The UPS tracking system is beautiful. But the veteran can't use it without knowing the tracking number. Only the VA has the UPS tracking number for the medicine they mail to the veteran.

Why not allow the veteran to see the tracking number? When the veteran requests a refill by checking an empty box on, the refill is mailed out and the refill status is reduced by 1. The tracking number for that 1 fill sent out could be shown at the same time. The veteran and the VA would be looking at the same UPS tracking number that only UPS controls.

It would create accountability and protect against misunderstandings. It would protect the veteran against being made to appear as if he were receiving medicine when he is not receiving medicine:

"Dear Randi Schmeling,
I contacted Joe Rindone and he didn't know anything about the new INR monitoring plan you told me about,
ie., that he was supposed to monitor me. Please tell again me why I can't get monitored like any other
veteran living in Green Valley.
I have no refills remaining on 9 of my 11 medicines and 1 refill remaining on the other 2. Would you please refill them?
Thank you.
Anthony O'Connell 7637"
(April 10, 2013, veteran to provider)

"Pharmacy is still working on a plan as they do not want to monitor since you do not have a
phone. we are working on an alternate plan; for now Joe is monitoring. your meds are due
to be sent in june and not due for refills until sept.
(April 11, 2013, provider to veteran)

"1) your medicine is due for release; you can go to main VA since you do not have a phone get it.
2) For the last time-social work has addressed the advance directive issue. I do not have a copy-you can go to the Release of Information office at the main VA and they may have to it."
(May 7, 2013, provider to veteran)

"Mr. Oconnel
Your medication was sent out to you, you will receive it in the mail.
ANP Schmeling does not have your "will" she does not keep any patient records in her
office. Please refrain from continuing to ask her for this. You can contact the main facility at
(520)792-1450 if you have questions regarding your "will".
I am also asking that you use this service to ask general question only and if you need to
schedule an appointment to see ANP Schmeling you can call our clinic at (520)399-2291.
Thank you and have a good day
(May 8, 2013, fabian to veteran)

Progress Notes
This letter is to address your misuse of secure messaging. You have written the
same thing over 6 times and we have sent you the answer as many times. You MUST
stop doing this. Your medications are not being withheld, they are being sent
. We have told you how to contact Release of Information each time regarding
the coPy of your advanced directives as we do not have access to them. The MSA,
the soc1al worker, pharmacist and I have all responded to you numerous times.
If you do not stop misusing secure messaging, I will have to request from the
overseer of secure messaging contact you and if necessary suspend your secure
Randi Schmeling MS, RNP, ANP, BC"
(May 9, 2013, 13:34, provider to veteran)

"We have answered your questions many times-my MSA, the
, social worker and myself. We cannot continue to write the
same thing over and over. We do not have the time to keep repeating
ourselves as we have many other patients. We have answered your
medication issue; they were sent out. If you have not received them.
then you need to go to main va to the pharmacist since you do not have
a phone.
You are misusing the system because you keep writing the
same thing over even though we have answered your questions. and do
not use outlook again-it is not a secure site and I will not respond back in
(May 15, 2013, 13:34, provider to veteran)

"Mr. Oconnell
I addressed your medication issue yesterday is there something else going on. Your
medication was sent out from the main facility to you and should arrive shortly.

This clinic and ANP Schmeling does not hold any copies of patient records, if you would like
to receive your living will please contact release of information at the main facility at
I hope this has answered your questions about your medication and living will. We need to
get past this and assist you with the care you may need.
Thank you
(May 9, 2013, 3:41pm , fabian to veteran)

"I will not answer in Outlook as you should not be using it.
I refilled your meds but with just one refill as I will be retiring November 27. When you are
on your last refill, you will need to make an appointment with your new provider.
If you did not receive the medications that went out then you will need to drive to the main
VA and talk to pharmacy since you do not have a phone. They can trace them and provide
a refill if they were lost.

Regarding cardiology, you requested the referral since you were having chest pain.
Therefore they ordered a stress test and changed your cholesterol medication since your
cholesterol was not at the goal they wished. If you have any questions regarding any of
this, I suggest you drive to the main VA and make a followup appointment with cardiology to
diScuss since you do not have a phone and cannot call them.
To change your living will, make an appointment with the social worker to get a new one
with your current wishes on file."
(October 24, 2013, provider to veteran)