Opinions on mandatory e-prescribing?

[Aviane]

Going into effect in NY next year. I personally can't wait until this becomes the law in all states, but it will be a very long wait. E-prescribing has its own issues but it's still a lot better than phone-ins and hard-to-read faxes/handwriting. Drop-off area will be gone, data-entry will occur at pick-up - or at least that's what I assume will happen. Anyone in NY wanna chime in?

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[BidingMyTime]

In theory it sounds good, but like most things that sound good in theory, I would expect there will be all kinds of unforeseen problems and costs.

 

[Ackj]

There will still be plenty of exceptions. I know my dentist who probably writes 5 rx/day or less will not purchase some major software bundle to keep the PenVK and T#3 flowing. Same for optometry.

 

[Gombrich12]

No thanks, you'd have to hire someone just to handle all the call in scripts.

 

[zelman]

No thanks, you'd have to hire someone just to handle all the call in scripts.

I'd assume call ins will not be allowed

 

[owlegrad]

No thanks, you'd have to hire someone just to handle all the call in scripts.

How does that work, if escribing is mandatory? Someone to answer the doctor line and say, "You must escribe it"?

 

[RxMonkey]

Im curious how mandatory e-scribing would work, too. What if the pharmacy that initially recieves the rx doesn't have it in stock? Does that immediately put the burden on the pharmacy to call around to find the drug (assuming the pt can't wait until the next day). I also forsee a lot of e-scripts getting sent to the wrong stores. Would mandatory e-scribing apply to controlled drugs as well?

 

[zelman]

Im curious how mandatory e-scribing would work, too. What if the pharmacy that initially recieves the rx doesn't have it in stock? Does that immediately put the burden on the pharmacy to call around to find the drug (assuming the pt can't wait until the next day). I also forsee a lot of e-scripts getting sent to the wrong stores. Would mandatory e-scribing apply to controlled drugs as well?

No and yes.

 

[Gombrich12]

How does that work, if escribing is mandatory? Someone to answer the doctor line and say, "You must escribe it"?

I'm sure there will be some exceptions to the rule. Whether they will be based on acute/short day supply or maybe just in the event of a power outage or emergency it will be abused.

 

[genesis09]

I don't believe mandatory e-scribing is a good thing. I believe it should be pushed, but not required. There are situations which it doesn't make since to e-scribe.

 

[zelman]

I don't believe mandatory e-scribing is a good thing. I believe it should be pushed, but not required. There are situations which it doesn't make since to e-scribe.

Please, name one.

 

[eagles22]

Please, name one.

Hey, send the script to that Walgreens next to the Chinese place. You know the one on Washington? Or is it 2nd? It's definitely right by that gas station. Or is it a CVS? I think it's 2400 S Lincoln actually.

That's when you just hand them a written rx and tell them byebye.

 

[drcrispmd]

Does this include controlled meds? Right now these have to be printed. What about when the doc's system goes down?

 

[zelman]

Hey, send the script to that Walgreens next to the Chinese place. You know the one on Washington? Or is it 2nd? It's definitely right by that gas station. Or is it a CVS? I think it's 2400 S Lincoln actually.

That's when you just hand them a written rx and tell them byebye.

No. That's when you tell them where to pick up their RX.

 

[zelman]

Does this include controlled meds? Right now these have to be printed. What about when the doc's system goes down?

I believe that's the main reason for it.

 

[eagles22]

No. That's when you tell them where to pick up their RX.

Are you forgetting people get lost between the pharmacy counter and the aisle with the laundry detergent all the time? I have no idea where most of the people I see live and what is between the clinic and their homes. I have a basic grasp of the area I work in but don't know every pharmacy within a 2 mile radius of the clinic. Patients have even less of an idea of what pharmacy is located where. Trust me, I have no problem sending that crap to any place and letting the pharmacists chase down who has it when the patients goes to the wrong pharmacy since it doesn't cost me any more time, but it makes your lives miserable and it leads to poorer continuity of care. You're going to see a lot of docs just sending rx's anywhere and letting the **** roll downhill because they don't want to play let's look at googlemaps 15 times a day.

 

[zelman]

Are you forgetting people get lost between the pharmacy counter and the aisle with the laundry detergent all the time? I have no idea where most of the people I see live and what is between the clinic and their homes. I have a basic grasp of the area I work in but don't know every pharmacy within a 2 mile radius of the clinic. Patients have even less of an idea of what pharmacy is located where. Trust me, I have no problem sending that crap to any place and letting the pharmacists chase down who has it when the patients goes to the wrong pharmacy since it doesn't cost me any more time, but it makes your lives miserable and it leads to poorer continuity of care. You're going to see a lot of docs just sending rx's anywhere and letting the **** roll downhill because they don't want to play let's look at googlemaps 15 times a day.

It's simple. One of the two of you decides where the Rx is going. Why are you afraid of decisiveness?

 

[PharmDstudent]

What about patients who don't have a pharmacy picked out already or what happens whenever patients what to shop around for a better price?

I imagine the whole "you can't transfer a controlled script more than so many times" law(s) being phased out, because transferring a script and shopping around for a better price would essentially be one in the same.

 

[naseuy]

NYS does not allow transfers for controlled substances.

 

[zelman]

What about patients who don't have a pharmacy picked out already or what happens whenever patients what to shop around for a better price?

Their needs are not urgent. They can request the RX be sent after they do their research.

 

[Ackj]

It's simple. One of the two of you decides where the Rx is going. Why are you afraid of decisiveness?

I thought there was some sort of law discouraging prescribers choosing what pharmacy to send their patients to. Or maybe it's only discouraged if the pharmacy is encouraging the doc to do it?

 

[eagles22]

It's simple. One of the two of you decides where the Rx is going. Why are you afraid of decisiveness?

I have no problem with deciding where the rx goes. The problem is people don't know the place I am sending it even if I provide information. Again, after I hit send, I don't give a single ****. I'm just trying to make it easier for my patient and for you to get my patient the meds. It may come down to me just saying, what chain do you go to and me just sending it to that chain and letting the pharmacists within transfer the rxs around.

 

[eagles22]

Their needs are not urgent. They can request the RX be sent after they do their research.

Doesn't work that way. You tell me at the visit where the rx goes. If you need to research, you get a written rx and then take it to where you want to go.

 

[zelman]

Doesn't work that way. You tell me at the visit where the rx goes. If you need to research, you get a written rx and then take it to where you want to go.

If everything was supposed to stay the same, lawmakers wouldn't be involved.

 

[zelman]

I thought there was some sort of law discouraging prescribers choosing what pharmacy to send their patients to. Or maybe it's only discouraged if the pharmacy is encouraging the doc to do it?

I don't think it applies if the patient is unable to choose a pharmacy.

 

[genesis09]

We can all imagine this scenario; a C-2 script is e-scribed to pharmacy on Friday afternoon, and it turns out you don't have it. However, after calling around, you determine the next pharmacy up the road has it. By the time this is done, the office has closed until Monday, and of course, the patient is out of the medication and needs it today. By law, you cannot transfer an electronic C-2. You need the office to send it to the new pharmacy. This will be a fun situation. With a paper rx, you can just send them on their way, but with an e-scribe, there is nothing you can do.

 

[Sparda29]

There are still a lot of problems with it. Patient walks in and says my doctor e-prescribed 5 things. I check to see if it's done, nope. Is it in the verify queue? No. Is it in the e-script queue? Nope. Call the doctor, he says he e-prescribed them already but he'll send it again. Didn't get anything.

Turns out the doctor has been sending them to another pharmacy because he got the location or town wrong or misspelled or misclicked somewhere.

 

[Jibby321]

^^^^ what Sparda says. I can't tell you how many times a day patients come in an say something was "emailed" in and we have nothing for them. I call the office the MA gives me an attitude because she says that she sent them 45 mins ago. Meanwhile I have received 15 other escribed RXs from every offices except from theirs. So I know our system is not down.

 

[Old Timer]

Let's start with Mandatory C-II rxs with exceptions for emergent situations. We can all reason together as to what would be an exemption. Fake scripts go away overnight. All state databases are updated at once. Once we have digested that, we move to other controls. By then we will have enough experience to handle other rxs. Action blockers always try to block progress. Any system will have problems. But a verified C-II e-script will kick the ****e out of the diversion world. Now a doctor will not be able to prescribe 7 rxs for John Smith under 7 different names and him go to 7 different pharmacies for 120 oxy 30's each. Each script will go directly to the DEA. They will see daily who is a croaker and shut them down in a heart beat. We could also come up with a way to transfer an Unfilled C-II between pharmacies as long as there is an adequate audit trail. Don't fight it, it's the wave of the future....

 

[Sparda29]

Let's start with Mandatory C-II rxs with exceptions for emergent situations. We can all reason together as to what would be an exemption. Fake scripts go away overnight. All state databases are updated at once. Once we have digested that, we move to other controls. By then we will have enough experience to handle other rxs. Action blockers always try to block progress. Any system will have problems. But a verified C-II e-script will kick the ****e out of the diversion world. Now a doctor will not be able to prescribe 7 rxs for John Smith under 7 different names and him go to 7 different pharmacies for 120 oxy 30's each. Each script will go directly to the DEA. They will see daily who is a croaker and shut them down in a heart beat. We could also come up with a way to transfer an Unfilled C-II between pharmacies as long as there is an adequate audit trail. Don't fight it, it's the wave of the future....

I'm cool with that. Only problem then would be that when doctor's overclick, it sometimes sends duplicates and you'd have to find out if it was a duplicate or if it was for a different indication/strength.

I dunno, there's something that I just love about writing out scripts on the pharmacy script pad after taking a telephone Rx.

 

[Old Timer]

I'm cool with that. Only problem then would be that when doctor's overclick, it sometimes sends duplicates and you'd have to find out if it was a duplicate or if it was for a different indication/strength.

Nothing good software couldn't fix.

I dunno, there's something that I just love about writing out scripts on the pharmacy script pad after taking a telephone Rx.

I also fondly remember making capsules, suppositories and powder papers. That doesn't mean I want to go back to that.... I used to drive a car with a carburetor and i had to set the points. I don't do that anymore either......

 

[owlegrad]

The thought of not having to take voice mails fills me with tears. The good kind. Why anyone would leave a message rather than use a perfectly good e-scribing system is beyond me. Can't wait for mandatory e-scribing. Sure, it will have it's own set of flaws, but no more "What does this say?" and "They didn't leave the DEA number on the voicemail and now I can't get a hold of them" is enough to make me leap for joy.

 

[PharmDstudent]

My guess is that this regulation isn't going to get pushed through until the feds change their stance on the transfer of controlled prescriptions. The state of NY will get their ass sued if people go without medicine because of mandatory e-scribing.

 

[drcrispmd]

My only concern is when the physician e-scribing system is down or the entire system is down. It does happen and is a pain (especially when patients say I need everything refilled and does not know the names). If there are laws in place that prohibit written rx then what will we do in this situation? The e-scribing system we have can accepted refill request from pharmacy electronically, but for some reason most prefer to call and leave us a voicemail for refills (which goes to the nurse responsible for messages that day, then task sent to team nurse then task to doctor). If sent electronically it goes directly to the physician task list.

 

[Old Timer]

My guess is that this regulation isn't going to get pushed through until the feds change their stance on the transfer of controlled prescriptions. The state of NY will get their ass sued if people go without medicine because of mandatory e-scribing.

What stance? You can transfer controlled rxs once at the present time

 

[Old Timer]

My only concern is when the physician e-scribing system is down or the entire system is down. It does happen and is a pain (especially when patients say I need everything refilled and does not know the names). If there are laws in place that prohibit written rx then what will we do in this situation? The e-scribing system we have can accepted refill request from pharmacy electronically, but for some reason most prefer to call and leave us a voicemail for refills (which goes to the nurse responsible for messages that day, then task sent to team nurse then task to doctor). If sent electronically it goes directly to the physician task list.

There will have to exceptions for emergent situations......

 

[PharmDstudent]

What stance? You can transfer controlled rxs once at the present time

Restricting access to medicine. Whether it's intentional or not, the state of New York is unnecessarily limiting a person's right to access their medication by demanding that all prescriptions originate electronically from healthcare provider to pharmacy. Like I said before, the feds will have to loosen up their regulation on the transfer of controlled substances before this can go any further without the threat of backlash. Allowing just one transfer is too restrictive, and people who are disadvantaged the most will suffer the most from it.

Let's take Diastat AcuDial gel for example. It's a controlled substance with the potential to save lives. So what happens whenever someone's insurance plan no longer has a contract with XYZ pharmacy chain, like a lot of people on January 1st, and now they have to fill it elsewhere in order to be able to use their insurance? You might say, "then they can just transfer it." Well that's all fine and good until the patient realizes that they can't transfer their prescription again for the second time. So in effect, this law turns CIII-CV drugs into CII drugs in terms of their portability. Why? Well, what if the patient never even filled their prescription in the first place before they transferred it out due to cost, availability, service, etc., and now they can't transfer it again even though they've never filled it or only filled it one time? Basically, moving electronic prescriptions from pharmacy to pharmacy is the act of transferring a prescription while walking a hard copy next door is not.

 

[naseuy]

New York State does not allow for transfers of CS:

1. Can controlled substance refills be transferred from one pharmacy to another?
   
   Answer: NO.

http://www.op.nysed.gov/prof/pharm/pharmelectrans.htm

I don't believe this has been updated for the upcoming mandatory e-RX requirement. If it were up to me, I would exclude controls for the mandatory requirements for the time being. It's just going to be a huge headache.

 

[Old Timer]

Restricting access to medicine. Whether it's intentional or not, the state of New York is unnecessarily limiting a person's right to access their medication by demanding that all prescriptions originate electronically from healthcare provider to pharmacy. Like I said before, the feds will have to loosen up their regulation on the transfer of controlled substances before this can go any further without the threat of backlash. Allowing just one transfer is too restrictive, and people who are disadvantaged the most will suffer the most from it.

Let's take Diastat AcuDial gel for example. It's a controlled substance with the potential to save lives. So what happens whenever someone's insurance plan no longer has a contract with XYZ pharmacy chain, like a lot of people on January 1st, and now they have to fill it elsewhere in order to be able to use their insurance? You might say, "then they can just transfer it." Well that's all fine and good until the patient realizes that they can't transfer their prescription again for the second time. So in effect, this law turns CIII-CV drugs into CII drugs in terms of their portability. Why? Well, what if the patient never even filled their prescription in the first place before they transferred it out due to cost, availability, service, etc., and now they can't transfer it again even though they've never filled it or only filled it one time? Basically, moving electronic prescriptions from pharmacy to pharmacy is the act of transferring a prescription while walking a hard copy next door is not.

See, this is what an action blocker does. You put straw men arguments up to block action from the way we have always done it. So, first Diastat is NEVER an emergency fill rx. It's ALWAYS an insurance fill in that you need to have the medication on hand before the seizure begins. You do not leave your seizing child and run to the pharmacy to pick up your emergency Diastat. Remember whatever regulations are passed will have exceptions for emergencies. You are already limited by Federal law to one transfer regardless of the origin of the prescription, except for New York (and maybe a few others) that prohibits transfers on controlled items.

1. So first every single policy that is being considered will have an exception for emergencies.
2. The one transfer limit has been in effect since before e-scripts and nobody dies because of it and in fact you can transfer within a chain until all refills are used as per Federal Law. Your state laws will vary.
   
3. There is no law against this, by the way. It's a regulation and the DEA can make it go away anytime it wants.

   CONTROLLED SUBSTANCES LISTED IN SCHEDULES III, IV, and V
   §1306.25 Transfer between pharmacies of prescription information for Schedules III, IV, and V controlled substances for refill purposes.
   (a) The transfer of original prescription information for a controlled substance listed in Schedule III, IV, or V for the purpose of refill dispensing is permissible between pharmacies on a one-time basis only. However, pharmacies electronically sharing a real-time, online database may transfer up to the maximum refills permitted by law and the prescriber's authorization.
   
   (b) Transfers are subject to the following requirements:
   
   (1) The transfer must be communicated directly between two licensed pharmacists.
   
   (2) The transferring pharmacist must do the following:
   
   (i) Write the word “VOID” on the face of the invalidated prescription; for electronic prescriptions, information that the prescription has been transferred must be added to the prescription record.
   
   (ii) Record on the reverse of the invalidated prescription the name, address, and DEA registration number of the pharmacy to which it was transferred and the name of the pharmacist receiving the prescription information; for electronic prescriptions, such information must be added to the prescription record.
   
   (iii) Record the date of the transfer and the name of the pharmacist transferring the information.
   
   (3) For paper prescriptions and prescriptions received orally and reduced to writing by the pharmacist pursuant to §1306.21(a), the pharmacist receiving the transferred prescription information must write the word “transfer” on the face of the transferred prescription and reduce to writing all information required to be on a prescription pursuant to §1306.05 and include:
   
   (i) Date of issuance of original prescription.
   
   (ii) Original number of refills authorized on original prescription.
   
   (iii) Date of original dispensing.
   
   (iv) Number of valid refills remaining and date(s) and locations of previous refill(s).
   
   (v) Pharmacy's name, address, DEA registration number, and prescription number from which the prescription information was transferred.
   
   (vi) Name of pharmacist who transferred the prescription.
   
   (vii) Pharmacy's name, address, DEA registration number, and prescription number from which the prescription was originally filled.
   
   (4) For electronic prescriptions being transferred electronically, the transferring pharmacist must provide the receiving pharmacist with the following information in addition to the original electronic prescription data:
   
   

   (i) The date of the original dispensing.
   
   (ii) The number of refills remaining and the date(s) and locations of previous refills.
   
   (iii) The transferring pharmacy's name, address, DEA registration number, and prescription number for each dispensing.
   
   (iv) The name of the pharmacist transferring the prescription.
   
   (v) The name, address, DEA registration number, and prescription number from the pharmacy that originally filled the prescription, if different.
   
   (5) The pharmacist receiving a transferred electronic prescription must create an electronic record for the prescription that includes the receiving pharmacist's name and all of the information transferred with the prescription under paragraph (b)(4) of this section.
   
   (c) The original and transferred prescription(s) must be maintained for a period of two years from the date of last refill.
   
   (d) Pharmacies electronically accessing the same prescription record must satisfy all information requirements of a manual mode for prescription transferal.
   
   (e) The procedure allowing the transfer of prescription information for refill purposes is permissible only if allowable under existing State or other applicable law.
   
   [75 FR 16309, Mar. 31, 2010]​

   http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_25.htm

You need better reasoning. Nobody will be denied medication if mandatory e-scribing is required. Neither rich nor poor. The status of transfers does not change from the present system. Is any system perfect, No. Never let the perfect be the enemy of the good. The amount of good to society in controlling the spiraling tragedy of rx drug abuse will more than make for the slight inconvenience that some people will experience.

Our nation is in the midst of an unprecedented epidemic of drug overdose deaths. Overdose deaths have increased five-fold since 1980. In 2009, prescription drug overdoses overtook every other cause of injury death in the United States, outnumbering fatalities from car crashes for the first time.

Prescription drugs, especially opioid pain relievers such as oxycodone, hydrocodone, and methadone, have largely driven this tragic increase. We're losing nearly 17,000 of our friends, family members, and neighbors each year. And with every death, the fabric of a home, a family, a community is torn.

http://www.huffingtonpost.com/bill-corr/reversing-the-prescriptio_b_5648046.html
http://www.huffingtonpost.com/bill-corr/reversing-the-prescriptio_b_5648046.html
So compared to reducing some of the 17,000 deaths per year, you are worried about inconveniencing a few people, not delaying their treatment, inconveniencing them. Nice try. Next argument please.

 

[PharmDstudent]

New York State does not allow for transfers of CS:

1. Can controlled substance refills be transferred from one pharmacy to another?
   
   Answer: NO.

http://www.op.nysed.gov/prof/pharm/pharmelectrans.htm

I don't believe this has been updated for the upcoming mandatory e-RX requirement. If it were up to me, I would exclude controls for the mandatory requirements for the time being. It's just going to be a huge headache.

I don't care about their laws. Like you're suggesting, they can include or exclude whatever they want. It's the feds I'm concerned with.

 

[PharmDstudent]

See, this is what an action blocker does. You put straw men arguments up to block action from the way we have always done it. So, first Diastat is NEVER an emergency fill rx. It's ALWAYS an insurance fill in that you need to have the medication on hand before the seizure begins. You do not leave your seizing child and run to the pharmacy to pick up your emergency Diastat. Remember whatever regulations are passed will have exceptions for emergencies. You are already limited by Federal law to one transfer regardless of the origin of the prescription, except for New York (and maybe a few others) that prohibits transfers on controlled items.

1. So first every single policy that is being considered will have an exception for emergencies.
2. The one transfer limit has been in effect since before e-scripts and nobody dies because of it and in fact you can transfer within a chain until all refills are used as per Federal Law. Your state laws will vary.
   
3. There is no law against this, by the way. It's a regulation and the DEA can make it go away anytime it wants.http://www.deadiversion.usdoj.gov/21cfr/cfr/1306/1306_25.htm

You need better reasoning. Nobody will be denied medication if mandatory e-scribing is required. Neither rich nor poor. The status of transfers does not change from the present system. Is any system perfect, No. Never let the perfect be the enemy of the good. The amount of good to society in controlling the spiraling tragedy of rx drug abuse will more than make for the slight inconvenience that some people will experience.
http://www.huffingtonpost.com/bill-corr/reversing-the-prescriptio_b_5648046.html
So compared to reducing some of the 17,000 deaths per year, you are worried about inconveniencing a few people, not delaying their treatment, inconveniencing them. Nice try. Next argument please.

So you don't agree that the benefits of e-scribing do not outweigh the problem of all controlled substances having highly restrictive portability? Restrictive portability is obviously not the intention of mandatory e-scribing, but it's most definitely a consequence, which is why I'm concerned; it's heavy backlash.

 

[naseuy]

I don't care about their laws. Like you're suggesting, they can include or exclude whatever they want. It's the feds I'm concerned with.

This is a thread about the mandatory e prescriptions that's coming to NY..Of course NY laws matter.

 

[PharmDstudent]

This is a thread about the mandatory e prescriptions that's coming to NY..Of course NY laws matters.

NY laws can change to adjust for this. Not so much for federal laws.

 

[Old Timer]

So you don't agree that the benefits of e-scribing do not outweigh the problem of all controlled substances having highly restrictive portability? Restrictive portability is obviously not the intention of mandatory e-scribing, but it's most definitely a consequence, which is why I'm concerned; it's heavy backlash.

It has ZERO effect as the transfer laws are no different from the present. And I would assume that transfers would be permitted as they are now so THERE IS NO CHANGE that would be caused by mandatory e-prescribing. And even if there was some inconvenience, it's negative effects would be outweighed by the benefits of reducing fraudulent opioid rxs...

 

[Gombrich12]

The only way I would prefer this is if it comes with the benefit of doing transfers by e-script. I wonder if Surescripts network already supports this?

 

[zelman]

What stance? You can transfer controlled rxs once at the present time

Not in NY. No transfers.

Restricting access to medicine. Whether it's intentional or not, the state of New York is unnecessarily limiting a person's right to access their medication by demanding that all prescriptions originate electronically from healthcare provider to pharmacy. Like I said before, the feds will have to loosen up their regulation on the transfer of controlled substances before this can go any further without the threat of backlash. Allowing just one transfer is too restrictive, and people who are disadvantaged the most will suffer the most from it.

Let's take Diastat AcuDial gel for example. It's a controlled substance with the potential to save lives. So what happens whenever someone's insurance plan no longer has a contract with XYZ pharmacy chain, like a lot of people on January 1st, and now they have to fill it elsewhere in order to be able to use their insurance? You might say, "then they can just transfer it." Well that's all fine and good until the patient realizes that they can't transfer their prescription again for the second time. So in effect, this law turns CIII-CV drugs into CII drugs in terms of their portability. Why? Well, what if the patient never even filled their prescription in the first place before they transferred it out due to cost, availability, service, etc., and now they can't transfer it again even though they've never filled it or only filled it one time? Basically, moving electronic prescriptions from pharmacy to pharmacy is the act of transferring a prescription while walking a hard copy next door is not.

We're talking about NY. It's illegal to bill Medicaid for transferred prescriptions in NY. You really think they care about this? They made benzos C2's (basically). The policy makers don't care.

 

[Old Timer]

Not in NY. No transfers.

I believe I noted that and I am speaking only of Federal law.

You are already limited by Federal law to one transfer regardless of the origin of the prescription, except for New York (and maybe a few others) that prohibits transfers on controlled items.

 

[PharmDstudent]

It has ZERO effect as the transfer laws are no different from the present. And I would assume that transfers would be permitted as they are now so THERE IS NO CHANGE that would be caused by mandatory e-prescribing. And even if there was some inconvenience, it's negative effects would be outweighed by the benefits of reducing fraudulent opioid rxs...

We're talking about NY. It's illegal to bill Medicaid for transferred prescriptions in NY. You really think they care about this? They made benzos C2's (basically). The policy makers don't care.

I get that. Currently, you can bring in your hard copy prescription to 100 different pharmacies if you wanted. You just can't move it once you decide where you want to redeem it. But that'll no longer be the case if they make electronic prescriptions mandatory. You're locked in before you even step foot into the pharmacy. Do you get that this is a big difference?

"The wait's 5 hours." Too bad. "The pharmacy thought they had the medication in stock, but it turns out that they really don't. Now I'm stuck without it until Monday." Too bad. "It's twice as expensive here as it is at my other pharmacy." Too bad. "They don't have a drive-thru, and I just got out of surgery." Too bad. "They can't flavor my son's Quillivant XR, and it makes him gag." Too bad. "The pharmacy is allocated for Dilaudid, and they're out." Too bad. "Their order hasn't come in yet, and I have to catch a flight." Too bad. "They never have enough of my ______, and now I can't transfer it out to another pharmacy." Too bad. "I'm allergic to yellow dye, and they don't carry the brand name." Too bad. "I'm not due for a refill yet, and I'll be out of town on vacation whenever it's due to be refilled. Oh, and there's no XYZ chain pharmacy in the area where I'll be traveling." Too bad... and on and on and on.

 

[Old Timer]

You are already limited by Federal law to one transfer regardless of the origin of the prescription, except for New York (and maybe a few others) that prohibits transfers on controlled items.

I get that. Currently, you can bring in your hard copy prescription to 100 different pharmacies if you wanted. You just can't move it once you decide where you want to redeem it. But that'll no longer be the case if they make electronic prescriptions mandatory. You're locked in before you even step foot into the pharmacy. Do you get that this is a big difference?

"The wait's 5 hours." Too bad. "The pharmacy thought they had the medication in stock, but it turns out that they really don't. Now I'm stuck without it until Monday." Too bad. "It's twice as expensive here as it is at my other pharmacy." Too bad. "They don't have a drive-thru, and I just got out of surgery." Too bad. "They can't flavor my son's Quillivant XR, and it makes him gag." Too bad. "The pharmacy is allocated for Dilaudid, and they're out." Too bad. "Their order hasn't come in yet, and I have to catch a flight." Too bad. "They never have enough of my ______, and now I can't transfer it out to another pharmacy." Too bad. "I'm allergic to yellow dye, and they don't carry the brand name." Too bad. "I'm not due for a refill yet, and I'll be out of town on vacation whenever it's due to be refilled. Oh, and there's no XYZ chain pharmacy in the area where I'll be traveling." Too bad... and on and on and on.

ALL BULL----- This is the way the world is now and e-scribing will have no effect on that. People are dealing with these issues right now and that has nothing to do with electronic prescribing of prescriptions. Period, end of report. This is what we have Please show me how many people have been injured. They would sue. The papers would be all over it. Trouble is you anecdotal reports of patient's being inconvenienced with NO PROOF OF harm. You have much prrof for this assertion as Zetia does for preventing heart attacks, none.

You object to the inability to transfer controls more than once and not at all in New York. Please start a separate thread as this is a derail and is not germane to electronic prescribing.

 

[maria1oh]

What is the cost of electronic prescriptions? I believe the software vendor charges the pharmacy something like $0.30 for the privilege of receiving an electronic prescription. If the person typing it in makes a mistake and has to resend it then it's another $0.30. If you have to switch it to something covered by insurance it's another $0.30 to send something else. If the patient never comes to pick it up and you have to return it to stock then it's a waste of $0.30. This seems small and insignificant but pharmacies will be paying for something they used to get for free. Pharmacies still have to re type the entire prescription because there is a lack of standards with sig codes and drug codes with the software programs.