Pharmacy Department Overview &
Prescription Regulations
House Staff Orientation 2015
University of Utah Hospitals and Clinics
Salt Lake City, UT
Overview
• University of Utah Hospitals & Clinics overview
• Department of Pharmacy Services overview
• Pharmacy patient care services
• Prescription Regulations
• Tips for your success
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University of Utah Hospitals & Clinics
• Four Hospitals:
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University Hospital
Huntsman Cancer Hospital
University Orthopedic Center
University Neuropsychiatric Institute
• Ten Community Health Centers
• Several Specialty Centers
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Moran Eye Center
Cardiovascular Center
Utah Diabetes Center
Clinical Neurosciences Center
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University of Utah Hospitals & Clinics
• Four Hospitals:
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University Hospital
Huntsman Cancer Hospital
University Orthopedic Center
University Neuropsychiatric Institute
• Ten Community Health Centers
• Several Specialty Centers
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Moran Eye Center
Cardiovascular Center
Utah Diabetes Center
Clinical Neurosciences Center
UUHC Pharmacy
Services are
prevalent in nearly
every UUHC
location. Do not
hesitate to ask for
help!
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UUHC Pharmacy Services
• Outpatient Pharmacy Services
– 14 retail pharmacies
• Discharge medication reconciliation and bedside prescription services
• Accepts most major prescription plans
• Competitive pricing
– $4 pricing on many commonly used medications
– https://pulse.utah.edu/site/dirc/Pages/4-dollar-drug-list.aspx
– Possible to fill for a 90 day supply
• Mail order available
• Accepts e-prescriptions, except C-II medications
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Patient Assistance Program
Thrombosis Consult Service
Pharmacists in specialty clinics
Medication therapy management (MTM) in many locations
Medicare Part D enrollment assistance
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UUHC Pharmacy Services
• Infusion Pharmacy Services
– Three ambulatory infusion centers throughout the valley that provide
services 7 days a week
• University Hospital
• South Jordan
• Huntsman (primarily oncology infusions)
– University Home Infusion Pharmacy
• Focuses on home intravenous therapy on patients discharged from UUHC
facilities
– Total parenteral nutrition
– Anti-infective agents
• Service provides comprehensive insurance reviews and works with
medical team to determine most appropriate medication based on
vascular access
• Service available 24/7: 801-587-8600
UUHC Pharmacy Services
• Inpatient Pharmacy Services
– Centralized operations: 24/7
• Drug distribution
• Medication preparation
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UUHC Pharmacy Services
• Inpatient Pharmacy Services (continued)
– Decentralized clinical services on nearly all inpatient units
7 days a week, generally from 0700-1500 (some areas have
staff until 2300)
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Pharmacist rounding and consults
Drug information
Formulary recommendations
Medication monitoring
Medication policy guidance
Epic navigation assistance
Home medication reconciliation
Medication Reconciliation
Pharmacy staff will review within 24 hours of admission
Prescription Regulations
• First year residents (unlicensed)
– Permitted to write for inpatients of affiliated hospitals:
includes controlled and non-controlled substances
– No outpatient prescription writing permitted
• Second year residents and older (licensed, DEA and
NPI)
– Permitted to write for controlled and non-controlled
substances for both inpatients and outpatients
– Prescriptions can be filled in any Utah pharmacy
Prescription Requirements
• Prescriber’s name, address, telephone, NPI
• Patient’s name and address
• Name of medication, strength, dose, quantity, route and
directions for use
• Prescriber’s signature, printed prescriber’s name, contact
number
• Date prescription written
• # of refills
• ****For controlled substances*****
– Patient’s date of birth
– Prescriber’s DEA
• ****Remember, C-II’s have to be written and cannot be
processed electronically
Other Relevant Rules
• Providers MAY NOT write controlled substance
prescriptions for personal use or for family members
• Medicaid patients:
– Providers must be registered as a “limited provider”
– If not registered, an attending who is registered must sign
the prescription
– GME Office handles this process
• Medicare patients:
– Providers must be registered for Provider Enrollment,
Chain and Ownership System (PECOS)
– GME Office handles this process
Tips for Your Success
• Know your pharmacist – some is there to help you all hours of
the day
• Use Epic – tips
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Order sets
Understand phase of care (tip sheets)
Limit use of comment fields
Watch for therapeutic duplication
All PRN orders must have specific instructions (mild, moderate, severe
pain) and you may not have 2 meds ordered with the same indication.
– Preference list has formulary status
• Medication reconciliation of home medications
– If possible, wait for the pharmacist to complete the medication
reconciliation
– DO NOT just reorder medications from the clinic list!
Tips for Your Success
• Know the on-line tools
– On-line formulary
– Pharmacy & Therapeutics Committee approved guidelines,
restrictions, and policies
• Therapeutic interchanges
• IV to PO policy
• Restricted medication policy
– https://pulse.utah.edu/policies/Lists/Policies/DispForm.aspx?ID=2313
– Medications that require medical director approval (Smartweb – Medical
Director)
» Outpatient only list
» Factor VII (NovoSeven® RT)
» Immune Globulin (IVIG)
» Other high cost or high impact medications (REMS)
– Restricted anti-infectives (Smartweb – Stewardship or ID Pharmacist)
» Caspofungin (Cancidas®)
» Daptomycin (Cubicin®)
» Linezolid (Zyvox®)
Tips for Your Success
• Know the on-line tools (continued)
– Restricted medication policy
• https://pulse.utah.edu/policies/Lists/Policies/DispForm.aspx?ID=2313
• Medications that require medical director approval (Smartweb – Medical
Director)
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Outpatient only list
Factor VII (NovoSeven® RT)
Immune Globulin (IVIG)
Bivalirudin (Angiomax®)
Dofetilide (Tykosyn®)
Inhaled nitric oxide (INOmax®)
Dalteparin (Fragmin®)
Other high cost or high impact medications (REMS)
• Restricted anti-infectives (Smartweb – Stewardship or ID Pharmacist)
– Caspofungin (Cancidas®)
– Daptomycin (Cubicin®)
– Linezolid (Zyvox®)
Tips for Your Success
• Use Pulse for assistance – there is a wealth of information on
the internal website to assist with your prescribing questions
• Let us help with the discharge process
– Call us early and if possible, engage us days in advance of discharge
– Many medications require prior authorization
– We want to ensure that the patient has access to the medication and
will obtain it upon discharge
• Ask us for help!
– Pharmacists should be available in most patient care areas or via
Smartweb
– If you need help off-hours, call the University Hospital Central
Pharmacy at 801-585-2330