Pharmacy
Frequently Asked Questions
Electronic Transmittal of Prescriptions in New York State
Electronic Transmittal of Prescriptions |
Pharmacist/Pharmacy Requirements | Controlled
Substances | Further Information
Electronic Transmittal of Prescriptions
- What is an electronically transmitted prescription?
Answer: An electronically transmitted prescription is created, transmitted, recorded AND stored by electronic means such as facsimile or computer systems.
- Are there any special requirements when transmitting
prescriptions electronically?
Answer: YES. Prescribers and pharmacists must have a secure (encrypted or encoded) system for electronic transmission from computer to computer. Any equipment used for electronic transmission of prescriptions should be so located to ensure the security and confidentiality of the transmission. Procedures for electronic transmission of prescriptions should be documented. Electronically transmitted prescriptions must:
- Contain the prescriber's signature or the electronic equivalent
- Be protected from unauthorized access, alteration or use
- Have the initials of the pharmacist or pharmacy intern entered into the pharmacy's records to indicate acceptance of the prescription by the pharmacy.
The information retained electronically should be capable of being reconstructed in the event of a computer malfunction or accident resulting in the destruction of data.
Other electronic transfer requirements are outlined in the following questions and answers.
- When can a pharmacy accept a prescription that contains an electronic signature and an electronic DAW?
Answer: Only when a prescription is electronically-generated AND electronically transmitted by the prescriber from the prescriber's computer or PDA to the computer or fax machine of the pharmacy of the patient's choice.
- Can an agent or employee of the prescriber electronically create and electronically transmit an electronic prescription to the pharmacy?
Answer: No. - Can a pharmacy accept an electronically-generated prescription that contains an electronic signature and/or electronic DAW that is printed as a hard copy prescription at the prescriber's office and faxed to the pharmacy or handed to the patient?
Answer: No. Education Law 6810 requires the prescriber to sign and add DAW in his/her own handwriting. - Are pharmacists/prescribers obligated to transmit
prescriptions electronically?
Answer: NO. Electronic transmission of prescriptions is an option. Prescribers and pharmacists do not have to transmit prescriptions electronically.
- Can a prescriber direct prescriptions to a particular
pharmacy?
Answer: NO. Patients have the right to choose the pharmacy where they wish to have their prescription filled. Practitioners who exert undue influence on a patient (known as steering) to have a prescription filled at any one pharmacy over another whether electronically transmitted or via a written or oral prescription are subject to charges of professional misconduct.
Pharmacist/Pharmacy Requirements
- Is a pharmacist responsible for determining the authenticity
of a prescription transmitted electronically?
Answer: YES. Pharmacists are responsible for assuring the validity of all written, oral and electronically transmitted prescriptions. There are a number of ways to do this, such as using new software programs that require passwords, personal identification numbers (PINs) or other authentication of the prescriber. These programs also notify the pharmacist if an encrypted or encoded electronic message or "envelope" has been tampered with or altered. Prescribers and pharmacists must use compatible programs.
Prescriptions transmitted by facsimile also require careful attention. For faxed prescriptions, we suggest that pharmacists apply strategies similar to those now used to verify oral and written prescriptions received when authenticity is not apparent. The best professional judgment of the pharmacist is the key to a safe and effective process. The steps used to verify phoned prescriptions may also be useful for faxed prescriptions. These steps may include:
- Calling the prescriber's office to verify a prescription if the prescriber is not known to the pharmacist;
- Accepting a phoned in prescription in lieu of the faxed or computer transmitted prescription;
- Asking for proof of identity if the person picking up the prescription is not known to the pharmacist;
- Asking prescribers in the area to use an identifier on the faxed prescription form that indicates recopying or retransmittal. Such marks are commonly used to indicate if that document has been copied from an original;
- Ensuring that the prescribed drug, based on quantity, directions for use, etc., is consistent with the patient's medication profile;
- Using other methods such as installing "Caller ID" on the phone line that is used to receive fax prescriptions;
- Considering whether the prescribed drug is one with an abuse potential or otherwise has "street value."
Without special safeguards, E-mail transmissions do not independently assure the required confidentiality of patient records and do not, therefore, meet the definition of an electronically transmitted prescription in the new rules and regulations. If a pharmacist has reason to question the authenticity of the electronically transmitted prescription, the pharmacist's professional judgment must prevail. If verification is not possible, the pharmacist can choose not to accept the electronically transmitted prescription and can request transmission by another means from the prescriber.
- Is a pharmacy required to print and maintain a hard copy of
an electronically transmitted prescription?
Answer: No. Pursuant to recently approved regulations a hard copy is not required to be maintained as long as the electronic message is securely maintained. The same applies to refills. Similar to other records, the electronic records must be maintained for five (5) years and must be reproducible and provided to the Department upon demand. Likewise, facsimile copies must be maintained in a readable fashion for five (5) years.
- What should a pharmacist do if he or she believes that
dispensing a prescription will cause harm to the patient?
Answer:All pharmacies, including those providing prescriptions through a mail order service, are required to maintain a medication profile for each patient and to check for adverse drug reactions. Each licensee must practice according to his or her best professional judgment and the law. If there are concerns that a prescription can cause harm to a patient, a pharmacist may contact the prescriber. If a pharmacist believes that a prescription can cause harm to a patient, even after discussion with the prescriber, the pharmacist can choose not to fill the prescription.
- What should a pharmacist do if he or she believes a
prescriber is ordering a prescription that is not consistent with
the prescriber's scope of practice?
Answer: If a prescriber cannot legally order the prescription based upon the prescriber's scope of practice, the pharmacist must not fill the prescription.
Controlled Substances
- May a controlled substance prescription be electronically
transmitted?
Answer: NO. A prescription for a controlled substance may not be transmitted electronically pursuant to Article 33 of the Public Health Law.
- Can controlled substance refills be transferred from one
pharmacy to another?
Answer: NO.
Further Information
- Who do I contact for more information about the electronic
transmission of prescriptions?
Answer: The mailing address for all offices listed below is: Office of the Professions, State Education Building - 2nd floor, 89 Washington Avenue, Albany, New York 12234
- Dentistry: New York State Board for Dentistry (518) 474-3817 ext. 550; Fax (518) 473-6995; E-mail dentbd@mail.nysed.gov.
- Medicine & Veterinary Medicine: New York State Boards for Medicine & Veterinary Medicine (518) 474-3817 ext. 560; Fax (518) 486-4846; E-mail medbd@mail.nysed.gov and vetmedbd@mail.nysed.gov.
- Nursing: New York State Board for Nursing (518) 474-3817 ext. 120; Fax (518) 474-3706; E-mail nursebd@mail.nysed.gov.
- Optometry: New York State Board for Optometry (518) 474-3817 ext. 210; Fax (518) 474-6382; E-mail optombd@mail.nysed.gov.
- Pharmacy & Midwifery: New York State Boards of Pharmacy & Midwifery (518) 474-3817 ext. 130; Fax (518) 473-6995; E-mail pharmbd@mail.nysed.gov and midwifbd@mail.nysed.gov.
- Podiatry: New York State Board for Podiatry (518) 474-3817 ext. 180; Fax (518) 474-6375; E-mail podbd@mail.nysed.gov.
