Doctors Argue For Exceptions To Electronic Prescriptions

INDIANAPOLIS—Physicians who write few prescriptions or treat kidney dialysis patients should be exempt from a new law requiring that all controlled substances be prescribed electronically by Jan. 1, 2021.

“Our concern is for those practitioners who work in small practices or outside a large health system that have not yet adopted e-prescribing due to financial or technological barriers” Dr. Steve Tharp, of the Indiana State Medical Association, said.

Tharp made his argument Wednesday at the Statehouse before the Interim Study Committee on Public Health, Behavioral Health, and Human Services which was hearing testimony about electronic prescribing. The General Assembly passed Senate Enrolled Act 176 in the 2019 session, which requires e-prescribing for all controlled substances. It is modeled on a federal law that was enacted to combat the opioid and drug addiction crisis.

More than 80 percent of physicians across the state have already begun prescribing medications electronically, Tharp told the committee. But it could be burdensome for some physicians to implement the electronic prescribing system.

It is because of the costs that Tharp proposed an exception for physicians who write no more than 100 prescriptions per year along with several other exceptions including if the doctor is working at a temporary site.

A group of doctors from DaVita Kidney Care who specialize in dialysis for kidney-related illnesses told the committee that their operations need an exception because the medications prescribed to patients can change from session to session depending on lab results. The group represents over 9,800 dialysis patients nationwide and about one-third are Hoosiers.

“It would fundamentally disrupt how we are able to care for each patient from week to week and a day to day basis,” Dr. Adam Weinstein, DaVita’s chief medical officer, said.
Electronic prescribing could be an issue for patients undergoing dialysis because a majority of the patients are disproportionately from minority populations, said Jolene Adams, the regional operations director of DaVita Kidney Care.

“They are dealing with transportation concerns that they have, making sure they are getting to their dialysis on time, they are dealing with a multitude of medications, they have many limitations to their fluid intake, protein, their diet and things like that,” Adams said. “Our ultimate goal is to give them the best quality of life that we can until they hopefully get a kidney transplant.”

Grant Monahan, president of the Indiana Retail Council, agreed that dialysis exceptions is worthy of discussion but are ultimately in support of the bill.

“Electronic prescribing provides new dimensions of safety and security to the prescriptions, prescriptions cannot be altered or copied but they are electronically trackable,” Monahan said.

He argued that electronic prescribing would be less prone to error, allow for better monitoring of controlled substances, reduce the number of lost prescriptions and improve the workflow of physicians and pharmacists.

Sen. Ron Grooms, R-Jeffersonville, who authored the bill, told the committee, “The more pieces of paper that you can keep off the street and out of the homes and hands of those who do not have the right to possess that prescription on a piece of paper the better chance we have at combating opioid abuse and drug addiction in the state of Indiana.”

Changes to the law would have to be enacted by the General Assembly next year.

Brynna Sentel is a reporter for TheStatehouseFile.com, a news website powered by Franklin College journalism students.