Electronic transmission of prescriptions allowed in limited circumstances
March 9, 2016
A new College of Physicians and Surgeons of Alberta (CPSA) standard entitled Prescribingcomes into effect this month. The prescribing standard, which replaces the CPSA Faxing Prescriptions standard, now applies to all forms of prescription transmission. Additional details are included as Advice to the Profession.
The CPSA standard is designed to allow electronic transmission of prescriptions in the future when approved or official secure system-to-system messaging between physician’s Electronic Medical Records (EMR) and Netcare and/or Pharmacy systems become available. Until such systems are available, the standard allows prescriptions to be faxed directly from a physician’s password-protected EMR when all requirements of the standard are met. It is the responsibility of the physician to ensure that the system meets the requirements of the standard and that their password is kept private and secure. This is currently CPSA’s recommended electronic method of transmission of prescriptions. TPP prescriptions still require handwritten signature authorization on a TPP form (process is unchanged). Click here to learn more about the Triplicate Prescription Program.
The CPSA documents identify the required content of a prescription and emphasize security to prevent diversion and safeguard patients. The Advice to the Professionemphasizes the importance of collaboration between prescribers and dispensers and explicitly indicates that patients have a right to choose where to have their prescriptions filled. Consult the documents on the CPSA website and this week’s edition of CPSA’s Messenger for additional information.
- You may accept prescriptions faxed directly to your pharmacy from the physician’s EMR. In the absence of a handwritten signature, the physician’s password access to their EMR may be considered the prescriber’s direct authorization. (i.e. meets the requirement for a signature in ACP’s standards)
- The obligation for a pharmacist or a pharmacy technician to determine the authenticity of prescriptions  has not been removed. It is expected that you will assess authenticity of the prescription as you have done in the past for prescriptions faxed to your pharmacy. This may include such things as considering the origin, phone number, header etc. of the fax; your history and knowledge of the prescriber etc.
- If you have any doubts or concerns about the authenticity of the prescription you should contact the prescriber for confirmation. If you are not familiar with the physician or you have not received prescriptions via this method in the past you may wish to contact the prescriber to confirm.
 Standard 6 – Standards of Practice for Pharmacists and Pharmacy Technicians
- The CPSA standard only authorizes transmission of prescriptions directly from the physician’s EMR to the fax machine in the licensed pharmacy of the patient’s choice. Prescriptions must not be sent electronically via patients or other third parties. Images of prescriptions transmitted by patients to the pharmacy are not valid prescriptions.
- Handwritten signatures are required for all prescriptions delivered to the pharmacy by patients.
- The standard does not authorize transmission of prescriptions or sharing of patient specific information via email.
- It is unlikely that any physicians-pharmacies have an on-line secure system-to-system messaging service that meets the requirements of the standard. Development of a provincial wide system for electronic transmission of prescriptions continues to be a consideration in Alberta. Until such a system is available, electronic transmission of prescriptions via any method other than directed fax from EMR must be closely scrutinized and may require privacy impact assessments at both the pharmacy and the physician’s office.
Originally published in March 9, 2016, issue of The Link