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E-prescribing's Next Steps: Controlled Substances

   March 28, 2017

"An EPCS prescription goes directly to the pharmacy, so there's a lower chance of forgery, as well as clinical alerts to ensure the safety of the prescription," says Peter Kaufman, MD, chief medical officer of DrFirst based in Rockville, Maryland. DrFirst offers providers an EHR-agnostic, web-based secure EPCS connection to Surescripts' network, which, in turn, connects securely to pharmacies.

EPCS finished 2014 with a small portion of the total controlled substance prescription mix, but experienced a surge in 2015, growing from 341,000 prescriptions in 2013 to 1.67 million in 2014 and 12.81 million in 2015, according to Surescripts.

Nationwide, 88% of pharmacies are enabled to accept EPCS, although only 13% of prescribers are enabled, says Paul Uhrig, chief administrative, legal, and privacy officer at Surescripts in Arlington, Virginia.

E-prescribing for Controlled Substances Zooms 600%

In 2015, a state law in New York was enacted that required all medications, including all controlled substances, to be prescribed electronically. However, the effective date of the law was pushed back a year, from March 2015 to March 2016. In 2011, Minnesota, and in 2016, Maine, required EPCS as well.

EHR vendors' lack of readiness to integrate EPCS into the prescribing workflow was a major reason for the delay in New York's law. The process also required provider leadership to implement two-factor authentication to verify the identity of prescribing clinicians, according to George Hickman, executive vice president and system chief information officer of the 734-licensed-bed Albany (New York) Medical Center.

The second authentication factor varies, according to technology and healthcare providers. Even within provider groups, prescribers sometimes have a choice of a second factor. For instance, a healthcare provider's IT management/operations department may offer a biometric second factor, or as an alternative, may send a one-time password to the prescriber's mobile phone as the second factor.

"Physicians obviously have a lot going on in terms of providing care, so when you're changing the workflow, that takes a little bit of time and effort," says Uhrig.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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