The Department of Justice's Drug Enforcement Administration in June will issue proposed regulations requiring that doctors and pharmacists use digital signatures and biometric scanners when transmitting electronic prescriptions for Class II drugs.
The DEA argues that "passwords are not enough" and another level of security is needed. Biometric controls at the point of access, it says, would improve security because the device will recognize an individual's fingerprint or iris.
The DEA points out that 33 states now authorize the electronic transmission of drug prescriptions. Even so, only two-Arizona and Ohio-are actively involved in pushing that effort. And the DEA's own estimates show biometrics will be costly--as much as $150 per finger scanner at each computer station.
A formal comment period of 60 to 90 days will follow the initial proposals before final regulations can be issued later this year. But physicians in the informatics field predict the proposals will be unwelcome in the larger medical community.
"(Doctors) will buy into this when it becomes essential to an efficient practice and when systems are adequately unified," says Alan Zuckerman, M.D., director of primary care informatics at Georgetown University School of Medicine in Washington, D.C.
In pharmacy and medicine, there was little activity on biometric security devices until the DEA began sounding out pharmacists and drug manufacturers at conferences in Florida earlier this year. Sos Mboijana, M.D., a fellow in clinical informatics at Washington Hospital Center in Washington, D.C., says any effort to promote biometrics and digital signatures must be implemented gradually to gain physician acceptance.
"I think the overall concept is a good idea, but getting people to buy into that is where the challenge will be," Mboijana says. "They should start first with e-prescribing, learning to use and trust it, and then start adding more robust security features like digital signatures and biometrics. Throwing everything at them all at once would not be a good idea."
Implementing biometrics on a wide scale requires an electronic marriage between physicians and pharmacists. Toward that end, the AMA and the American Pharmaceutical Association have launched Internet ID, a free digital certificate program.
VeriSign of Mountain View, Calif., provides the service. In addition to routine passwords, the program provides the ability to authenticate the identities of doctors and pharmacists. It gives doctors the ability to access patient records, initiate lab orders and prescribe drugs with assurance the transactions will be protected by the digital certificate.
About 2,000 physicians are with the program now, and pharmacists are just starting to sign up.
Peter Basch, M.D., medical director of e-health initiatives at Medstar Health, a seven-hospital healthcare network in Columbia, Md., is an advocate of electronic prescription transmissions. He is setting up Medstar's new network with security features like digital signatures and the requirement of two passwords to enter the Web- and PDA-based system.
Basch says the DEA proposal is good but "might be a little bit premature. It might force doctors who were thinking about getting into e-prescribing to hold off. I can tell you right now the doctors are not going to buy into it, because they are not buying into e-prescribing now."
Benjamin Bluml, national vice president for research for the American Pharmaceutical Association Foundation in Washington, says the DEA's efforts to make sure prescription transmissions are "safe and secure is the first step in the right direction in moving this agenda forward."
"I believe it is one of the important concepts to create secure transactions by having secure, effective authentication at both ends," Bluml says.
States also are moving into biometrics, partly to curtail fraud.
Ohio laid the groundwork nearly a decade ago by giving pharmacists many options, including biometric devices, to verify positive identification of either doctors or pharmacists who prescribe or dispense dangerous drugs.
Arizona last year passed legislation requiring that Medicaid beneficiaries have a finger scan and that information be stored in a central database. But with state budget restrictions, the system has not been funded and is in limbo, says Kathy Boyle, executive director of the Arizona Pharmacy Association.
Dennis Blank is a freelance business writer based in Altamonte Springs, Fla.