Reducing Prescription Fraud and Misuse through e-Prescribing

By Rashaad Bhyat

The numbers paint a grim picture — the opioid crisis is worsening in Canada. In 2021, 21 Canadians a day died due to opioids, a 162 per cent increase from 2016 and a 101 per cent increase from just the year before. The crisis is multifaceted and addressing it will require many different solutions to address different aspects.

Reducing Prescription Fraud and Misuse through e-Prescribing

These solutions can include policy changes, the creation of harm reduction centres, the availability of mental health and addiction services, and more. One element of the solution that I’m encouraged to see being rolled out in Canada is the adoption of e-prescribing.

e-Prescribing, as defined by the Canadian Medical Association and Canadian Pharmacists Association in their 2012 Joint e-Prescribing Statement “is the secure electronic creation and transmission of a prescription between an authorized prescriber and a patient’s pharmacy of choice, using clinical electronic medical record (EMR) and pharmacy management software.”

In Canada, the federal government is funding a national e-prescribing service, which is available free of cost to all physicians and nurse practitioners: Canada Health Infoway’s PrescribeIT®. Infoway has a memorandum of understanding with all of the provinces and territories in Canada, and has rolled out PrescribeIT® in seven provinces to date.

What part can e-prescribing play in helping to address the opioid crisis? PrescribeIT® can help ensure the authenticity of prescriptions. While faxed, printed and handwritten prescriptions can easily be subject to fraud, e-prescribing gives pharmacists the assurance that the prescriptions they receive are authentic. In fact, according to a 2022 survey of community pharmacists conducted in partnership by Canada Health Infoway and the Canadian Pharmacists Association, the highest value of e-prescribing as seen by Canadian community pharmacists is the ability to confirm the authenticity of a prescription, along with improving patient safety by reducing transcription errors.

Not only can pharmacists be sure that the prescription belongs to the patient in front of them, but they can be confident it hasn’t been tampered with — that a “1” hasn’t been added in front of a number, or that a “3” hasn’t been changed to an “8.” Additionally, paper prescriptions can be copied and brought to multiple pharmacies.

e-Prescribing also makes it easier for physicians to prescribe smaller quantities of opioids, as it makes it easier to request refills when a patient needs it. This simple step can make a significant difference. Currently, prescribers frequently order larger quantities of opioids after surgeries or procedures out of concerns that a patient may run out and be left in pain. As a result, there are left-over opioids in medicine cabinets across the country, which can then be stolen, misused or sold. e-Prescribing modernizes the renewal request process by enabling pharmacists to request renewals through their PMS directly into an EMR. The request is tied to the original prescription.

Visit to learn more about the benefits of e-prescribing and please share any questions you have with me.

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About the author
Rashaad Bhyat

Rashaad Bhyat

Dr. Rashaad Bhyat serves as Clinician Leader on the Engagement team at Canada Health Infoway. He is a family physician with a passion for digital health, advising Infoway on numerous initiatives across Canada since 2011, including virtual care, EMR adoption and optimization, electronic prescribing, remote patient monitoring, and increasing patient access to health records. He currently practices in an EMR-enabled family medicine clinic in the Greater Toronto Area.