New Rules for E-Prescribing Faxes Generated by Computers?

E-prescribing - a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point of care - is an important element in improving the quality of patient care. In an effort to encourage the adoption of e-prescribing (also known as e-rx), the U.S. Centers for Medicare & Medicaid Services (CMS) has proposed eliminating the exemption for computer-generated faxes from the e-prescribing standards by early 2009.

In the earlier rule, the U.S. government adopted e-prescribing standards for use by physicians and suppliers in connection with prescriptions under Medicare Part D. They included the SCRIPT standard for communications between physicians and pharmacies regarding prescription information, but provided that entities that transmit prescriptions via a computer-generated fax were exempt from the SCRIPT standard. SCRIPT is a data transmission standard intended to facilitate the communication of prescription information between prescribers and pharmacists.

Will Your E-Prescribing Software Pass the Test?

Many older electronic medical records (EMR) systems have a computer-generated fax function, whereby a fax is generated on a physician's computer and sent to a pharmacy's fax machine. Think of it as the halfway point between the old fashioned paper system and the "new fashioned" electronic system. CMS anticipated that physicians using computer-generated fax software would adopt the SCRIPT standard over time, but this hasn't occurred. In the words of CMS, developing e-prescribing standards "is one of the key action items in the government's plan to expedite the adoption of electronic medical records and build a national electronic health information infrastructure in the United States.

So, what's "wrong" with computer-generated faxing? In short, it retains some of the disadvantages of paper prescribing. For example, the pharmacy must key the prescription into the pharmacy system, where data entry errors could jeopardize patient safety. It's better than the old fashioned paper prescribing system, but in the minds of Medicare, it falls short of true electronic prescribing.