There appears to be no disagreement among influential and prestigious health organizations that handwritten and hand-carried prescriptions must be replaced with an efficient, electronic, nationwide infrastructure. The present arrangement consists of a hodge-podge of handwritten and electronic prescribing methods, which is not only highly inefficient, but harmful to patients. With about 7,000 patients killed every year because of medication errors, and hundreds of thousands injured, the federal government has stepped in with a powerful program to achieve acceptance of and uniformity in ePrescribing systems.

Safe Harbor Exception

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 sets a schedule for the establishment of standards in Medicare ePrescribing, and spells out financial assistance to physicians. Even though physicians might be willing to learn and use a new electronic system, they are not as willing to pay the expense involved in replacing handwritten prescriptions with electronic ones. Indeed, cost is the biggest obstacle for these practitioners.

In addition to significant financial incentives to defray expenses, this new law provides important legal protections to certain health workers who would be involved in the prescribing process. This Safe Harbor exception to fraud and abuse statutes allows health institutions to provide hardware, software, information technology and training to relevant personnel involved in ePrescribing. Exceptions are not made for an entire institution, such as a hospital, but only for those health workers who would have access to patient information and other medical data.

Exceptions include group practices, but only for those who are prescribing healthcare professionals and are members of the group. Health plans are also included, since physicians who belong must write prescriptions, but exceptions include only healthcare professionals and network-connected pharmacies and pharmacists. Hospitals are an obvious exception, because prescribing and dispensing medications are an essential part of treatment, but the exception applies only to medical staff.