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New law doesn't spell the end of paper prescriptions for nursing homes, vets or emergency rooms, says UB pharmacy law expert

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Wed, Mar 30th 2016 10:50 am

By the University at Buffalo

Despite the perception that medical prescriptions are now completely electronic in New York state, we haven't seen the last of paper prescriptions - or your doctor's bad handwriting - according to University at Buffalo pharmacy law expert Karl Fiebelkorn.

The new law, which became effective March 27, makes New York the first state to require and enforce that most prescriptions be created electronically and transmitted directly from a health-care provider to a patient's pharmacy of choice.

However, nursing homes, veterinarians and, in certain situations, emergency rooms, will find themselves exempted or waived from these new rules, said Fiebelkorn, MBA, senior associate dean for student, professional and community affairs in the UB School of Pharmacy and Pharmaceutical Sciences.

"Written prescriptions are not going away," he said. "Most of the prescriptions pharmacists will see will be electronic, but there's still going to be many instances where paper, verbal or fax prescriptions are needed."

The new laws were implemented to cut down on errors and to lower prescription drug abuse. By restricting patient access to prescriptions, the likelihood of a person filling multiple orders of medications with several doctors are slim to none.

"Imagine e-prescriptions being sealed and sent along an electronic pipeline; on one end is the physician and on the other is the pharmacy. No one else can access it," Fiebelkorn said.

An exception was made in the case of nursing homes, where nursing staff is responsible for managing and ordering patient medication, and both nurses and physicians need access to patient medical records.

Electronic systems with the ability to tie in nurses do exist, but they are expensive to set up and maintain. Many nursing homes are small and the new regulations place a burden on the homes to get an electronic health record system in place, Fiebelkorn said.

While many nursing homes will eventually meet the new standards, it may be a year or more before the systems are put in place, he noted.

Written prescriptions will also be allowed under specific medical emergencies, such as when a patient needs medication immediately and sending the prescription electronically would cause a delay.

For patients who visit an emergency room at a hospital or clinic, a care provider can bypass electronic prescribing if the prescription is for less than a five-day supply of medicine.

Other circumstances where written or phoned prescriptions are allowed include:

  • The health-care provider is a veterinarian.
  • The health-care provider practices outside of New York.
  • There is a power outage or technical failure with the electronic prescription.
  • The prescription is for a standing order or vaccination.
  • The prescription is for an opioid antagonist - such as naloxone, an antidote for opioid overdose.
  • The prescription is for a compounded substance - a mixture of several medications - that must be custom-made by a pharmacist.

As the medical community adjusts to the change, Fiebelkorn urged patients to show patience.

"We've got to give the doctors a break here," he said. "Many physicians are fiddling with the technology for the first time. It's no different than learning how to use a brand-new smartphone you've never had before. Things are not going to work magically overnight, and patients should expect some growing pains."

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