Does your EMR force you out of compliance?

eRX-Does your EMR force you out of compliance?I admit it, I’m blessed to work in a state (WA) that does not require collaboration for practice or for prescriptive activities. However, many of my colleagues are not so lucky. I recently spoke with an Scharmaine Lawson Baker, NP in Louisiana – a collaborative practice state where she is required to have her collaborating physician’s name on her prescriptions.  Many are familiar with this and in the past have had your prescriptions printed with the name of your collaborating physician. However, printed prescriptions pads are nearly a thing of the past.  

Enter EMRs.  Today, most of our prescriptions are generated by our EMR system to be printed or they are partnered with one of the electronic prescription services (eRx).  Here is the problem.  Apparently the EMR my friend uses is putting the name of her “Supervising Physician” on her prescriptions, not the “Collaborating Physician” as is recognized by her state practice act.

This potentially raises the issue of compliance and putting some NPs (and PAs to I’d imagine) at risk for being out of compliance with their state practice acts.

Because of the variations in state practice acts, EMRs/eRx systems, must be up to date in the states they operate in. It’s going to get even more confusing once a system is in place to accept controlled substances electronically.

While the best thing is to get all state practice acts to comply with the Institute of Medicine’s report, The Future of Nursing which calls for nurses and advanced practice nurses to practice to the full extent of their education, its likely going to take some time.

In the meantime, some EMRS/eRxs do not support more than one name on a prescription (ie, the NP and the collaborating physician), some do not support the appropriate language for each state rules. There are currently 189,000 NPs in the US with 97% of them writing an average of 19 prescriptions per day (Source:  This is not an issue that EMR and eRx vendors can ignore.

So my question to you is this:  Does your EMR and eRx vendor generate your prescriptions with your collaborative or supervising physicians name? And if so, is the correct language used (Supervising or Collaborative) as per your state practice act?  If it’s not, have you addressed this with your EMR/eRx vendor?  Be sure and let us know which state you are in and which software system you are using. We look forward to seeing your response below.

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