New York Implements Mandatory Electronic Prescribing
Starting March 27th, New York will require all prescriptions from physicians to be submitted electronically to pharmacies. Prescribers will be able to use paper or telephone prescriptions only in cases of emergency. Though Minnesota has had a similar requirement since 2011, New York is the first state to combine the requirement with penalties for non-compliance, including fines, loss of license, or jail time.
This technology will phase out paper and telephone prescriptions in an effort to reduce errors as well as fraud and abuse. The process, known as e-prescribing, emerged as health records moved from paper to electronic in the mid-2000s, and is currently used for about 60% of all prescriptions nationwide. Though state regulators argue that the process will create more convenience for both physicians and patients, critics have stated the process removes the opportunity for patients to shop around for cheaper prescriptions.
E-prescribing allows for a physician to submit prescription orders directly to a preferred pharmacy for a patient to pick up, rather than writing out a prescription on a prescription pad for a patient to bring to a pharmacy. The process eliminates the wait time for a patient at a pharmacy, and reduces the opportunity for fraud, as a patient could potentially alter and/or sell a written prescription. This could in turn reduce the cases of painkiller abuse, especially with opioids which have been a significant issue recently.
The task of switching to complete e-prescribing in New York is an enormous undertaking, and only a small percentage of prescribers have gotten extensions beyond the March 27th deadline. In New York, 48,000 prescribers wrote 73.6 million prescriptions in 2013, the most recent year available. Minnesota, the only other state requiring electronic prescriptions, is a quarter the size of New York and writes less than a quarter of the number of prescriptions.
Some critics of mandatory e-prescribing have argued that patients can no longer shop around for lower prices on subscriptions. Patients must choose one pharmacy for a prescription to be sent to during the process, whereas with a paper subscription, patients can take the subscription to multiple pharmacies to see where the price is lowest. In other instances, a certain drug may be out of stock at the preferred pharmacy, but the patient does not find out until they go to the pharmacy, causing the e-prescription to be cancelled and requiring the patient to return to the physician to have it reissued. Others have stated that mistakes are just as likely to happen as with paper subscriptions, since a prescriber can mistype or select the wrong option from a dropdown list.
With any change in healthcare, it will take time for physicians and patients to adjust to electronic prescriptions. New York officials believe that the convenience of e-prescribing for both the physician and the patient in the long run will outweigh the difficulties of implementation. If the program is successful, it is likely that other states will closely follow.
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