If the governor signs the measure, all prescribers -- and their patients -- receive a one-year reprieve before mandated electronic prescribing begins.
A March 27 deadline for mandated e-prescribing was signed into New York law three years ago, but doctors and other prescribers say they're still not ready.
"I hope the governor signs it as quickly as possible so we can get to work on how to do this correctly," said Dr. Andrew Kleinman, president of the Medical Society of the State of New York.
Kleinman cited a flurry of logistical issues plaguing the changeover from paper prescription pads to exclusive e-prescribing. Several electronic health-record vendors are not yet certified for e-prescribing of controlled substances in New York -- and if the vendors aren't ready, prescribers who need the electronic systems are hamstrung, Kleinman said.
Software problems
Even among doctors with certified systems, some are having problems with the software, while others have yet to introduce e-prescribing technology to their practices, prescribers have said.All of the problems will have to be resolved before they can move comfortably away from pen and prescription pads into a fully digital realm, Kleinman said. The State Assembly unanimously passed a measure last week calling for a one-year delay; the State Senate approved the delay earlier last month.
Tracy Russell, executive director of the Pharmacists Society of the State of New York, said she was surprised to learn that prescribers were still scrambling.
"The pharmacy community has been ready," she said. Russell said at last count, 97 percent of pharmacists in New York were prepared to meet the March 27 deadline.
Yet moving exclusively to e-prescribing is not a simple task. An estimated 300 million to 350 million prescriptions are filled statewide annually, according to Jeanne Beattie of the New York Education Department.
New York is the first state to legally eliminate paper prescribing, although veterinarians will still be allowed to handwrite prescriptions. And while paper prescription pads are being phased out, antiquated Latin terminology common to paper prescriptions is included in some electronic software, Kleinman said.
The electronic mandate applies to physicians, dentists, podiatrists, nurse practitioners and other medical prescribers. The mandate covers all drug classes.
Mandatory electronic prescribing is part of a larger measure known as I-STOP, or Internet System for Tracking Over-Prescribing Act, which was passed in 2012. Among the law's chief aims is reducing drug diversion and doctor shopping.
Stolen pads
Stolen prescription pads have proved lucrative tools in the widespread prescription opioid drug trade. A single pad with only 50 slips can net $150,000 in prescription drugs, experts say.Forgers also have used stolen pads to write illegal prescriptions for psychostimulants, such as Adderall, a drug prescribed to treat attention deficit hyperactivity disorder in children.
Another e-prescribing benefit, doctors say, is the elimination of illegible handwritten prescriptions. Allen Vaida, executive vice president of the Institute for Safe Medication Practices, said his organization called for the nationwide elimination of paper prescriptions years ago and had set 2003 as the deadline.
"Not everyone was ready at that time," Vaida said. But over the past several years many private practices, hospitals and clinics have moved forward voluntarily with electronic records and e-prescribing, he said.
"We still hear of errors due to handwritten prescriptions, but certainly not at the frequency we saw years ago," Vaida said. "We actually see more issues with e-prescribing now."
When the first three letters of a drug name are entered "a whole screen-full of drug names appear and you can easily choose the wrong one," said Vaida, a pharmacist. "We don't want electronic prescribing software to be just a word processing program," he said.
Kleinman, meanwhile, said news of the Assembly vote has caused some physicians to curtail efforts to get e-prescribing systems up and running.
"A lot of people who were scrambling to do it have slowed down the process," he said. "It's still not a done deal until the governor signs the bill."
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