How are Triplicate (Duplicate) Prescriptions handled in Connect Care?

Question: How should prescribers handle triplicate (or newer duplicate) prescriptions required for outpatient use of controlled substances?

Context: The Alberta Triplicate Prescription Program (now a duplicate program) monitors use of prescription drugs prone to abuse. It does this by ensuring that such prescriptions are handwritten to prescription pads with security features and copies. Unfortunately, the program has yet to take advantage of the additional security and surveillance made possible by digital health records. It is hoped that the advent of e-prescribing (PrescribeIT) will avoid paper. For now, physicians must follow CPSA requirements:

How, exactly, are Connect Care prescribers to keep a copy of a triplicate (duplicate) prescription?

Answer: Connect Care made application to the Alberta TPP program for workflow adaptations appropriate to a fully integrated clinical information system, like Connect Care. Some recommendations remain under consideration. However, a formal decision has been communicated (July 2019) to the effect that Connect Care prescribers do not need to scan a copy of the TPP paper form to the chart and can follow this workflow:

  • Order all prescriptions in Connect Care, including TPP Alberta specified Type 1 controlled substances.
  • Produce a manual (handwritten) paper 3-part or (newer) 2-part TPP prescription for specified Type 1 controlled substances.
  • Record the TPP prescription identification number (unique to each prescription) in Connect Care (ideally in the comments field of the actual order).
  • Provide the manual-paper TPP to the patient, or fax to the pharmacy (see guide).
  • Destroy any left-over paper copies or artefacts. 
The Connect Care order constitutes the official record. It is NOT necessary to scan or otherwise copy the paper TPP prescription to attach to the Connect Care digital record.