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Medication Management

Source: Call 34 (3-3), Call 35 (3-18). Most detailed requirements from 3-18. Priority: Tier 2 — high patient impact, reduces office calls KB Requirement IDs: #116-#118, #143-#150 Depends on: Onboarding survey (opt-in mechanism)

The Problem (Bawa, 3-18)

Patients don't let the office know they're running low on pain medication until it's too late. Then it's a weekend, the pharmacy doesn't have it, there's no prior authorization, and the patient is in pain. E-prescribing requires being at a computer — can't do it from a phone or verbally. This creates avoidable crises.

Bawa: "Patients get frustrated... they don't let us know. They're low on their pain medicine until too late... then it's like the pharmacy doesn't have it or they didn't get a prior authorization."

Requirements (All Decided Unless Noted)

Opt-in medication monitoring (KB #116)

Bawa: "Would you like us to help you monitor your medications? Yes... if they want, they can use, if they don't, they don't have to."

Medication monitoring is entirely optional. Ask during onboarding or as a separate prompt.

Dosing timers and schedules (KB #117)

Bawa: "Integrate a timer with like a schedule... set up a timer for your Percocet for every six hours."

Support interval-based reminders. Patient sets timing. System sends reminders.

Patient-entered dosing details (KB #118)

Bawa: "You can input your dosing and everything into it."

Patients enter what they're taking, how much, how often. This feeds the tracking system.

Tablet count tracking (KB #143)

Bawa: "The app should be able to tell us... this person's already gone through like thirty tabs based off of what they logged."

Track consumption based on patient logging. Calculate remaining supply.

Proactive refill identification (KB #144)

Bawa: "We would already know... they're gonna run out on Sunday and it's Friday. And we should get this taken care of."

System identifies refill needs BEFORE the patient runs out. Especially critical before weekends.

24-48 hour refill notice (KB #145)

Bawa: "Please make sure you give us 24 to 48 hours notice... we don't need a phone call in the middle of the night for that."

System prompts patients to request refills with lead time. Prevents after-hours crises.

Bawa: "It can link them to like the medication sheet... here is a list of the post operative medications again just for your reference."

When patients ask medication questions that are already answered in post-op instructions, re-surface that content instead of generating new guidance.

Tell patients when refill is NOT needed (KB #147)

Bawa: "The answer to that is no... it says you only take this medication for one week."

System knows medication durations and tells patients when they don't need a refill.

Refill UX with supply estimate (KB #148)

Bawa: "You only have approximately ten tablets of Percocet left. Would you like for us to request a refill?"

Show estimated remaining supply and offer to request a refill proactively.

Lower dose trial prompt (KB #149 — Open)

Bawa: "Do you want to trial a lower dose?"

When nearing refill, optionally ask if patient wants to try a lower dose. Useful extension, not yet fully scoped.

What's Deferred

E-prescribing integration (KB #150 — Open)

Bawa: "It'd be amazing if you could integrate that... but I think that's gonna be really hard... that's probably the fourth or fifth iteration."

Full e-prescribing requires DEA two-factor verification, compliance, and computer access. Not near-term. For now, the system requests refills as office action items for staff to process manually.

From 3-3 Call

Blood thinner suppression

If patient answers "yes" to blood thinners in onboarding, suppress DVT prophylaxis / aspirin reminders. Already implemented.

Protocol frequency

Medication reminders should respect the general touch-reduction principle. Don't remind about the same medication multiple times a day unless the patient opted into that level of tracking.

Integration Points

→ Provider Dashboard

Refill needs surface as action items on the dashboard (KB #141, #142):

Bawa: "Someone needs a refill, they can put it in there and that can show up on the back end provider side."

Refill-related issues are office action items, NOT urgent patient escalations.

→ Onboarding Survey

Medication opt-in question feeds the medication tracking system. If patient says no, no tracking.

→ Triage

Driving clearance integrates with medication status (KB #133):

Bawa: "Hey, it looks like you're still taking the Percocet... can't be driving while you're on the pain medication."

→ Conversation Factory

Medication questions are among the most common repetitive calls (Lauryn, KB #119). Factory scenarios should cover: "Do I need a refill?", "Can I stop taking this?", "What's this medication for?"

Typical user scenarios

Scenario System behavior
Patient on day 6, 30 of 40 tabs used "You have approximately 10 tablets left. Would you like us to request a refill? Please allow 24-48 hours."
Patient asks "Do I need to refill my aspirin?" "Based on your protocol, aspirin is typically taken for one week. You don't need a refill." + link to med sheet
Friday, patient projected to run out Sunday Dashboard alert to staff: "Patient X projected to run out of Percocet by Sunday. Refill needed."
Patient on opioids asks about driving Triage references med tracking: "We see you took Percocet 3 times yesterday. We recommend waiting until you're off pain medication before driving."