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E-prescribing's Next Steps: Controlled Substances

   March 28, 2017

EPCS can build on PDMP use by sending data from EHRs to the PDMP databases, which state agencies such as New York's BNE can query to look for patterns of abuse by prescribers as well as patients.

But at this point, not all EPCS data collected by EHRs makes its way into the PDMP databases, due to the inability of many PDMPs to accept such data from some EHRs.

DrFirst and other companies that seek to integrate EPCS data with EHRs, such as those in use at Northwell, are waiting for the state to publish an application program interface (API) that would permit EPCS data to flow from EHRs to I-STOP, says Kaufman.

Multiple Systems
As if the variation from state to state wasn't complicated enough, many healthcare organizations use multiple vendors' EHRs or specialty-specific clinical systems across their own enterprises.

Northwell Health is one such organization. It turned to DrFirst's web-based or smartphone-based service to provide an EPCS service for these systems that did not have EPCS functionality as provided by their specialty-specific systems, or for practices that had no EHR, including Allscripts, Oppenheim says.

"I-STOP took us a couple of steps forward," he says. "EPCS is taking us a couple of steps forward. Each bit builds on the previous and helps us tackle this issue a little bit better."

Because DrFirst's service operates independently from a healthcare provider's own EHR, DrFirst also envisions EPCS use within Northwell at community-based programs and school-based clinics where EHRs are not present, Oppenheim says.

Albany Medical Center is also waiting for the I-STOP API to be added to its Cerner-, Allscripts-, and Medent-based EHRs to eliminate the need to log into the I-STOP website before moving back to the EHR to electronically order the prescription, says Azmat Z. Ahmad, vice president at Albany Medical Center.

Any organization where physicians must use multiple EHRs also requires downloading or possession of multiple second factors of authentication, Hickman notes. "Think of even simple inconveniences of workflow to a clinician, a provider that’s doing ordering. One EHR uses a different authentication provider than another, so that means clinicians have to either download more than one token-giving application onto their phone, or carry more than one fob."

Patient convenience is also a benefit of EPCS because patients no longer have to go to their physician for every prescription, Herrick says.

"As long as they're on their treatment plan and have the appropriate tests done and have the appropriate agreement with the providers, they can … go straight to the pharmacy," he says.

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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