We have had a recent controversy at work. We have had e-prescribing for 3 years. Due to Alabama law, secondary to DEA regulation 1306.21a:
a) A pharmacist may dispense directly a controlled substance listed in Schedule III, IV, or V which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act, only pursuant to either a written prescription signed by a practitioner or a facsimile of a written, signed prescription transmitted by the practitioner or the practitioner’s agent to the pharmacy or pursuant to an oral prescription made by an individual practitioner and promptly reduced to writing by the pharmacist containing all information required in Sec. 1306.05, except for the signature of the practitioner.
Note that this regulation does not make provision for e-prescribing. We can have a clerk call in a prescription, but we apparently cannot transmit from a secure EHR a script of controlled substance.
I really do not understand this and wonder if other are aware of this problem Do the writers of the stimulus package know this? (Probably not, they did not have time to proof it or even understand it.)
Have other readers encountered this problem. We print out our controlled substances, have the physician sign them and then fax them. Does that make any sense?
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You cannot e-write controlled substances in NY State either.
Bohdan A. Oryshkevich, MD, MPH
Why not just have the EMR transmit a script with a jpeg of the prescriber’s signature? How would this be different from a facsimile, especially if sent over phone lines?
Amen to your rant! We experience the same thing. It is really insane that anybody on the street with a little knowledge could easily call in a prescription but it is not allowed via a secure e-script. We end up just printing the script as well.
We have the same problem in Michigan–it is presumably national as this comes from the DEA. From what I’ve heard they want a second level of security beyond the passwords to ensure that the person entering the password is really the doctor. They’ve talked about things such as the doctor having to actually plug something into the USB port which will identify them when signing onto the e-prescribing program.
Sure, it is possible that someone could get a doctor’s password and sign on to an e-prescribing program. While possible, that would be far more difficult than to get a doctor’s DEA number and call a pharmacy with a fake prescription over the telephone which would work with schedule III and IV but not schedule II drugs).
While more work than a fake phone call, people have also been known to take real prescriptions and use them as a template to make fake ones for whatever they want.
I sort of understand the DEA’s concerns about computer security, but it makes little sense to go this route when prescriptions sent electronically are far less likely to be faked than prescriptions sent in by other means.
IL can have faxed or e scribe rx on class IV and III
Class II emergency call in for hospice with faxed rx. written rx for all final rx on class II meaniing e prescribing is useless for class II meds. This includes many ADHD meds.
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