Passive Verification: A Flawed System Putting Patients' Sight at Risk.

Objective: To assess the rate of erroneous or expired (invalid) contact lens prescriptions submitted for passive verification at two practice sites in Cleveland, OH. Methods: Passive verification facsimile (FAX) requests were collected from office staff at a county hospital (MetroHealth [MH]), and at a private ophthalmology group office (University Ophthalmology Associates [UOA]) in Cleveland, Ohio, from January 2013 to January 2018. Results: A total of 415 verification requests were evaluated (339 MH, 75 UOA), 28.2% (104 MH, 13 UOA) were expired, 11.8% (48 MH, one UOA) were not under the care of the doctor to whom the request was directed, 8.9% (32 MH, 5 UOA) were incorrect, and 3.9% (16 MH, 0 UOA) did not complete fitting. The total rate of invalid prescriptions was 52.8% (200 MH, 19 UOA). Conclusions: There is a high rate of invalid prescriptions presented for passive verification. Although the majority of prescriptions are simply expired, there is a fraction of prescriptions that contain incorrect specification of lens parameters or no record of prescription by that doctor. The current mechanism of passive verification, with the burden on the provider for denial within a short time window, makes it likely that such prescriptions would be filled, potentially putting patient comfort and safety at risk.