electronic transmission of prescriptions

A patient has just presented you with a photograph of a prescription that they have received from their doctor via WhatsApp. Can you dispense based on this prescription? This article explores the issue.

Did you know that dispensing a prescription based on an electronic message sent to a patient and not directly to the pharmacy from an authorised prescriber requires validation by the pharmacy?

What means of electronic transmission of prescriptions are acceptable and why?

Regulation 33 of the General Regulations (2017) published in terms of the Medicines and Related Substances Act, 101 of 1965, allows for electronic signatures and the electronic transmission of prescriptions. In particular, Regulation 33(5) provides that “in the event of a prescription transmitted electronically by means other than an electronic agent, by fax or communicated verbally, a permanent copy of the prescription shall be made for record purposes”.

While many concessions and exemptions were made in the way pharmacy was conducted during the COVID-19 pandemic, as life returns to an adjusted normal, there are certain practices that place an additional burden on the pharmacy in terms of the authentication and validity of such prescription – one being electronic prescriptions presented at the pharmacy by patients for dispensing.

Electronically transmitted prescriptions sent directly from an authorised prescriber to a pharmacy, as a general rule, do not present a validity and authentication problem. As such the South African Pharmacy Council encourages pharmacists to make this the norm when receiving prescriptions that are electronically transmitted for purposes of dispensing.

However, many pharmacies and patients also think that, as a norm, prescriptions that are electronically transmitted by the authorised prescriber to the patient can be accepted as such. This notion can be dangerous, as one needs to take into consideration Regulation 33(4), which requires that the pharmacist who dispenses such a prescription shall verify the authenticity of the prescription before dispensing it.

The question that is asked is, can a pharmacist be sure that a patient that presents a prescription sent to the patient’s WhatsApp or email has not been presented to another pharmacy already, or that such prescription has not been changed in any way? Against a backdrop of concerns about the growing addiction to prescription medicines, and the spotlight on codeine-containing medicines, pharmacists accepting electronic prescriptions sent directly to patients need to ensure that some form of authentication and verification of the prescription has taken place.

As the authentication of a prescription now rests on the pharmacist, the South African Pharmacy Council advises that pharmacists, in order to avoid being charged with dispensing without a valid prescription, as far as possible accept electronically transmitted prescriptions sent directly to the pharmacy by authorised prescribers. While it is acknowledged that there is a need to educate authorised prescribers on the need to transmit prescriptions directly to a pharmacy based on the choice of the patient, such education begins by also educating the patient that prescriptions which are electronically transmitted to patients and not directly to the pharmacy will require authentication before being dispensed.

While the SAPC embraces the progression of technology in health care, such technology should not be used in a manner that compromises the standards of pharmaceutical care provided to patients. Remember, as a pharmacist, you are bound to the Pharmacy Act, Regulations and Rules, not the patient. And therefore, it is you who could face disciplinary action if you accept invalid and unauthenticated prescriptions.

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