Pharmacy Legislation

E-prescribing Usage Increases with Doctors, but Not Without Problems

August 2, 2010 | Lebowitz & Mzhen

As our Washington D.C. Pharmacy Error Injury Attorneys reported in a recent blog, physicians who are not prescribing medications electronically, or e-prescribing, by 2012 will be financially penalized by the federal government.

Although the use of electronic prescribing has increased in years, and evidence shows that e-prescribing can reduce pharmacy misfills that can lead to patient injury or even wrongful death, many local doctors reportedly clam that overall acceptance of this important technology is lagging.

According to a study published last week by the Washington-based think tank, the Center for Studying Health System Change, less than one-third of this country’s physicians in office settings, are e-prescribing. The study also revealed that even fewer physicians that were e-prescribing were using the beneficial aspects of the system, like searching for serious drug interactions and using the system to cross reference patient insurance for prescription drug verifications to ensure health plan payment coverage. The study also found that even fewer doctors who used the electronic system would actually prescribe medications electronically, opting to use the fax machine instead for prescription submittal.

The Institute of Medicine (IOM) claims 1.5 million people in this country are injured by preventable medication errors, with nearly 7,000 deaths every year.

Electronic Prescriptions and the Path to Preventing Medication Errors

April 30, 2010 | Lebowitz & Mzhen

In yesterday’s blog, our pharmacy error attorneys in Baltimore, Maryland, discussed the rapidly growing numbers of doctors switching from hand-written prescriptions to electronic prescriptions—to create a more efficient system that helps to prevent medication errors in every step of the prescribing and pharmacy process.

The Wall Street Journal documented an example of possible prescription error with 59-year old Debbie Kenny, who was prescribed a new hypertension medication by her doctor that had just become available at the end of last year. Unknown to both Kenny and her doctor, the medication had the potential to interfere with her asthma—a dangerous side effect. Kenny consequently had trouble breathing after coming down with a cold, still not understanding the side effects of the medication.

After Kinney’s doctor started to e-prescribe the following month, the new electronic system indicated very clearly that Kinney should not be taking that particular hypertension drug, because of her asthma, and the drug’s side effects. She was promptly switched to another medication for hypertension that was compatible with her asthma. Kinney said that she feels more comfortable now with the new electronic system. If her doctor prescribes a new drug, she can ask for a clear computerized diagram of the side effects or the drug interactions before taking the medication—to avoid any personal injury.

As of last year, the Center for Medicare and Medicaid Services (CMS) was helping to promote the switch to electronic prescribing by enticing doctors and paying them a bonus for e-prescribing. As of the beginning of 2012, a stronger encouragement will appear, as CMS will begin penalizing doctors who haven’t embraced the electronic system to issue patient’s prescriptions.

Hollywood Prescription Drug Abuse —Illegal Drug Rackets and “Doctor Shopping”

April 26, 2010 | Lebowitz & Mzhen

In a blog from last week, our Washington-D.C. area Pharmacy Error Attorneys at Lebowitz and Mzhen covered the topic of illegal prescription drugs, after a Maryland pharmacist was sentenced to federal prison for selling illegal painkillers to a drug dealer—drugs that were meant to be used under the supervision of a doctor, that could lead to personal injury, drug overdose and death.

According to the Baltimore Sun, prescription drugs are currently the number one cause of death overdose in the country. The Office of National Drug Policy claims that in his past year of drug abuse, prescription pain killers now rank second, behind marijuana as the nation’s most prevalent illegal drug problem. The National Institute of Medicine reports that 20 percent of people in the United States have used prescription drugs for non-medical reasons, leading to addiction.

In a recent Hollywood tragedy, Corey Haim, star of the 80’s film The Lost Boys, died in what officials from the Los Angeles Police Department claim was an accidental overdose of prescription drugs. After an investigation, Haim’s name surfaced in connection with an illegal prescription drug ring in Southern California with the painkiller OxyContin. The drug ring was linked to as many as 5,000 prescriptions—by ordering prescription pads from authorized vendors and stealing doctors’ identities.

Prescription drug overdose has been ruling news headlines over the past few years, after deaths of high profile celebrities like Michael Jackson, Heath Ledger, Anna Nicole Smith.

Many addicts are reportedly getting their prescriptions drugs by “doctor shopping,” or going from doctor to doctor to collect prescriptions. According to the Sun, Maryland needs a system to monitor the number of prescriptions that are written for every patient, which if abused by “doctor shopping” can lead to medication error and injury. The Sun calls for Maryland Legislators to set up a drug task force to better monitor and control this drug epidemic.

New Legislation for the Safe Disposal of Nursing Home Resident Drugs

February 26, 2010 | Lebowitz & Mzhen

In a recent news story that our Maryland Medication Error Attorneys have been following, state legislators across the country have proposed bills that are aiming for the disposal of unused or expired medicine at nursing homes, for resident health and safety and the protection of the environment

According to ABC News, Maryland, Maine, Minnesota, Colorado, and Washington have all proposed new legislation that is trying to address the issue of dealing with excess and expired prescription medicine from nursing homes that end up in landfills and water sources every year, or if accidentally accessed by residents or other people, can cause serious harm or personal injury.

The Associated Press did a study in 2009, and reported that at least 250 million pounds of pharmaceuticals and contaminated medication packaging are generated in medical facilities every year. Some states are working on bills that would give nursing homes a choice to donate unused medication to charities in other countries. Other states are trying to send the unused medication back to the prescription drug manufacturers, with ‘take back’ programs, returning the responsibility back to the pharmaceutical company for disposal.

When a prescription is written for a resident in a nursing home, the pills aren’t reportedly dispensed in the same way that they are in a pharmacy. When the prescription is ordered for a nursing home resident, the pharmaceutical companies allegedly ship out 30-day supply cards, with each pill nestled in a small bubble pocket so nurses can easily pop the pill out of the card. If the patient has a bad reaction to the medication, if the patient passes away, or there is a medication mistake with the prescription, the medicine is most likely thrown out.

Medication Error Injury Prevention—Study Recommends Knowing Your Pharmacist

October 26, 2009 | Lebowitz & Mzhen

A recent American Pharmacists Association (APhA) survey, that our Maryland Pharmacy Error Injury Attorneys have been following, revealed that 1.5 million people are injured by medication-related errors every year. The APhA commissioned the consumer survey, led by Harris Interactive, to investigate how consumers interact with their pharmacists, and how building relationships with pharmacists can avoid patient error and reduce medication mistakes and pharmacy misfills.

The APhA always recommends that people carry an updated list of their current prescription medications, over-the-counter (OTC) drugs, herbal supplements and vitamins. The list should include the name of the medications, the dosage, as well as the conditions that the medications treat. Any patient allergies should also be included in the list.

The study reports that while a large percentage of Americans have an up-to-date list of medications, only 28% of consumers actually carry the list with them at all times—an act that could prevent personal injury and medication mistakes, by providing emergency personnel and pharmacists with lifesaving information regarding drug names, proper dosing, allergy information, and drug interactions and side effects.

According to Kristen Binaso, pharmacist and national APhA spokesperson, until electronic medical records are used as the standard in sharing patient information in the health care industry, consumers should protect themselves by keeping a current medication list with them at all times, to show the doctor and pharmacist—to avoid the risk of improper dosing, medication duplication, pharmacy misfill, and harmful drug side effects and interactions. In a recent post, our Maryland Mistake Attorneys further discussed how these electronic health records will help pharmacists and doctors to eliminate medication errors.

Next to doctors, pharmacists are the second most trusted health care providers and trained medication experts, yet the survey found that 77% of consumers do not know their pharmacists names, and only 40% of consumers have asked their pharmacists valuable questions about their medication needs.

Maryland Law Encourages Maryland Doctors to Computerize Patient Records

May 27, 2009 | Lebowitz & Mzhen

In prior posts concerning Maryland medication mistakes, the attorneys at Lebowitz & Mzhen Personal Injury Lawyers have discussed how computerized health records help doctors and pharmacists eliminate medication errors.

Today, Governor Martin O’Malley, signed a bill that is designed to increase the speed with which Maryland doctors implement electronic patient records. The new law hopes to reduce the high costs that doctors must pay to implement electronic patient records systems by requiring private insurance companies to give physicians financial incentives to implement electronic patient records. Under the law, after a doctor implements a computerized records system, insurance companies may offer the doctor increased reimbursements for procedures they perform, a lump sum payment, or some other monetary advance. Additionally, under the new law, the state will fine physicians who have not adopted a computerized records system by 2015.

Since 2003, Maryland has been on the cutting edge of the movement towards computerized patient records. In that year, The Montgomery County Health Information Exchange Collaborative began a pilot program that linked community hospitals, the county’s health department, and area health clinics. The link allowed participating health care providers to easily access patient records.

The program developers believed that their medical information network would have the greatest impact on the county’s poorer citizens and those without health insurance. These individuals generally receive care in a number of different locations, and often times, the facilities do not share vital patient information. The link allowed the facilities to share patient information and reduce the risk of medication errors.

Maryland medication mistake attorneys will review the impact this law has on patient safety, and the state’s progress towards completely computerized patient records.

New York Pharmacies to Provide Foreign Language Prescription Instructions

January 30, 2009 | Lebowitz & Mzhen

Maryland pharmacy error attorneys serve a number of clients who do not speak English as their first language. Some of these clients have raised the issue of not being able to receive prescriptions or dosage instructions written or spoken in their native languages from big box pharmacies. The attorneys at Lebowitz & Mzhen Personal Injury Lawyers believe that this shortcoming places a large number of citizens in danger of harmful pharmacy errors. According to the 2000 US Census, 667,357 Marylanders speak a language other than English in their homes.

As we discussed in an earlier post, Maryland pharmacists must provide medication counseling to patients when requested, and must provide written dosage instructions with prescriptions. Counseling and written instructions in English are useless to a pharmacy patient that has difficulty understanding the language.

Pharmacy Today reports that following an undercover investigation by New York Attorney General, Andrew Cuomo, Rite Aide and CVS have agreed to provide medication instructions in languages other than English at their New York locations. The investigation began after reports that pharmacies failed to provide side effect information and drug interaction warnings in patients’ native language. New York Rite Aid and CVS locations will now provide dosage and side effect information to patients in Russian, Spanish, Chinese, Italian, French and Polish. The companies also agreed to provide assistance using an over the phone translation service.

Our attorneys believe that Maryland pharmacies should follow suit and help ensure that all patients fully understand their medication dosage instructions and other relevant information.

Maryland Passes Law to Regulate Pharmacy Technicians

January 19, 2009 | Lebowitz & Mzhen

In the past, when you filled a prescription at a Maryland pharmacy, you may have wondered about the training received by the technicians behind the counter. In some cases, technicians have attended nationally accredited pharmacy technician training programs. Other time, however, the pharmacy technician training is limited to training received on the job.

Under a new state law, all Maryland pharmacy technicians must attend and successfully complete training approved by the Maryland Board of Pharmacy.

By February 28, 2009, any person working in a pharmacy, except for clerical workers, must receive certification from the Board of Pharmacy. In order to receive the certification, the applicant must already be a registered pharmacy technician or be enrolled in an accredited training program approved by the Maryland Board of Pharmacy. After an applicant completes a Board approved training class, the technician must then pass an examination within six months to continue working at the Maryland pharmacy.

Maryland Pharmacists Must Offer to Educate Patients on Medication Errors

January 15, 2009 | Lebowitz & Mzhen

We recently posted that pharmacists owe a duty of care to patients filling their prescriptions in Maryland pharmacies. Pharmacists owe a duty to accurately fill these prescriptions. Maryland law, however, increases the duty of care owed to Medicare pharmacy patients in the state by requiring pharmacists to offer to discuss issues pertaining to the prescription being filled. A Maryland pharmacist may be responsible for injuries that occur as a result of a failure to comply with this expanded duty of care.

In 1990, Congress passed legislation that increased the responsibilities of pharmacists with regard to Medicare recipients. The Omnibus Budget Reconciliation Act of 1990 (the “OBRA”) required pharmacists to offer to educate individuals receiving Medicare on the medications that they are taking. Under federal law, a pharmacist’s patient counseling must address a number of topics designed to reduce the chance of prescription errors. In the OBRA, Congress also suggested that individual states develop their own laws that require pharmacists to educate consumers about the risks of medication errors pose.

Maryland’s legislature passed laws that increase a pharmacist’s duty of care in the state that helps protect patients from prescription errors. Under Maryland law, a pharmacist must offer to discuss information pertaining to a Medicare recipient’s prescription. A Maryland pharmacist must offer this consultation through face to face communication, or by way of pamphlets included within the prescription’s packaging, signs posted throughout the pharmacy, or communication by telephone. The topics addressed during the consultation may include the following:
1. the name and description of the medication;
2. how to take the medication;
3. any special directions and precautions for preparation, administration and use by the patient;
4. common severe side effects or drug interactions;
5. techniques for the patient to monitor the drug’s effectiveness;
6. proper drug storage;
7. prescription refill information; and

8. actions to be taken in the event of a missed dose.

However, the law does not make these consultations mandatory, and a patient may waive his or her right to talk with their pharmacist. The medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers suggest that our readers take full advantage of the protections provided by Maryland law and consult with their pharmacists when receiving their prescriptions.

Related external source

Article discussing how the OBRA 1990 has affected pharmacists’ duty of care

Maryland law requiring pharmacists to educate patients

Maryland and D.C. Pharmacies Among Those Requesting Federal Aid

January 12, 2009 | Vadim A. Mzhen

In the past year Americans have watched the federal government bail out failing banks, and the lagging automobile industry. As the economic downturn progresses, the flow of government funds into the flagging commercial sector is likely to continue. The pharmacists’ lobby has added its name to a growing list of corporations seeking federal stimulus dollars. Recently, representatives from the American Pharmacists Association and similar organizations wrote a letter on behalf of America’s pharmacists to Congress. The letter sought federal stimulus money to help employ cutting edge health information technology (“Health IT”) in more pharmacies.

According to the U.S. Department of Health and Human Services, Health IT can help reduce medical errors, improve health care quality, and reduce health care costs. In an earlier post, we noted how the use of technology reduced the number of medication errors in cancer outpatient clinics. The attorneys at Lebowitz & Mzhen Personal Injury Lawyers recognize the important role technology will play in reducing the threat caused by prescription errors.

However, medication error attorneys believe that increased technology alone is not the solution to the widespread problem of prescription misfills. Lebowitz & Mzhen Personal Injury Lawyers urges Congress to, for example, require pharmacies to implement better training of their technicians, and to increase the number of pharmacists who staff busy pharmacies in order to reduce the number of prescriptions filled per pharmacist, per day. Additionally, Congress should better monitor and enforce the requirement that pharmacists review all prescriptions before they are dispensed.