How are triplicate (duplicate) prescriptions handled in Connect Care?

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

Context: The Alberta Tracked Prescription Program (TPP, tppalberta.ca) 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 emergence of e-prescribing (PrescribeIT) will avoid paper workflows in the future. Please note that the new Connect Care workflow for sending prescriptions directly to community pharmacies via electronic fax ("eFax") cannot be used for prescriptions for drugs classified as Type 1 under the TPP; these prescriptions still require the use of a paper TPP secure prescription form.

Prescribers must follow TPP requirements for managing tracked prescription copies and records:

• TPP: Program Guide

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 Connect Care, as a fully integrated clinical information system, like Connect Care. A TPP decision was made (July 2019) to the effect that Connect Care prescribers do not need to scan a copy of the TPP paper form for attaching to the digital chart. The acceptable workflow is as follows:

• Order all prescriptions in Connect Care, including TPP specified Type 1 controlled substances.
• Write out a manual (handwritten) TPP prescription (3-part or newer 2-part TPP pad) 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 original (paper) TPP to the patient. A copy can be faxed to the pharmacy to assist with advance drug preparation (pharmacy dispense still requires original; see guide).
• Physician continue to protect the TPP (duplicate or triplicate) pad with its copy of the hand-written original.
• Destroy any leftover copies or artefacts. 

The Connect Care tracked prescription 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.