Electronic Health Records

Oregon looks to remove legal barriers to e-prescribing

State lawmakers in Oregon are planning to reintroduce a bill to allow electronic prescriptions of Schedule II drugs, which include Oxycontin and Adderall, making it easier for providers to send prescription information through their EHRs, keeping the data within the system and hopefully reducing medication errors and the potential for patients to commit fraud.

More than 30 states currently allow Schedule II drugs to be prescribed electronically, says Gary A. Schnabel, executive director of the Oregon Board of Pharmacy.  Medications including painkillers, opiates, stimulants, and anti-depressants are vulnerable to abuse by patients, who may try to forge or alter the paper orders in their hands, and are also dangerous when inaccurately prescribed due to confusion over smudged handwriting or incorrect data entry by the pharmacist.

Nationwide, e-prescribing rates are currently above 75%, according to a recent poll.  With e-prescribing, providers tend to have more information about medications on hand, which results in the prescription of lower-cost drugs for patients.  However, despite the decrease in costs and greater efficiency of e-prescribing, some experts don’t believe the process is as patient-friendly as it could be.

“E-prescribing as it stands today is the equivalent of a doctor writing an email to a pharmacist and the pharmacist not being able to respond, having to print the email, handwrite on it, and fax it back to the doctor,” says Zoe Barry, CEO of ZappRx, an e-prescribing platform being piloted in New York City. “There’s no visibility into patients picking up their medications. It’s incredibly difficult to communicate with the pharmacist.”

As Stage 2 of meaningful use approaches quickly, and puts the spotlight on engaging patients with their care, Barry believes that involving the consumer with their medications is an opportunity to get patients logging into portals and viewing their personal data on a regular basis.  Transmitting the prescription electronically may reduce the opportunity for fraud or abuse while still allowing patients to participate in the process.

That assumes that providers are allowed to electronically prescribe the medications they want to, and there is no organized resistance to the idea in Oregon, says Schnabel.  Every e-prescription would need to be authorized by two credentialed practitioners before being approved, and must be transmitted across certified EHR systems.  The bill is likely to be reintroduced into the State Legislature in February.

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