Facsimile And Electronic Medical And Prescription Orders

(1) Facsimile Orders. (a) The transmission of a facsimile medical or prescription order shall be to a pharmacy practice site of the patient’s choice and shall occur only at the option of the patient. (b) Medical and prescription orders may be transmitted to a pharmacy practice site by a facsimile device. Medical and prescription orders for controlled substances may be transmitted by facsimile devices in compliance with 21 C.F.R. 21306.11, 1306.21 and 1306.31. STANDARDS OF PRACTICE CHAPTER 1140-03 (c) A pharmacist may dispense medical and prescription orders transmitted by facsimile devices only when transmitted by an authorized prescriber or the prescriber’s designated agent. (d) A facsimile medical or prescription order which meets the requirements of this rule shall be deemed the original medical or prescription order for purposes of filing. The facsimile medical or prescription order must either be photocopied or the original medical or prescription order should be of such quality to not fade within the legal requirements of medical or prescription order record keeping. (e) Wholesalers, manufacturers, pharmacists and pharmacy practice sites are prohibited from supplying facsimile devices or supplies to any authorized prescriber under any conditions. (f) An original medical or prescription order that indicates that it has been faxed to a pharmacy practice site, consistent with the provisions of this rule, may only be dispensed as an original medical or prescription order by the pharmacy practice site to which it was faxed, consistent with the notation on the medical or prescription order to be made in accordance with the requirements contained in this rule. (2) Electronic Orders. (a) Prescription or medical orders transmitted electronically shall meet the following criteria: 1. All prescription or medical orders shall be transmitted directly from an authorized prescriber or prescriber’s agent to a licensed pharmacist or to an area in a licensed pharmacy of the patient’s choice that is under the direct supervision of a licensed pharmacist, with no intervening person or entity having access to the order for purposes other than transmission of the order. Subject to the provisions of this rule, a prescriber or prescriber’s agent may electronically transmit medical or prescription orders to a pharmacist within an institutional facility for inpatients and/or outpatients currently under treatment at that facility. Nothing in this subsection shall apply to distributors of medical gases. 2. The transmission shall include: (i) The telephone number of the authorized prescriber to allow verbal confirmation of the validity and accuracy of the order; (ii) The correct time and date of the transmission; (iii) The name of the pharmacy to which the order is being transmitted; and (iv) The prescribing practitioner’s electronic signature or other secure method of validation. “Electronic Signature” is defined as the process that secures the user authentication (proof of claimed identify, such as by biometrics, fingerprints, retinal scans, hand written signature verification, etc.) at the time the signature is generated and creates the logical manifestation of a signature. (v) If the transmission is delegated by the prescriber to an agent of the prescriber, the identity of the agent shall be included in the transmission. STANDARDS OF PRACTICE CHAPTER 1140-03 (b) Electronic data related to the transmitted order shall be maintained in the pharmacy and shall be deemed the original prescription or medical order meeting all requirements of rule 1140-03-.03 of the rules of the Board. (c) The pharmacist receiving any transmitted order shall not knowingly participate in any system that restricts the patient’s choice of pharmacy. (d) The pharmacist may not provide financial or other remuneration to the prescriber for any prescription transmitted to the dispensing pharmacy. No person or entity, including but not limited to wholesalers, distributors, manufacturers, pharmacists, and pharmacies, shall supply electronic equipment, software, devices, or modems to any prescriber in exchange for transmitting orders. (e) The pharmacist shall not use the electronic transmission of orders to circumvent or violate any provision of state or federal drug laws, or the Tennessee Pharmacy Practice Act, or the regulations of the board. (f) This rule shall not apply to medical or prescription orders electronically transmitted between pharmacies or medical or prescription orders transmitted by facsimile. (g) Upon request, the Board may waive selected portions of these requirements so long as any waiver granted is consistent with the Board’s authority under Tenn. Code Ann. Title 63, Chapters 1 and 10, and Tenn. Code Ann. Title 4, Chapter 5.