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Dec 31 2019

STOP Act e-prescribing requirement in effect Jan. 1

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It’s here: the STOP Act e-prescribing requirement. Effective Wednesday, Jan. 1, all prescriptions for Schedule II and III opioids and certain other controlled substances such as buprenorphine are required to be issued via electronic prescription.

In recent weeks NCMB has heard from numerous concerned licensees, hospitals, healthcare facilities, pharmacies and others that many prescribers do not have e-prescribing capability in place and will not be able to comply with the law.

Although there is no exemption for prescribers who have not implemented e-prescribing due to cost or other factors, the law does provide some flexibility to ensure patients have access to needed medications. The STOP Act specifically authorizes pharmacies to fill any medically valid prescription. That is, if patients present a paper prescription, the pharmacy will be able to fill it. Please understand this is not a long-term solution. Prescribers are expected to make a good faith effort to comply with the law.

NCMB is not able to assist licensees with selecting an e-prescribing solution or offer advice on available solutions. NCMB has developed FAQs to address some of the most-asked questions regarding the STOP Act e-prescribing requirement.

 Comments on this article:

Im not a fan of this ruling for several reasons. While at first it sounds like a great idea, it’s very flawed.
First off, I’m not a fan of EMR/EHR. As a primary care provider, I receive many consult notes that are 4-5 pages of jibberish. They touch all of the meaningful use bullet points, but they often have no real information. They’re too easy to use vague nonspecific boilerplate templates or they’re copied and pasted. Ex: Why does a note from an ENT state “rectal vault empty. Sphincter tone good.”?
Second, it’s too much vulnerability/liability for eprescribing that dishonest staff can potentially have access and prescribe (with or without permission) at will?  It’s almost akin to leaving a pre signed prescription pad lying around.
Third, Google is currently undertaking “project nightingale” where they’re essentially stealing bulk random medical records without permission from patients or providers.  This is a HUGE HIPPAA violation. Research it. It should make us all quite uncomfortable.
I prefer to the security of paper/ written prescriptions, which ate all copied and/or scanned into the chart, and urge the Board to agree with my sentiment.

By Mike Winn on Dec 31, 2019 at 5:22pm

To Whom It May Concern,

This policy is clearly well-intentioned and a good faith effort to address the opioid crisis. However, although all three of my places of work have e-prescribing options, these do not address several exceptions that occur commonly. The out-of-town or out-of-state patient who does not have an in-town pharmacy. The prescription that is faithfully sent to a pharmacy that is now closed at night or weekends. The homeless patient who does not have an established pharmacy. Everything done perfectly only to discover the location in question has run out of X medication and cannot/will not transfer it electronically to a location that does. Please consider modifying your policy to generating an electronic record of an opioid prescription but then having the option of EITHER paper or electronic delivery. Thank you

By Heidi Weilbach, MD on Jan 01, 2020 at 4:08pm

Mr. Winn and Dr. Weilbach - Thanks to you both for taking the time to share your concerns. Just to be clear, e-prescribing is required by state law - it is not a policy adopted by the North Carolina Medical Board. As a service to licensees, NCMB has been sharing information about the change in state law. It may be best to direct concerns about the e-prescribing requirement to your elected representatives in the NC General Assembly, or consider sharing them with any professional societies or membership organizations you may be involved with.

By Jean Fisher Brinkley on Jan 02, 2020 at 3:35pm
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