Home Forums Discussions Feedback and Recommendations Security prescriptions

New guidelines from CMS to the NCPDP now will allow prescriptions from an EMR onto plain paper as long as they contain a security feature from each of the 3 categories.
They recommend a microprint signature line for category 1.
Use of ** or ## or other characters on the number of pill or refills ##20## to stop changes will work in category 2.
For category 3 they recommend listing the security features on the prescription.
The whole info is here:
http://www.ncpdp.org/pdf/Final_ltr_to_medicaid_directors.pdf
It would be very helpful to have these changes integrated into the next update and avoid the need for security paper.
Greg Phillips

Wow, this would be great if we could use regular paper. BUT...

Very small font (0.5 or less) may be possible with some laser printers but not all, probably isn't available with ink jet because of bleeding (unless you use SPECIAL PAPER we are trying to avoid).

Erasure requires either ink jet which does not bleed but back to previous paragraph or laser with SPECIAL PAPER.

The other things appear doable and probably a good idea anyway, although it may require a drop down box rather than fill in box which I do most of the time currently.

Guess I should have checked before I wrote.

I could not go below 1 point on both notepad and MS Word. Unsure if this is program or XP, did try several different fonts.

Both the laser and the inkjet were readable, but when it was all caps the inkjet became fused.

Could create a 1/2 sized font which would meet the requirement. I will try copying the 1 points later and see if they are still readable.

I did need a magnifying glass to read.

The new version (which should be in beta release next week) has these security features in the default script... hold on for just a bit longer...

It made me really happy to see this, I'm really looking forward to it. (I hope I'm on the list.) How do beta's happen around here? I don't imagine anyone places the beta into production, so how are bugs searched out?

I have actually put the beta on and used it in the past when it came out. My experience is that it is fairly stable and working almost well enough that it will be released. As a matter of fact in the past I have noted that they released the beta version to the general users a week or two after being beta - Jon is really leary of releasing betas until he is pretty sure of it.

my state is also dropping the hammer on this as well...looking at the fine print, these 3 changes to AC would be the easiest (ie. wouldn't require new equipment, and only software mods) to meet the requirements:

1a. Micro-fine printed security message generated by a computer, electronic medical records system or other electronic means. The message may serve as a signature line or border. This must be printed in 0.5 font or smaller and readable when viewed at 5x magnification or greater and illegible when copied.
or if people are having probs printing this:
1b. Paper with a watermark. This is paper that contains a watermark that can be seen when backlit. ie. print in big letters but really finely "Authentic"

2. Characters surrounding the authorized dispensing quantity and the number of refills. Special characters such as a series of asterisks must be repeated on both sides of the numbers indicating the quantity and the number of refills authorized, e.g., Quantity ***50*** Refill ***3***. This is acceptable only for prescriptions that are generated by a computer, electronic medical records system or other electronic means.

3. Security features listed visibly in a box, band or border on the prescription. This must be a complete listing of all of the security features incorporated into the prescription pad/paper in order to minimize tampering. We can list the 2 above measures around in small letters in a box around our sig, or wherever.

also, could adding a image (ie. our scanned sig) be done as well? this would provide maybe another layer of authenticity--we've had complaints that there's no actual signature on our faxed scripts.

thanks and looking forward to the beta!

Luckily, all of our over 50 pharmacies accept our scripts without a signature -- only the "Digitally signed by..." Of course, we sign and fax controlled substances. Some don't require it, most do. We used to have about five pharmacies that didn't take the signature-deficient script, but we faxed them a letter indicating we would no longer send patients to them (unless the patient really wanted to go there), and they changed their mind. It's crazy. At this point in time forgetting ePrescribing, a faxed script is by far the most secure of the three methods.

Luckily, all of our over 50 pharmacies accept our scripts without a signature -- only the "Digitally signed by..." Of course, we sign and fax controlled substances. Some don't require it, most do. We used to have about five pharmacies that didn't take the signature-deficient script, but we faxed them a letter indicating we would no longer send patients to them (unless the patient really wanted to go there), and they changed their mind. It's crazy. At this point in time forgetting ePrescribing, a faxed script is by far the most secure of the three methods.

I basically did/do the same thing, Bert and I have absolutely no problems with the regional pharmacies. If they send me a requst for a refill and I mark it up on Paperport, I do include my digital signature. I still get returned scripts (by fax) from some mail-order places in some states that require an original (not stamped) signature. They then request me to fax that original back. I tell them if they need an original signature then they will have to send me the document with a self-addressed return envelope as a faxed signature is not an original either. I am sure that ticks them off but too bad.

You gotta love Leslie. She is awesome. Leslie, I will have to send you my newest book I wrote:

"How To Fight Back Against Paperwork And Bullshit In Medicine -- The Passive-Aggressive Approach"

The new version (which should be in beta release next week) has these security features in the default script... hold on for just a bit longer...JB

Simply amazing! Keeping up with CHANGES.

Passive-Aggressive hell....just plain aggressive. I won't give them an inch.

Leslie

Florida Requires (per Florida Statute 456.42) that the month be written on in textual letters ( 11 MAR 2009 instead of 03/11/2009 ). Could we get this added to a future release? I have submitted this through the recommend and improvement form also.