BATAVIA — If you’ve ever needed a prescription, you know the drill.
Prescription pads and scribbled signatures have been part of drugstore life since, well, forever. But when the state switches over to electronic prescriptions next week, the change will be nothing new for most area pharmacies and hospitals.
Beginning Sunday, all prescriptions written in New York State must be transmitted electronically from the prescriber to the pharmacy.
Smooth transition for pharmacies
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“In general, most offices have been doing this right along, so it’s not really a huge change for us,” said Kelly Beck, a staff pharmacist at Alberty Drugs in Batavia. “We’ve been set up for both the non-controlled and controlled substances electronically.”
The electronic prescriptions are an everyday part of life at Alberty’s. And starting Sunday, they’ll be the law of the land, as a key part of the state’s I-STOP initiative.
The measure is designed to help combat drug abuse by allowing easier tracking of prescriptions. It will also eliminate the difficulties posed by scrawled handwriting, which pharmacy staff can often find tough to read.
But the system isn’t necessarily new.
“In general, we’ve been doing it right along, at least for a good year or so, and almost all of our scrips are sent over electronically at this point,” Beck said.
The concept is simple. Instead of using paper, doctors and other providers complete subscription forms on a computer, with the information transmitted to the relevant pharmacy.
Beck is matter-of-fact about the technology, saying it seems to work.
“I don’t have an opinion either way,” she said. “It’s nice because there is a delay, and for the most part doctors can send it while the patient’s still in the office. They send it to the pharmacy, so by the time they get here, we’re working on it and it’s already completed. It does save a bit of time.”
According to Jim Rutkowski at Sinclair Pharmacy in Warsaw, this transition should operate rather smoothly for all involved.
“We’ve been accepting them this way for the better part of two years,” he said, adding that the industry has “been moving in this direction.”
He also said how this helps for a fast turnaround.
Patients are able to leave their doctor’s office and pick up medications within a reasonable amount of time with electronic prescriptions.
Holley Pharmacy, located on 3 Geddes St. Ext. in Holley, has been doing e-prescriptions for the last four to five years.
“We try to stay on top of things. We knew eventually it was going to happen where everyone would be doing it, so we like to stay ahead of the game I guess,” said Luke Miller, a pharmacist for Holley Pharmacy.
Miller said updating the system didn’t involve too much, just a call to the pharmacy’s software vendor who took care of everything behind the scenes.
Predominantly preferred at UMMC
Electronic prescriptions have been in use for the past year at United Memorial Medical Center, said Kurt Calman, the facility’s vice president for technology and clinical services.
The state had originally set an e-prescription enactment deadline of March 27, 2015, he said. But the date was pushed back a year, leaving UMMC with its preparations already in place.
The hospital and its outpatient services moved forward regardless, so they’re well-acquainted with the system.
“Predominantly the providers like it better,” Calman said. “…When they do the transcribing, the medications are automatically entered into the electronic medical record, which is a benefit.”
In the paper world, prescriptions were transcribed onto a chart, which was difficult to keep up with, he said.
E-prescriptions make the process easier. The system likewise allows prescribers to check if a person’s insurance covers the recommended medications — a big concern for many residents.
At the state level, I-STOP will also allow easier tracking, to help stem over-prescribing and outright abuse.
An electronic prescription form will automatically be transmitted a person’s preferred pharmacy if they need medication after leaving UMMC — making the process relatively simple.
Doctors use a special electronic key — Calman describes it as similar to a watch fob — for extra security when prescribing controlled substances, he said. The device needs to be physically within a doctor’s hand, and involves a six-digit code which refreshes repeatedly, making fraud and forgeries difficult.
No more struggle to read handwriting
With the new e-prescription software, in addition to making it harder to abuse prescription medication and make wait times shorter for patients, pharmacists will no longer need to struggle reading a doctor’s messy handwriting.
“If the doctor writes something we can’t read, we have to get a hold of them. Often times they don’t get back to us until hours to days later,” said Miller of Holley Pharmacy. “So if we have a patient sitting here without their medication, we can’t do anything about it because we don’t know what the doctor wrote.”
“You don’t have to worry about the need to read handwriting, so there’s no guesswork on the pharmacy side about what’s being prescribed,” said Calman of UMMC
“Doctors may mean one thing, but they’ve written something and the pharmacist can’t interpret it appropriately or they have to call with any questions they have because they can’t understand what’s being written on the prescription due to illegible handwriting,” added Kathleen Brauen, pharmacy director for Orleans Community Health. “The Institute for Safe Medication Practices has a list of medical abbreviations that are unacceptable, and part of that list came about because of improper or poor handwriting on the part of the prescriber not being able to be read, or a lot of errors happening because of illegible writing. That’s been a hot topic for many years.”
On the downside
The new mandate does come with some cons. The technology has a few issues, like anything.
Although handwriting’s no longer an issue — pharmacists can usually get used to local doctors’ styles — they might still accidentally select the wrong setting on the electronic form, or provide vague instructions.
Beck, of Alberty Drugs, said in that case, as before, pharmacists typically notice the issue and make a call over to the prescriber, to double-check.
“In New York the only person who is supposed to send (prescriptions) is the doctor. So if we can’t get a hold of the doctor, we can’t take a verbal over the phone from a nurse or anything like we used to be able to,” explained Miller of Holley Pharmacy. “Usually it’s not too big of an issue, but now with controlled drugs going in electronically it becomes an issue because doctors are the only one who are supposed to change anything on a controlled prescription.”
“Technologically you can have issues with getting it to the correct pharmacy. I know the governor put out a statement last week of what the exceptions will be to the I-STOP law in regards to prescriptions,” said Brauen of Orleans Community Health. “If you were to compound something, like a speciality pharmaceutical compound, you are not required by law to send that over electronically because some of the important information could be lost due to software limitations.”
Jerry Krull, East Side Nursing and Rehabilitation Center administrator, said that this legislation would put him and other nursing homes in a “hardship.”
According to Krull, none of East Side’s prescriptions are done electronically and only a portion of its medical records are available electronically, something that’s consistent across the industry.
But this won’t affect him for now. Krull said he and other nursing homes have another year to comply with this legislation as part of a “blanket waiver” to the industry.
Date: March 23, 2016