State Board of Pharmacy; 77 South High Street, Room 1702; Columbus, Ohio 43215-6126

Tel: 614/466-4143 Fax: 614/752-4836 Eml: exec@bop.ohio.gov

Electronic Prescription Transmission Systems

(11/03/09)

Electronic prescription transmission systems allow prescriptions to be sent electronically from a prescriber to a pharmacy. The prescriber can send the prescription directly from his/her computer to a pharmacy computer or facsimile machine. Some of the systems are office-based, some are web-based, and some use a switching station to route the prescription to the pharmacy. The office-based systems allow the prescriber to send a prescription electronically directly from his/her office to the pharmacy. The web-based systems allow the prescriber to log onto a website, enter a prescription, and the website sends the prescription to the pharmacy. Systems utilizing a switching station allow the prescriber to enter a prescription that is transmitted to a switching station. The switching station identifies the prescriber using specific data elements and then sends the prescription to the pharmacy.

Prior approval by the Board of Pharmacy is required for all electronic prescription transmission systems intended to be used in Ohio. The Board approval process includes reviewing that each system has true “positive identification” of the prescriber sending the prescription as defined in paragraph (N) of Rule 4729-5-01 of the Ohio Administrative Code (OAC), that every system has security and accountability of all confidential information, that the pharmacist receiving the prescription can identify that the system has approvable status with the Board of Pharmacy, and that the pharmacist receiving the prescription can identify that the prescription is legitimate.

Some important information you should know about electronic prescription transmission systems:

1.	No Schedule II controlled substances shall be sent to a pharmacy using an electronic prescription transmission system.
2.	There can be multiple prescriptions, including controlled substances in Schedules III, IV, and V, issued on one prescription blank when using an electronic prescription transmission system to send a prescription to a pharmacy [see OAC Rule 4729-5-13]. However, it should be noted that the DEA currently does not allow for the electronic transmission of controlled substance prescriptions. The DEA does allow the information to be transferred to a pharmacy, but then requires the pharmacist to treat it as an oral prescription. To create an oral prescription the pharmacist must then personally contact the prescriber by telephone and verify the transmitted information. Therefore, due to the increased legal burdens placed on the pharmacist and prescriber, many vendors involved with the transmission of electronic prescriptions have chosen to prohibit the transmission of controlled substance prescriptions at this time.
3.	“Dispense As Written” or “DAW” does not have to be handwritten on a prescription sent through an electronic prescription transmission system [see Section 4729.38 of the Ohio Revised Code (ORC)]. It does, however, require a positive action by the prescriber to physically select “Dispense As Written” or “DAW” when creating an electronic prescription. The electronic prescription transmission system cannot automatically default to "Dispense As Written" or "DAW".
4.	You may, or may not, see a signature on a prescription sent to a pharmacy by a prescriber using an electronic prescription transmission system. Electronic signatures are not recognized as a means of “positive identification” and therefore are not required. If a signature is present, the prescription must indicate that the signature was computer-generated.
5.	A prescriber may elect to print a prescription from the electronic prescription transmission system in his/her office and give it to the patient to personally present to a pharmacy. The prescription must be issued as per any written prescription [see OAC Rules 4729-5-30 and 4729-5-13]. These prescriptions may contain a Schedule II controlled substance, there can only be one controlled substance per prescription blank, “Dispense As Written” or “DAW” must be handwritten, and the actual handwritten signature of the prescriber must be on the prescription.

The systems that currently have obtained an approvable status with the Board of Pharmacy are (NOTE: The approvable status applies ONLY to the electronic prescription transmission system and NOT to any other related electronic products, such as an electronic medical record):

A4 Health Systems Allmed Allscripts Allscripts eRX NOW Allscripts-HealthMatics EHR Allscripts MyWay Alteer Amicore Aprima Athenahealth BlueFish ChartLogic CyberAccess DrFirst e-Clinicalworks EHS Emdeon e-MDs Epic at Cinc. Children’s Epic at Cleveland Clinic Epic at Dayton Children’s Epic at Ohio State

Epic at Premier Health Center Epic at Tri-Health E-Physician e-Referral GEMMS Greenway Medical Health Probe iMedica InfoScribeRx InteGreat I-Scribe KeyScribe MedicWare McKesson Horizon Ambulatory Care Medent MedInformatix MedPlus MI-LifeNet MicroMD Misys at Family Practice Assoc. Of Dayton Misys at Greater Cincinnati Cardiovascular Consultants

Misys at Northeast Center for Women’s Health Misys at The Family Medical Group Mt Carmel/Medical Manager My Practice Community NetPracticeEHRweb at Premiere Medical Partners NetScript NewCrop NextGen OnCallData Practice Partner Pocket Scripts Positive Business Solutions Inc./PBSI-EMR Relay Health RxNT Sage Health SigmaPoint Wellinx

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