Quan Sherman, Zwarenstein Merrick F, Dainty Katie N, Sibbald William J, Adhikari Neill K J
Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario.
Healthc Q. 2007;10(4):106-10, 112.
Newer outpatient electronic prescribing software programs produce typewritten paper prescriptions with electronically created signatures. Current Canadian federal legislation forbids static (unchanging) signature images on prescriptions. We conducted a randomized trial of electronic prescribing in outpatients at a university-affiliated hospital. The application was a wireless Palm-based system that creates a prescription that is either printed and given to the patient or faxed to a pharmacy. Using the software, the physician creates a unique signature image for each prescription. We successfully overcame challenges related to wireless network reliability, local printer availability and physician training. However, to comply with federal legislation and provincial regulations, we were required to design workarounds to create acceptable prescribing processes. Our experience suggests that the legality of the electronic signature must be clearly defined to realize the full potential of standalone outpatient electronic prescribing systems and fully integrated hospital-wide electronic medical records.
更新的门诊电子处方软件程序可生成带有电子创建签名的打印纸质处方。加拿大现行联邦法律禁止在处方上使用静态（不变）签名图像。我们在一家大学附属医院对门诊患者的电子处方进行了一项随机试验。该应用程序是一个基于无线掌上电脑的系统，它可以创建一张处方，要么打印出来给患者，要么传真给药房。使用该软件，医生为每张处方创建一个独特的签名图像。我们成功克服了与无线网络可靠性、本地打印机可用性和医生培训相关的挑战。然而，为了符合联邦法律和省级法规，我们需要设计变通方法来创建可接受的处方流程。我们的经验表明，必须明确界定电子签名的合法性，以充分发挥独立门诊电子处方系统和全院范围完全集成电子病历的全部潜力。
