of redundant or conflicting information in the Notes field can cause ambiguity and confusion that may result in pharmacy workflow disruptions, physician callbacks for clarification, and/or potential patient safety risks.

Inappropriate use of the Notes field includes information that already has a structured and codified field within the e-prescription message. The most concerning inappropriate use of this field is for patient directions, either supplemental or conflicting. This can lead to critical information not being conveyed to the patient.

Examples of inappropriate Notes content include:

 

The Notes field should only include information to the pharmacist that does not already have structured fields designated for such information, so long as it does not conflict with information sent in other structured fields.

Examples of Appropriate Notes content include:

Below are the Surescripts application certification requirements (ACR) that address appropriate use of the Notes field:On a New Rx, the notes going into the message shall*106R-134 be labelled as “Notes to Pharmacist” or something similar on the user screen.

It shall*106R-187 be clear that data passed in the 210 character Notes field will not be shared with the patient. Prescription information that has a designated, standardized data field within the NCPDP script standard shall*106R-175 not be entered into the “Notes to Pharmacist” field. Some Examples: SIG, Effective Date, Drug Name, Strength, or Quantity.

In order to optimize workflow efficiency and improve patient care and safety, please ensure your systems and end-users adopt and adhere to the guidelines explained above.

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