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Oregon News: Electronic Prescribing of Controlled Substances
Published in the February 2008 Oregon State Board of Pharmacy Newsletter
Considering the recent influx of questions and comments from pharmacists, physicians, and other prescribing practitioners regarding Drug Enforcement Administration’s (DEA) current position on electronic transmission of controlled substance (CS) prescriptions, it seems a high degree of confusion and frustration continues to exist. While it is true that many hospitals and medical clinics are converting to electronic records and prescribing systems, it is also true that federal law continues to prohibit electronic transmission of prescriptions for CS.
The Oregon State Board of Pharmacy spent the past several years, alongside other state agencies, with direction and encouragement from the state legislature and the governor’s office, performing intensive reviews of its laws and rules to identify and eliminate barriers to the use of electronic transactions and e-commerce. The Board’s staff met with DEA representatives in October 2007 in an effort to clarify DEA’s expectation where state laws allow electronic transmission of prescriptions. Formal clarification came in the form of a letter written to Board of Pharmacy Executive Director Gary Schnabel, from Mark W. Caverly, chief, Liaison & Policy Section, DEA Office of Diversion Control dated November 21, 2007.
The Caverly letter states, in part: “. . . the Oregon Board of Pharmacy has allowed pharmacists to fill unsigned faxed prescriptions for schedule III-V controlled substances . . . the Board also allows for the electronic transmission of prescriptions for schedule III-V controlled substances. . . . Neither of these allowances is supported by the Controlled Substances Act. . . . Please be advised that both the prescribing practitioner and the pharmacist have responsibilities when it comes to making sure that a prescription conforms to the law and regulations.”
In short, this means Schedule III through V CS may not be prescribed electronically because of the federal “prescriber’s signature” requirement. Electronically transmitted prescriptions for CS are not considered valid and may not be dispensed by a pharmacist. A pharmacist may choose to fulfill the requirements of an oral prescription when presented an electronically transmitted CS prescription or an unsigned faxed prescription. For an Oregon pharmacist to fulfill the requirements of an oral prescription for a Schedule III through V CS, the pharmacist must call the practitioner to establish it as an oral prescription and then reduce it to writing.
The Caverly letter does contain further specific clarifications and details regarding the July 2006 public meeting, which was held to hear from members of industry and law enforcement regarding electronic prescriptions. As a result of this meeting, DEA is drafting a Notice of Proposed Rulemaking, which would change the current regulations to address the use of electronic prescriptions for CS. Transcripts of the meeting are available on the DEA’s Web site at: www.deadiversion.usdoj.gov. The Caverly letter can be seen in its entirety on the Board’s Web site at: www.pharmacy.state.or.us/Pharmacy/Imports/Memos/DEA_TransmissionSchIII-V.pdf. Feel free to copy the letter and pass it on to other pharmacists or prescribing practitioners. It is important that pharmacists and prescribers know and understand both the federal and state prescribing and dispensing requirements.
