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Should Controlled Substances Be E-Prescribed?

For years, people have made jokes about doctors’ notorious bad handwriting. While the jokes may […]

For years, people have made jokes about doctors’ notorious bad handwriting. While the jokes may have been funny, the reality is that illegible prescriptions and chart entries can be in fact dangerous. Many medications look similar and are often spelled with just a few different letters. Hand-written prescriptions that are not readable can lead to the patients being dispensed the wrong medication, which can be quite harmful. It can also leads to wrong directions being given to patients and wrong doses. Everyone can see the potential adverse outcomes in this situation.
With the advent of electronic prescribing, many of these problems have been improved. Yet, there are still frequent issues that need to be worked out in the e-prescibing process: pharmacies never receiving prescriptions, prescriptions that are received in the pharmacy that have some information missing from them and several others. Another big frustration is that for many doctors, controlled substances cannot be sent electronically. For many of us, we feel that out of all the medications that are e-prescribed, it is more important that these medications be transmitted electronically and not hand-written.

Why Should Controlled Substances Be Allowed to be Transmitted Electronically?

1. Handwritten prescriptions, as stated above, can be misinterpreted. Controlled substances can be very dangerous agents and need to be dispensed correctly.

2. Handwritten prescriptions can be altered. I think most doctors have a story of a patient who has tried to alter one of their prescriptions. It may be that they alter the amount dispensed or the dosage, but this is not possible in the electronic chart. A patient would have to go to great extremes to hack the medical software and added efforts to be able to send an altered prescription. It would be near impossible.

3. Handwritten prescriptions can be sold for purposes of drug diversion. This is an all too common occurrence. While the prescription drug epidemic flourishes, the possibility of having handwritten prescriptions available for diversion should be nullified. By having the ability to send controlled substances electronically, it would cut and/or eliminate the number of handwritten prescriptions in existence. Once the prescription leaves the doctor’s hands, they no longer have control over where it will go. In e-prescribing, it will go only where the doctor sends it.

4. There are stories of whole prescriptions pads being stolen from doctors. If controlled substances could be sent electronically, this would make the need for having prescription pads obsolete.

5. Patients who abuse controlled substances or divert them, often get prescriptions filled from different providers and different pharmacies. With electronic prescribing, it would be easier to track these diversionary tactics. The patient would have to go to the pharmacy that the prescription was electronically transmitted to. They would not have the option of shopping it around.

While the concern over prescribing controlled substances is valid, more thought should be given to how they are prescribed. Many Americans are falling victim to addiction to these types of medications. Additionally, we are seeing a rise in IV heroin addiction that can be traced back to prescription drug abuse. This is not only occurring in adults but we are seeing a rapid increase in teenagers as well. We have fallen behind what needs to be done to stem the rising tide of prescription drug abuse. Perhaps, the ability to e-prescribe them can help rein it in and make it more trackable.


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Dr. Linda Girgis

Dr. Linda Girgis MD, FAAFP is a family physician in South River, New Jersey. She has been in private practice since 2001. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter's University Hospital and Raritan Bay Hospital. She teaches medical students and residents from Drexel University and other institutions. Dr. Girgis earned her medical degree from St. George's University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University where she was recognized as intern of the year. She is a blogger for Physician's Weekly and MedicalPractice Insider as well as a guest columnist for HIT Outcomes. She has had articles published in several other media outlets. She is on the medical advisory board of SERMO. Recently, she has authored the book, “Inside Our Broken Healthcare System” and "The War on Doctors". She has been interviewed in US News and on NBC Nightly News.

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