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EPCS Jumps 256% in One Year

Analysis  |  By Alexandra Wilson Pecci  
   June 26, 2017

Many prescribers erroneously believe electronic prescribing of controlled substances is illegal, but experts say it is a key tool in the fight against opioid abuse.

There are many resources and possible solutions in the fight against opioid abuse, but one is gaining traction across the country: electronic prescribing of controlled substances (EPCS).

According to the Surescripts 2016 National Progress Report, there were 45.34 million prescriptions for controlled substances delivered electronically in 2016, representing a 256% increase over the year before.

Experts say that EPCS is a key tool in the fight against opioid abuse, helping to reducing prescription fraud, ensuring that physician orders are followed accurately, and giving prescribers access to a patient's medication history.

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"It is a much more secure process," says Ken Whittemore, vice president of professional and regulatory affairs of Surescripts. "It gives providers and the environment in which they practice more comfort in the process itself."

Yet many prescribers incorrectly believe that EPCS is illegal, according to Kelly Clark, MD, MBA, DFASAM, president of the board of directors of the American Society of Addiction Medicine.

"Electronic prescribing of controlled substances is legal in all 50 states," she says. "It is important for C-suite leaders to make sure that the physicians they may employ… are well educated."

Despite this misconception, the 2016 National Progress Report shows that EPCS is growing steadily and at an impressive clip. Surescripts data shows that there were 45.34 million prescriptions for controlled substances delivered electronically in 2016, representing a 256% increase over the year before. Still, this only represents 14.1% of controlled substance prescriptions overall.

Also, compare that to general e-prescribing numbers: There were 1.6 billion electronic prescriptions in 2016, the new Surescripts report said.

One way states are starting to increase e-prescribing rates is through mandates. Minnesota has had a mandate since 2011, and New York State enacted one last year.

"It's been amazing the impact that that's had in the state of New York," Whittemore says, pointing to Surescripts data showing that New York as the No. 1 state for EPCS, with 72.1% of prescribers enabled and 91.9% of controlled substances prescribed electronically.

"It's proven the concept," he says.

Two other states, Virginia and Maine, have mandates in the pipeline.

Virginia's mandate, which was signed into law earlier this year, will require "a prescription for any controlled substance containing an opiate to be issued as an electronic prescription and prohibits a pharmacist from dispensing a controlled substance that contains an opiate unless the prescription is issued as an electronic prescription, beginning July 1, 2020."

Maine's mandate for e-prescribing goes into effect July 1, thanks to legislation called "An Act to Prevent Opiate Abuse by Strengthening the Controlled Substances Prescription Monitoring Program."

It will require EPCS by July 1 from all prescribers who have the capability to participate. Those who don't have the capability must request a waiver, which will only be granted if it's appropriate.

Whittemore says there are at least eight other states with active legislation that would require electronic prescribing for at least opioids, and he predicts that "there will be quite a few more states to go down this path as well."

Even without mandates, the use of EPCS is spreading. Four new states (North Dakota, South Dakota, Minnesota, and North Carolina) entered the top 10 for EPCS enablement among prescribers and pharmacies, the Surescripts report says.

"It's encouraging to see how physicians have taken up electronic prescribing even in states that have not mandated its usage," Clark says.

Overall, Surescripts' interoperable network connected 1.3 million healthcare professionals—21.5% more than in 2015—with secure patient data for 230 million Americans, or 71% of the population, according to its 2016 National Progress Report.

There were more than 10.9 billion secure transactions in 2016 (12% more than in 2015) and more than 1.08 billion medication history transactions. Surescripts also delivered more than 2.2 million documents to more than 165,000 clinicians that summarized where patients received care, including information from more than 43 million patient visits.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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