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The pharmacy process

Pills for the ill

Tech. Sgt. Judith Berry, 5th Medical Support Squadron NCO in charge, scans a filled prescription at Minot Air Force Base, N.D., Nov. 17, 2017. The pharmacy provides medication for active duty military members, dependents, and veterans. (U.S. Air Force photo by Airman 1st Class Alyssa M. Akers)


Have you ever wondered what’s going on back there, behind the pharmacy counter? Wondered why a prescription may take longer than you wished for it to be ready? After all, how hard could it be to slap a label on a bottle or to count 30 pills? Let’s explore the journey your prescription takes between being processed and dispensed, efficiently and safely.

First, either your provider enters the prescription electronically or gives you a hardcopy to bring into the pharmacy. Upon receipt of the prescription, your arrival to the pharmacy window prompts the technicians to transcribe the prescriptions into the pharmacy software. This can take a bit of time for hardcopies, as providers are not known for their penmanship. First, a technician must review the prescriptions for completeness and accuracy prior to transcribing them. This is important because there are state and federal requirements governing the information needed for a prescription. There are some instances where a pharmacy staff member would need to call your provider’s office. One reason could be if it was supposed to be entered electronically, but the provider has not yet entered it or if the prescription was incomplete. The time taken to make sure that all prescription information is complete and accurate not only increases your wait time, but also other patients’ wait time. After transcription, the prescription is processed through Tricare and an analysis is performed identifying any potential medication interactions based on your medical history. The technician assesses and documents the interaction for the pharmacist to review. After all of the checks are done on the prescription, a label is generated. The label has a unique barcode that is specific to you and your medication and is used in the next step, the filling process.

During the filling process, a technician working the filling station pulls the label from the printer, then scans the barcode. This tells the system to pull up detailed information on the prescription. The technician performs a second check of the prescription, validating accuracy and that the information in the system is correct. If an error is identified, the technician rectifies it in the system and creates new labeling. If it is not a controlled medication, then they retrieve the manufacturer medication bottle from the shelf and scan the barcode. This confirms the right medication was selected. The technician then counts out the specified quantity, puts it in a prescription bottle, affixes the label neatly to the bottle and passes it to the pharmacist for final review.

If the medication is controlled, it must be filled with additional steps in the vault. The vault is a double locked area just like what you would expect to find in a bank. In this area, a perpetual inventory is maintained. Additional electronic systems are utilized with multifactor authentication with fingerprint analysis. Filling controlled medications requires two-person integrity to complete a double-count. After the double-count and review of the prescription, it is ready for final review from the pharmacist.

The pharmacist performs a 3-way verification; checking the prescription your provider wrote, the label typed at the window and the medication used by the filler. The pharmacist verifies the appropriate usage and dosing of medications to ensure that it is safe for you to take. If necessary, the Pharmacist may confer with your provider on any medication interactions, dosing, evidence based medication therapy and formulary requirements. If the pharmacist identifies something that needs to be rectified, it goes back through the process.

Once all of these steps are complete your prescription is ready for pickup. A familiar sight will be your name popping up on the screen alerting you to come to the pharmacy pick up window. At this point the pharmacy staff will perform a final verification to ensure you are receiving the correct medication. At this point, you have the opportunity to speak to the pharmacist or address any questions or concerns with the pharmacy staff as you sign for your medication.

At the Minot Air Force Base Pharmacy, we strive to not only provide safe medication therapy, but better patient satisfaction. Our average wait time is less than 20 minutes. If you are not able to wait for your prescription or don’t want to brave the winter weather, have it delivered to your door, through the Tricare Mail Order Pharmacy. We understand that your time is valuable and we’d like to hear what we can do better. The next time you are at the pharmacy, if you have any feedback for us, please fill out a brief survey!

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