PURPOSE: This rule establishes basic guidelines to address new technology for the transmission of prescription data utilizing electronic mediums.

1. (1) Definitions.

   1. (A) Electronic transmission prescription— Includes transmission of both image and data prescriptions.
   2. (B) Electronic image transmission prescription—Any prescription order for which an exact visual image of the order is received by a pharmacy from a licensed prescriber.
   3. (C) Electronic data transmission prescription—Any prescription order, other than an electronic image transmission prescription, which is electronically transmitted from a licensed prescriber to a pharmacy.
   4. (D) Electronic signature—Means a confidential personalized digital key, code, number or other identifier used for secure electronic data transmissions which identifies and authenticates the signatory. Electronic signatures may be sent as part of an electronic transmission prescription to a pharmacy or it may be applied to a hard copy to be provided to the patient.

2. (2) When a prescription is transmitted to a pharmacy electronically, the following requirements must be met:

   1. (A) The original electronic facsimile transmission (FAX) document or all information from an electronic source must be readily retrievable through the pharmacy computer system;
   2. (B) To maintain the confidentiality of patient records, the system shall have adequate security and systems safeguards designed to prevent and detect unauthorized access, modification, or manipulation of patient records. Once the drug has been dispensed, any alterations in prescription drug order data shall be documented including the identification of the pharmacist responsible for the alteration;

   3. (C) In verifying the authenticity of a transmitted prescription, the pharmacist shall ensure the validity of the prescription as to its source of origin. Measures to be considered in authenticating prescription drug orders received via electronic transmission include:

      1. 1. Maintenance of a practitioner’s fac-

simile number reference or other electronic signature file;

1. 2. Verification of the telephone number

of the originating facsimile equipment;

1. 3. Telephone verification with the prac-

titioner’s office that the prescription as both written by the practitioner and transmitted by the practitioner or the practitioner’s authorized agent;

1. 4. Other efforts which, in the profes-

sional judgment of the pharmacist, may be necessary to ensure the transmission was initiated by the prescriber;

1. (D) At the option of the patient, an electronically produced prescription may be sent to a pharmacy electronically or provided as a hard copy generated from the prescriber’s electronic prescribing system;
2. (E) Hard copy prescriptions presented to the patient generated from electronic media shall be applied to paper that utilizes security features that will ensure that the prescription is not subject to any form of copying and/or alteration; and
3. (F) Electronic transmission technology utilized by pharmacy personnel shall not be used to circumvent or violate any provision of state and federal drug laws or the Pharmacy Practice Act and accompanying regulations.

AUTHORITY: sections 338.010, 338.095 338.140 and 338.280, RSMo 2000.* This rule originally filed as 4 CSR 220-2.085. Original rule filed Sept. 25, 1995, effective April 30, 1996. Amended: Filed July 28, 2000, effective Jan. 30, 2001. Amended: Filed April 16, 2001, effective Nov. 30, 2001. 20 CSR 2220-2 Moved to 20 CSR 2220-2.085, effective Aug. 28, 2006.

*Original authority: 338.010, RSMo 1939, amended 1951, 1989, 1990; 338.095, RSMo 1993; 338.140, RSMo 1939, amended 1981, 1989, 1997; and 328.280, RSMo 1951, amended 1971, 1981.