Service of Potential Typos: New York State’s Electronic Prescription Drug Law

April 7th, 2016

Categories: Doctors, Internet, Medicine, Pharmaceutical

Typo

The new law in New York State that makes it mandatory for physicians to order drugs electronically immediately made me think of a few things. 

  • I worked in an office where if one person chronically left open a window midwinter potentially causing frozen pipes and other calamities or did some other thing management frowned upon, everyone got a memo—not just the offender. The alleged major reason for ordering prescriptions online is to cut down on doctor shopping for pain killers like Vicodin or Percocet. So why make doctors go through the rigmarole for all doctor shoppingprescriptions?
  • An ace editor reporting on product introductions in a trade magazine mistyped one digit in a client’s toll free number, [prior to websites]. Readers calling the number got an earful of porn. We laughed, she was embarrassed, errors happen when you juggle work and are rushed. I predict that when a doctor types a bunch of digits while listening to a patient’s complaints and questions he/she either won’t hear important information or is set up to make mistakes in the order.

Say you’re the receptionist tasked with the pill ordering chore. As you take messages, make appointments, greet patients and mishear the name of the drug the boss yelled in from another room, do you think you’ll get right all the codes for meds and pharmacies? What the patient gets may be a surprise. 

I feel that the more personal information we are forced to put in easily hackable places the worse for all. In a recent comment about a previous post “hb” wrote: “Given that the internet is now totally insecure as to confidentiality… if you catch syphilis cavorting with a prostitute, not just your wife/husband and children/parents, but also all your friends and neighbors are going to know about it within weeks. Maybe the young just don’t care, but I do!” My thoughts precisely.

Drs John LaPook and Holly PhillipsI heard Jon LaPook, MD, chief medical correspondent for CBS News with Holly Phillips, MD, [Photos, Left], on the “Morning Rounds” segment of CBS This Morning Saturday on April 2. Dr. Phillips admitted it’s faster for her to call in a prescription and doesn’t think the electronic logon and pharmacy search is time-effective but she seemed resigned as all NY docs must be. If they don’t comply, they are subject to fines, loss of license—even jail time. 

Dr. LaPook said he loved the system. A patient contacted him while he was on a flight and he was able to submit a prescription from the plane. However, the only additional benefit he could point to, in addition to controlling access to painkillers, was that there will be no mistakes made by bad handwriting where the pharmacist “reads quinine when the doctor meant Quinidine.” He admitted that the checking part of the process—to confirm that the patient isn’t getting painkillers elsewhere–is clunky but predicted that the system will eventually be great.

A young friend, who can fix any computer and is more tech-savvy than most, told me that the only winners in this new arrangement are the people who sold the programs to physicians and pharmacies. Do you agree?

Tech savvy

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6 Responses to “Service of Potential Typos: New York State’s Electronic Prescription Drug Law”

  1. Judy Schuster Said:

    My clinic has faxed prescriptions directly to the pharmacy of the patient’s choice for many years. Doctors only speak to the pharmacy if there is a question. I can’t recall the last time I heard a doctor say he or she would call in a prescription. I don’t know exactly how long this has been the practice, but I know it has been true for many years in Minnesota. I receive written prescriptions for narcotic medications, because that leaves less room for error. This system seems to work well for both the patient and the clinic. I find it particularly nice when I have a new prescription (often for an illness), because it means that the prescription is ready by the time I get to the pharmacy. I believe it is easier for the doctors, and, since prescriptions are in writing, there are fewer errors.

  2. Jeanne Byington Said:

    Judy,

    Faxed prescriptions are fine. And for those who want to send in electronic ones, fine. But to force a small business with tiny staff to learn the programs and use the electronic form of communication exclusively–is wrong.

    A friend told me how she advised a room full of hotel executives. I’ve mentioned this before but it is apt so I will repeat it here. She told them to consider all their clients–those who want to check in by mobile phone as they walk off the plane and those who want someone to carry their bags to the front desk and register in person. People communicate in many different ways. To deep six all but the electronic check-in options is short-sighted and will lose valuable customers. In the case of doctors, to force them to communicate in only one way is discriminatory.

    When you say you have “written prescriptions” it wasn’t clear if they are written on paper or electronically.

  3. hb Said:

    A great doctor much honored both nationally and internationally, once told me, “If you want a good doctor, get an old one.” He was a humble man. This was not typical distain for youth, rather a recognition that the honed intuition and “feel” experience brings to long practicing doctors is often far more important in medicine than book knowledge. It cannot be taught, and, so far, computers are unable to duplicate it.

    Yesterday, I saw a doctor I’ve been going to for thirty years. He knows me and has that extra “something” in spades; thanks to him I am still alive. Unfortunately, however, his computer skills are at the kindergarten level. He told me he is faced with a terrible dilemma. He can’t, given the insurance industry’s cutting back of his fee income, afford a fulltime “techie,” in addition to his long-serving and highly skilled nurse, and his existing receptionist who processes his paperwork, to deal with these new technological demands the State of New York is imposing on him.

    New York will soon lose yet another skilled practitioner who will inevitably be replaced by a technology- savvy younger doctor, who will give his or her (to them nameless) patient a less than five minute exam, prescribe by the book, and spend another five minutes keypunching data into a computer. So much for intuition… Obviously, this what the powers-that-be want because it does logically lead to a way to solve the problem of the rising cost of medical care.

    If you think it through, the direction technology is taking us is most frightening. Computers already are capable of having higher IQs than human beings. Once all our medical histories and all medical solutions from medication to therapies are input, what will we need doctors for?

    Have a problem? Attach yourself to your handheld, and it will examine you; punch in your compliant; it will question you; calculate a diagnosis; prescribe medications, and, presto, an hour of two later, FedEx delivers pills to your door! No more pharmacies, or doctor’s offices to visit or nurses to see. And to please the likes of the “I get even richer” crowd, the mechanics of the business can be outplaced offshore to India saving yet more money.

    Think further. With all that data, the power hungry like Trump, Cruz or Hilary, will be able to totally control the masses, through the judicious prescribing and distribution of highly addictive drugs. They could even close the prisons using such controls.

    It’s going to be a brave new world!

  4. Lucrezia Said:

    Electronic filing of prescriptions is a great idea, thus avoiding the horrors of having to decipher a doctors scrawl. The downside is a poor typist which could bring on tragic results. Each style of submission has risks.

    Who profits by this measure is irrelevant, unless one is against the concept of an inventor making a living.

    What stinks, is that it is mandatory, since this interferes with the doctor and patient relationship. Government has no business here.

  5. Jeanne Byington Said:

    hb,

    I am achingly sad for your doctor, who will be followed by hundreds if not thousands of others like him. The only answer for people in his spot now is to join a group of some kind where the cost of the techie is spread over a few practices. Perhaps they might be made up of a back surgeon, an ophthalmologist, a heart specialist, etc.

    I went to a mill for a broken foot. Everyone was nice and thank goodness it wasn’t a difficult thing as I saw the doctor for a minute or two during each brief visit after I had an x-ray. Someone asked me questions, someone else gave me a boot and goodbye. I wouldn’t know this doctor if he entered my office and he wouldn’t recognize me on the street.

    Up to now I have been spoiled. Like you, I’m probably alive today because of careful treatment by others.

    I went to a dr. a few years ago with a friend who was handed an iPad for the first visit. I helped the person respond to countless irrelevant questions that were of benefit to the pharmaceutical company that clearly was the sponsor of the program and maybe even paid for the iPad. The questions had nothing to do with the reason for the visit. The company was mining information.

    I have become increasingly blue as I think about this situation and the direction we are going.

  6. Jeanne Byington Said:

    Lucrezia,

    You’ve hit the black and blue mark where it hurts: Government does NOT belong between patients and their doctors on any issue.

    As for typos vs. handwriting, it’s a draw. Nothing is perfect. We joke about a doctor’s handwriting but are falling for an old saw as many write clearly. Others have their assistants type the Rx.

    I must use countless programs to post news of client events. I can spend 20 minutes on a two minute task when the program isn’t cooperating. I shudder to think of the time wasted doing this when someone could have written 10 prescriptions in the time to post one electronically.

    Last Saturday I panicked when I was bounced off my blog and couldn’t access it from either of two computers. I sent out a smokesignal and learned that one of the pieces to the puzzle that give my blog access to the Internet went down. I was lucky: The person was near his computer and could fix it. These things happen. To depend on a system that can go down for umpteen reasons is yet another major flaw in this concept.

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