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Legislative barriers to outpatient e-prescribing in a randomized trial.
Sherman Quan1, Merrick F Zwarenstein, Katie N Dainty
1Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario.
Healthcare Quarterly (Toronto, Ont.)
|November 21, 2007
Summary
Electronic prescribing software creates unique electronic signatures for prescriptions. However, Canadian federal legislation requires specific workarounds for compliance, highlighting the need for clear electronic signature legality.
Area of Science:
- Health Informatics
- Medical Technology
- Digital Health
Background:
- Outpatient electronic prescribing software generates prescriptions with electronic signatures.
- Current Canadian federal legislation prohibits static signature images on prescriptions.
Purpose of the Study:
- To evaluate the feasibility and challenges of implementing an electronic prescribing system in an outpatient setting.
- To assess compliance with Canadian federal legislation regarding electronic signatures on prescriptions.
Main Methods:
- A randomized trial was conducted at a university-affiliated hospital using a wireless Palm-based electronic prescribing system.
- Physicians created unique electronic signature images for each prescription.
- Workarounds were developed to comply with federal and provincial regulations.
Main Results:
- The system successfully generated electronic prescriptions for outpatient use.
- Challenges with wireless network reliability, printer availability, and physician training were overcome.
- Regulatory compliance required the development of specific prescribing process workarounds.
Conclusions:
- Implementing outpatient electronic prescribing systems requires addressing technical and training challenges.
- Current legislation necessitates workarounds for electronic signatures, impacting workflow.
- Clearer legal definitions for electronic signatures are crucial for realizing the full potential of electronic prescribing and integrated electronic medical records.
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