BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 1589|
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THIRD READING
Bill No: AB 1589
Author: Simitian (D)
Amended: 8/28/01 in Senate
Vote: 21
SENATE BUSINESS & PROFESSIONS COMMITTEE : 5-0, 6/25/01
AYES: Figueroa, Johannessen, Machado, O'Connell, Polanco
SENATE JUDICIARY COMMITTEE : 5-1, 8/21/01
AYES: Escutia, Ackerman, Kuehl, O'Connell, Sher
NOES: Haynes
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 75-0, 5/24/01 (Passed on Consent) - See
last page for vote
SUBJECT : Healing arts: electronic transmission of
prescriptions
SOURCE : Author
DIGEST : This bill requires the Medical Board in
consultation with the Board of Pharmacy to conduct a study
on the electronic transmission of prescriptions by
physicians and other health care providers.
ANALYSIS : This bill:
1.Makes Legislative findings that in 1993, approximately
7,000 deaths occurred in the United States as a result of
CONTINUED
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medication errors.
2.Makes further findings that illegible prescriptions
result in more than 150 million inquiries each year by
pharmacists for clarification of the prescription and
that while technology exists or electronic transmission
of prescriptions, less than 5 percent of physicians and
surgeons use this technology.
3.Requires the Medical Board to consult with the Board of
Pharmacy and commission a study that evaluates the
electronic transmission of prescriptions by physicians
and surgeons and report its results to the Legislature on
or before January 1, 2003.
4.Specifies that the reports should include recommendations
on whether the electronic transmission of prescriptions
should be encouraged, methods to encourage physicians and
surgeons, other specified health care providers, and
persons licensed to prescribe in another state to use
this method to transmit prescriptions and identify
systems to protect confidential, personal, and medical
information of patients, including the issuance of a
"digital certification."
5.Defines "digital certification" as an electronic
signature that verifies the identity of the physician and
surgeon, other specified health care provider, or person
licensed to prescribe in another state who is
transmitting the prescription electronically.
Comments :
According to the author, the Assembly Health Committee has
been researching various E-health issues, including
E-prescription issues. The Palo Alto Medical Foundation
has begun testing a new Web-based system that allows
patients to view their own medical records, request
appointments and renew prescriptions on line. The author
further explains that New Jersey is considering new rules
to allow physicians to E-mail prescriptions to a pharmacy,
a move aimed at reducing errors caused by illegible
handwriting. Also, as the industry explores options to
make health care delivery more efficient and
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cost-effective, there is a need to develop standard
protocols regarding signature verification, security, and
interfacing with current requirements relative to
prescribing drugs or oversight of drug prescription will
become unsound.
In November of 1999, the Institute of Medicine (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 the
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
A white paper from the Institute for Safe Medications
Practices (ISMP) called 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. The 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. The ISMP asserts that fortunately, the advent
of wireless hand-held devices is making it increasingly
possible to solve the "handwriting crisis," perhaps on all
three counts.
Related Pending Legislation :
AB 1490 (Thomson) - would provide for patients to access
laboratory test results online. This bill is on Senate
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Third Reading File.
AB 826 (Cohn) - would authorize a pharmacist to initiate
the drug regimen of a patient in a health facility pursuant
to a written order or prescription and would authorize the
pharmacist to provide written or electronic notification of
that action. This bill is on the Senate Third Reading
File.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/28/01)
California Medical Association
California State Board of Pharmacy
California Optometric Association
Medical Board of California
ARGUMENTS IN SUPPORT : The California Medical Association
(CMA) is in support of this measure and indicates that the
CMA continues to examine methods whereby physicians can
reduce medical errors through their Project SAFE CARE
(Strategic Alliance for Effective Care and Reduction of
Errors) Task Force. The Project is currently reviewing
several vendors that may have the capacity for
electronically prescribing medications in order to develop
important criteria that physicians may consider when taking
advantage of this technology. It is the belief of the CMA
that this bill will assist physicians in accomplishing
their goal of ensuring patient safety and reducing medical
errors.
The California State Board of Pharmacy (Board) indicates
that electronic prescribing has been proven to
substantially reduce the incidence of medication errors and
has the potential to bring substantial operating
efficiencies to prescribing and dispensing processes. As
explained by the Board, electronic prescribing has begun to
take hold in the hospital setting and experience in one
hospital found a 50% reduction in medication errors and a
two hour reduction in the time required to process the
order and administer the drug to the patient. A study
required by this bill will provide recommendations on how
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to speed up the adoption of this technology in other
settings.
ASSEMBLY FLOOR :
AYES: Aanestad, Alquist, Aroner, Ashburn, Bates, Bogh,
Briggs, Calderon, Bill Campbell, John Campbell,
Canciamilla, Cardenas, Cardoza, Cedillo, Chan, Chavez,
Chu, Cohn, Correa, Cox, Daucher, Diaz, Dickerson, Dutra,
Firebaugh, Frommer, Goldberg, Havice, Hollingsworth,
Horton, Jackson, Keeley, Kehoe, Kelley, Koretz, La Suer,
Leach, Leslie, Liu, Longville, Lowenthal, Maddox,
Maldonado, Matthews, Migden, Mountjoy, Nakano, Nation,
Negrete McLeod, Oropeza, Robert Pacheco, Rod Pacheco,
Papan, Pavley, Pescetti, Reyes, Richman, Runner, Salinas,
Shelley, Simitian, Steinberg, Strickland, Strom-Martin,
Thomson, Vargas, Washington, Wayne, Wesson, Wiggins,
Wright, Wyland, Wyman, Zettel, Hertzberg
CP:jk 8/28/01 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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