Legal Status of EPT in Puerto Rico

A prescription is an “original written order issued and signed by a medical doctor… in the normal course and legal exercise of his/her profession in Puerto Rico, in order for certain drugs or devices to be dispensed… It shall be the obligation of the physician issuing the same to comply with the professional responsibility of a true physician-patient relationship.” Puerto Rico Pharmacy Act No. 247 (2004), section 1.03 (ww); see also

“The Board may suspend, cancel, or revoke a license, censure, reprimand or place a physician on probation if he/she employs or delegates the authority to unauthorized persons to perform acts that can only be legally executed by authorized persons in the practice of medicine.” Medical Discipline and Licensure Board Act No.139 (2008), Section 26, subsection (e)(14)(9)

“It is not pretended for telemedicine to replace health care providers or relegate them to a lesser role in the offering of their services. By regulating telemedicine, the fundamental relationship between physician and patient is preserved, expanded and broadened.” Puerto Rico Telemedicine Regulating Act No. 227 (1998), Statement of Motives

“Should the patient agree to the use of telemedicine services, the physician shall obtain the oral and written informed consent of the patient before the services are rendered.” Puerto Rico Telemedicine Regulating Act No. 227 (1998) Section 8

EPT is potentially allowable.

The need to obtain verbal and written informed consent suggests that a physician does not need to perform a physical exam prior to issuing a prescription. Statutory ambiguities suggest that the recipient of a prescription may include a patient’s partner. At the same time, statutory authority prohibits the delegation of tasks reserved to individuals licensed to practice medicine.