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New Jersey News: Telemedicine Prescriptions
Reprinted from the April 2007 New Jersey Board of Pharmacy Newsletter.
The New Jersey Board of Pharmacy was recently asked to consider a proposal that would involve the generation of electronic prescriptions, including those for Schedule III-V controlled dangerous substances, from prescribers employed by a telemedicine company. For the patient, this process involves the use of an Internet Web site questionnaire and/or telephone consultation to complete an initial medical history and assessment. The remote physician/prescriber then reviews this history and speaks to the patient by telephone prior to generating the electronic prescription. Pharmacists should be aware that the New Jersey Board of Pharmacy considers such practices to violate the New Jersey Board of Medical Examiners definition of “doctor-patient relationship,” thereby rendering such prescriptions invalid.
NJAC 13:35-7.1A mandates that the physician examine the patient and properly document the results of the examination in the patient’s medical record prior to issuing a prescription. NJAC 13:35-7.1A(a)1 states that the physician must “perform an appropriate history and physical examination.” Exceptions not requiring this initial physical examination are outlined in NJAC 13:35-7.1A(b) and include newly hospitalized patients, the prescriber’s “established” patients, short-term prescription renewals for a new patient prior to that patient’s first visit, emergency medical conditions, or patients regularly treated by a physician colleague (a physician in collaborative practice or an “on-call” physician). NJAC 13:35-7.4A(a) defines a valid electronic prescription, and states that “a practitioner, acting within his or her scope of lawful practice and after an examination of the patient’s condition, as defined in NJAC 13:35-7.1, may transmit, or have an authorized agent transmit, an electronic prescription to a pharmacy which has been approved by a patient, a patient’s guardian, or a patient’s authorized representative, consistent with the requirements of this section.”
