State law catches up with technology

Dr. Michael Myers swivels his chair to a computer, calls up a patient record and types in a prescription. The computer dials up the pharmacy fax number and sends in a faxed prescription order. The Lincoln Family Practice residency program has used the electronic record system for about four years.

But until recently, state law did not recognize the computer age. Under state law, the pharmacist could not assume the prescription was valid because there was no traditional signature.

So pharmacists had to call the doctor's office to validate the prescription, erasing one of the time-saving benefits of computer-driven prescriptions.

This spring state law caught up with modern technology. LB382 allows pharmacists to accept new kinds of computer-driven signatures.

Myers believes electronic prescribing is good for the same reasons that some national groups are suggesting that everyone abandon the handwritten prescription pad.

It's safer, avoiding the problems of illegible handwriting. His computer program also cross-checks the prescription with a patient's other medications or allergies, said Myers, director of the residency program.

And it's speedy, moving directly from office to pharmacy.

Heath care is moving, from paper to electronic record-keeping and electronic prescribing, said Joni Cover, with the Nebraska Pharmacists Association.

In fact, Medicare is creating standards for electronic prescribing and hopes to have some grants available to help doctors purchase the equipment.

But electronic prescribing won't eliminate all errors, estimated to kill up to 7,000 people and cost nearly $77 billion a year.

Doctors need to be well-trained, so they understand how to use the computer drug menus, said Cover. Software that can point out potential errors is helpful, she said.

And the pharmacist is still expected to check out any prescription that appears to be inaccurate with the wrong dosage or wrong medicine, said Becky Wisell, a Health and Human Services System employee who works with the Board of Pharmacy.

The new state law covers electronic signatures (as on faxes) and digital signatures on prescriptions delivered directly from the doctor's computer to a pharmacy computer, Wisell said.

Nebraska law is ahead of the curve on the digital signature, Myers said.

At least a half-dozen physician offices and clinics in the state have some kind of computer system that can fax in prescriptions, according to Myers.

But there are probably no physicians in the state yet who use pure electronic prescriptions, where a doctor sends a prescription using a handheld computer like a blackberry, directly to the pharmacy computer, he said.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.