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    Saturday, July 15, 2006

    Shape of Things to Come: Ohio's State Board of Pharmacy has its watchful eyes on the evolving electronic medical record field. They are terrified that people will mass produce their own prescriptions and send them to the pharmacy via "electronic prescription transmission systems." So, they've taken upon themselves to decide what is and is not kosher when it comes to electronic medical records. But they go beyond just listing features that are required, they've gone the extra distance to "approve" what software can and can't be used to write a prescription that is sent to the pharmacy.

    Here is the State Board of Pharmacy's definition of an "electronic prescription transmission system":

    Electronic prescription transmission systems allow prescriptions to be sent elec­tronic­ally from a prescriber to a pharmacy. The pre­scriber can send the pre­scrip­tion dir­ectly from his/her computer to a pharmacy computer or fac­simile machine. Some of the systems are office-based, some are web-based, and some use a switching station to route the prescrip­tion to the pharmacy. The office-based systems allow the pre­scriber to send a prescription elec­tronically directly from his/her office to the phar­macy.

    Does that mean a fax machine has to be approved by the pharmacy board before it can be used to fax a prescription? Sure sounds like it, if it communicates in anyway with the computer generating the prescription. So, what if a physician has a printer that's also a fax. Would his software program have to be approved if he printed his prescription out on paper, then turned around and put the paper right back in the fax machine and manually faxed it? Or would it only have to be approved if he skipped the printing and manual entry of the fax number and just had the printer fax it instead? I may be wrong, but I read the rule to mean that you can not fax a printed prescription unless it was written on a typewriter.

    Computers are scary. Hackers can do all sorts of bad things with them, like creating their own prescriptions. These rules ostensibly make things more secure, but there is a much more commonly used method of electronic transmission of a prescription. It's used every day in every physician office, and even from physician homes and cars. Just about every patient has one, too, or at least easy access to one. It's been in use for over a hundred years. It's the telephone, and anyone can call any pharmacy and claim to be a doctor or a doctor's representative and give themselves a prescription for just about anything. There is absolutely no authentication at the point of use. They just take your word for it.

    But, oddly, there aren't any rules about telephones. Go figure.

    posted by Sydney on 7/15/2006 11:23:00 PM 0 comments


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