BILL ANALYSIS
AB 1589
Page 1
Date of Hearing: April 17, 2001
ASSEMBLY COMMITTEE ON HEALTH
Helen Thomson, Chair
AB 1589 (Simitian) - As Introduced: February 23, 2001
POLICY QUESTION :
Should the Medical Board be required to conduct a study on the
electronic transmission of prescriptions by physicians, and
report its results to the Legislature before May 1, 2002?
SUBJECT : Healing arts: electronic transmission prescriptions.
SUMMARY : Requires the Medical Board of California (Board) to
conduct a study on the electronic transmission of prescriptions
by physicians, and report its results to the Legislature before
May 1, 2002. Specifically, this bill :
1)Requires the Board to conduct a study and report its results
to the Legislature before May 1, 2002, on the electronic
transmission of prescriptions by physicians.
2)Requires the report to include recommendations for methods to
encourage physicians and surgeons to issue prescriptions by
electronic transmission and identification of systems to
protect patients for whom prescriptions are issued using that
process, including, but not limited to, the issuance of
digital certification to physicians to use when transmitting
prescriptions electronically.
3)Defines "digital certification" as an electronic signature
verifying the identity of the physician who is transmitting
the prescription electronically.
4)Make various legislative findings, based on a specified
report, that approximately 7,000 deaths occurred in the United
States as a result of medication errors in 1993. Makes
further legislative findings, based on the Institute for Safe
Medicine Practices, that of the 3 billion prescriptions issued
each year in the United States, nearly all of them are
handwritten, and illegible prescriptions result in more than
150 million inquiries each year by pharmacists for
clarification from the physician who issued the prescription.
AB 1589
Page 2
EXISTING LAW :
1)Establishes the Board within the Department of Consumer
Affairs, charged with the licensing and regulation of
physicians.
2)Establishes the Board of Pharmacy to regulate the practice of
pharmacy.
3)Prohibits dangerous drugs or devices from being sold or
furnished without a prescription, and defines a "prescription"
as an oral, written, or electronic transmission order issued
by licensed prescribers, as specified. Further defines
"electronic transmission prescription" as including both image
prescriptions (facsimile) and data prescriptions
electronically transmitted from a licensed prescriber to a
pharmacy.
4)Permits a prescriber to electronically enter a prescription
into a pharmacy's or hospital's computer from any location
outside of the pharmacy or hospital with the permission of the
pharmacy or hospital.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, as the
industry explores options to make health care delivery more
efficient and cost-effective, there is a need to develop
standard protocols regarding signature verification, security,
and interfacing with current requirements relative to
prescribing drugs.
The author provided a white paper from the Institute for Safe
Medication Practices (ISMP), calling for the elimination of
handwritten prescriptions within 3 years. The ISMP paper
stated that the health care industry has been slow to adopt
new technologies, and that prescription writing is perhaps the
most important paper transaction remaining in our increasingly
digital society. ISMP argues that the hurdles until very
recently have been clinicians' reticence about computers, a
lack of hardware and software that would conveniently allow
prescribers to select medications electronically, and fear of
the costs associated with such technology. ISMP asserts that
AB 1589
Page 3
fortunately, the advent of wireless hand-held devices is
making it increasingly possible to solve the "handwriting
crisis," perhaps on all three counts.
2)INSTITUTE OF MEDICINE (IOM) REPORT . In November of 1999, IOM
released a report, "To Err is Human: Building a Safer Health
System," which found that approximately 7,000 hospital
patients die annually across the country from preventable
medication-related errors. The IOM report found that 2 out of
every 100 hospital patients will die or be injured as a result
of preventable medication errors, and that each medication
error increases the cost of a hospital stay by an average of
$4,700. The IOM report included several recommendations to
address medication-related errors, including that health care
organizations and the professionals affiliated with them
establish patient safety programs which incorporate
well-understood safety principles, such as standardizing and
simplifying equipment, supplies, and processes, and that
health care organizations implement proven medication safety
practices.
3)COMMENT . While the Medical Board licenses and regulates
physicians, who make up the bulk of the providers permitted to
issue prescriptions, the Board of Pharmacy oversees the
practice of pharmacy and should be included in any state
effort examining ways of improving the prescription process.
Additionally, regulatory boards are not always the most
appropriate entities to conduct studies. The author may wish
to consider an amendment that would require the Medical Board,
in consultation with the Board of Pharmacy, to commission a
study under the parameters of this bill. Finally, the author
may wish to consider a later reporting date; the May 1, 2002
deadline currently in this bill for reporting the results to
the Legislature may not give the Board sufficient time to
develop and conduct the study.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file
AB 1589
Page 4
Opposition
None on file
Analysis Prepared by : Vincent D. Marchand / HEALTH / (916)
319-2097