Home Forums Discussions Problems Narcotic Prescriptions

I would like to know if there is an easier way to send narcotic prescriptions from AC. At present, I print the prescription to Updox, then add signature and then Fax to the pharmacy. Very time consuming.

Not only that, some pharmacies, particularly Medco and RightSource, still return those prescriptions, and demand a signature, stating stamped signatures are not acceptable.

In my previous E-prescription program, RXNT, the narcotic prescriptions were sent like ay other prescription but RXNT then converted it to FAX and faxed it.

Does anyone have suggestions on how to handle narcotic prescriptions in a more efficient way?

I am doing it the way you are so I would be interested as well.

Currently to my knowledge sure scripts has not made compliant way to send controlled substances. I just print and fax.

I have not done this, but have been tempted to print the e-Rx out of AC with signature, then send to a fax modem. Any idea if pharmacies accept this? It seems as reasonable as signing in UpDox.

DrFirst has the ability to electronically prescribe all scheduled drugs. It sure would be nice if SureScripts/AC did likewise. Currently we have to print out schedule 2 rx's, I have to physically sign them, then the patient has to pick up the hard copy. Massachusetts does not permit use of fax for schedule 2.

I wouldn't think many states would. I thought this was due to either a federal law or state law, and you had to use three criteria:

Something you own
Something you know
Something you are

How can a certain type of ePrescribing program change that? Or does it somehow have those things for you.

Thanks.

I think it is Federal. Plus, Medicare requires all sched II (and maybe all controlled drugs... I forget, I just do them all) be written on tamper-proof paper. I will certainly agree that the current DEA requirements are over the edge of reason.

Lyrica, robitussin with codiene, hydrocodone, ambien are the ones that I can send by way of updox with a signature and it works here.
percocet, fentanyl, morphine, ritalin I write and sign and give to patient.

write or print up and sign and give to patient--correction

2 years ago the DEA published guidlines for electronic transmission of controlled substances (III, IV and V). I read the guidlines, and AC has the required safeguards. I work in Lakewood CO and the pharmacy board was not interested in pursuing this, so this won't fly in Colorado at this time.

From what I read, it isn't so much the EMR as it is proving who you are.

Maybe I can help a little. As an invasive/ non-invasive pain physician, I'm kindof familiar with the rules and regs of narcotic prescriptions. Importantly you can not apply the same standards and laws to all situations in all locations.
Eg. whenever federal, state, or local laws are different for one geographic location, the more strenuous law is the one the one that is followed. It trumps other laws so to speak. State law can sometimes supersede federal.
There are also various laws that treat DEA class III meds and class II meds differently. Some allow faxing some don't, some require real physical signiture and some don't. Some allow faxing of class II meds if followed by original physical script within a certain time frame.
As far as mail order meds, it depends on where you are sending it from and where your sending it to. Each location may be governed by a different law.
My personal habits are: Never allow refills of any sort on class IIs, must physically see a patient to write a class II RX, urine drug test everyone randomly, get urine drug tests when things appear odd. If I want a urine test and they can't pee,then no Rx until they come back and give me a urine sample.
Please everyone remember, our DEA registration doesn't just allow us to write for controlled meds,it also REQUIRES us to suspect, investigate, and take measures to avoid narcotic diversion. Paper work rules and headaches are a small price to pay to keep a 9 yr old from ODing on a prescribed narcotic.
Check the fed/state/ local laws were you practice.
Nate

My office manager tells me we will be able to prescribe lortab and other class II meds via AC e-scripts in the near future. Is that the case? or did he misunderstand? I personally have not read anything about this. I have looked around the forums and found no answer.

Gerardo

Law allows but implementation is sketchy in all states and not sure when AC will get done.

check your local, state, and then federal laws and regulations as your guide.
Nate