Practice Fusion, Honestly?

Last Monday I received an email message from Practice Fusion informing me that electronic prescribing (eRx) would not work for awhile. Only after direct inquiry did they blame the problem on pending review by the state board of pharmacy. But the WA Board of Pharmacy’s story belies that of Practice Fusion:

Your practice is one of a limited number that are currently experiencing an issue affecting the ability to e-prescribe. You are still able to input prescription requests in your EHR and print the prescription, but you are not able to send it electronically.

To print a prescription:

  • Enter the eRx workflow as you would normally

  • Input your prescription request

  • Select the Print button at the bottom of the page

We apologize for the inconvenience to your practice. We’re currently working on a resolution and will provide you with updates to the issue via email.

When it still did not work two days later I attempted to find out from support when they might expect to restore functioning. With 19 ahead of me in Live Chat I tried “logging a ticket” (PF-speak for send an email form). Then I decided to see whether I could get a human by telephone. Surprisingly, I did get a human, but she knew nothing about the problem.

I received an email response consisting of a repeat of the message above.

The next day I received a slightly more enlightening message:

We're actively working to restore your practice's e-prescribing and would like to provide you with an update on our progress.

We'll be able to restore your ability to e-prescribe once the Board of Pharmacy for the State of Washington completes review of our e-prescribing system. This review is currently underway.

Practice Fusion's e-prescribing system was reviewed as a component of our Meaningful Use certification, and closely tracks Washington's substantive requirements.

Our team is working to expedite the review process and hope to have it completed in January. We'll continue to update you on our progress.

Sorry, PF, but that does not add up. First, I find it suspicious that we cannot use the “system” while the Board of Pharmacy conducts this review. Second, Meaningful Use has nothing to do with the State of Washington. Rather, the federal Medicare (CMS) program provides for rewards and penalties to encourage use of electronic records. I put in a call to the WA Board of Pharmacy. Ms. Roberts there tells me a very different story:

Thank you for your email.  WA State Pharmacy Commission requires that any electronic transmission of prescription system (sending or receiving) comply with our Chapter 246-870 WAC.  It is required that any electronic prescribing vendor seek pharmacy commission approval of their system prior to implementation in WA State.  This is required specifically in WAC 246-870-060.  Electronic prescribing systems are required to seek re-approval of their system every three years.  This it to ensure that prescribing systems are compliant with all prescription statutes and rules in WA State.

The intermediary network that connects prescribing systems has shut off electronic prescriptions from passing through their network when they realized PracticeFusion not only was not approved in WA State, but has never contacted the WA State Pharmacy Commission for approval prior to selling their system and initiating business in WA State.

I was contacted by PracticeFusion yesterday with a question regarding how they go about getting approval.  I explained to them that the pharmacy commission meets every 6 weeks.  They have passed the deadline for the January meeting and would need to submit all materials for review.  I told them the next commission meeting would be in March 2015.  At no point did they mention this issue to me.  They only submitted materials yesterday (Dec 18, 2014) which are now in a considerably long queue behind many other submissions for review.  I was not aware until I spoke to the intermediary network yesterday that PracticeFusion was already conducting business in Washington with no legal approval to do so.

I see the letter from PracticeFusion you forwarded.  PracticeFusion mentioned nothing to me regarding an expedited review.  PracticeFusion failed to mention to their clients in their letter that they engaged in electronic prescribing business in WA State with no legal authority to do so.  The review is not currently underway as they stated in their letter.  We only just received their materials yesterday.  The meaningful use certification has nothing to do with our approval process.  WA pharmacy commission is only interested in the electronic prescribing system meeting current WA requirements.

I can still order by telephone or fax, or hand patients in the office a printed prescription. I soon discovered, however, that my old fax number still appeared. I immediately updated it in Practice Fusion, but the old one still appeared. Another inquiry to Practice Fusion yielded an explanation: It will take a few days to update the record of my fax number with SureScripts, the eRx intermediary. Never mind that a printed prescription has nothing to do with SureScripts.

In how many other states does Practice Fusion operate without legal approval? Does the meaningful use excuse reflect ignorance, poor management, or deliberate deception? Does this debacle foretell the demise of the company? The big question remains: Can we trust a company like this with patient records?

Okay, Practice Fusion, do you want to come clean?


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