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National Healthcare Leaders Embrace Electronic Prescribing of Controlled Substances

Dr. Sean Kelly, Chief Medical Officer, Imprivata

In October of 2018, President Trump signed into law the “SUPPORT for Patients and Communities Act,” a comprehensive bill designed to address the opioid abuse epidemic. This landmark legislation presents a unique opportunity for the healthcare IT community: we now have a real chance to position electronic prescribing of controlled substances (EPCS) as a crucial technology component of the national fight against opioid abuse.

This opportunity stems from a provision within the federal legislation that is specific to EPCS. Having heard the voice of the HIT community, federal legislators included in the bill an electronic prescribing requirement for all controlled substance prescriptions for a covered part D drug under a prescription drug plan (or an MA–PD plan). The deadline to comply with this section of the new law is January 1, 2021.

The federal opioids bill is not the only legislation driving these EPCS readiness efforts. Additionally, 16 states (NY, ME, CT, AZ, NC, RI, IA, OK, TN, VA, MA, CA, WY, AR, KY and PA) have already enacted legislation containing some form of an EPCS mandate for controlled substances prescribed in those states. These are just the latest in a growing trend of state legislatures and national healthcare leaders pushing to create a more secure opioid distribution chain by requiring that prescriptions for controlled substances be completed electronically.

As a provider, I know EPCS alone isn’t a “magic pill” for solving the nation’s growing opioid epidemic. But I’ve also witnessed first-hand the vital role technology can play in preventing over-prescribing, addiction, misuse, and abuse before it begins.

Numerous leading healthcare systems, including the Geisinger Health System in Pennsylvania, are proving this point. Geisinger recently released data demonstrating that EPCS (in conjunction with other safety and security measures) helped reduce overall opioid prescribing by approximately 50 percent. By recouping lost clinical productivity, reducing pharmacy and helpdesk callbacks, and reducing diversion control costs, they also estimate that they are saving over a million dollars per month by using EPCS.

And health systems are not alone in using technology to fight this epidemic. Just last spring, Walmart – one of the nation’s largest pharmacy chains – stated that “e-prescriptions are proven to be less prone to errors, they cannot be altered or copied and are electronically trackable.” They too, are requiring EPCS by January 1, 2020.

Clearly, EPCS is undergoing real momentum on both the legislative and corporate fronts. Why? Because instituting EPCS can help curb opiate abuse by creating accountable and secure practices for those who prescribe and dispense controlled substances. EPCS provides a secure, transparent system that makes it easier to prescribe controlled substances to those patients who legitimately need them, while making it more difficult to commit fraud or abuse.

Electronic prescribing of opioids and other controlled substances helps address drug diversion, fraud, and doctor shopping by taking the paper prescription—and the prescriber’s DEA number—out of the hands of the patient. Prescriptions are securely sent directly to the pharmacy, which improves patient safety and prescription security, all while increasing patient and provider satisfaction as well.

While EPCS does help fight opioid abuse, healthcare organizations and prescribers still must meet a number of specific requirements to comply with DEA regulations pertaining to EPCS. These requirements are designed to create a secure, auditable chain of trust through the entire prescribing process. If implemented incorrectly, however, organizations introduce the risk of non-compliance or limited adoption by providers.

Technology is undoubtedly integral to the prevention of opiate abuse. But it must be applied in a thoughtful way that works for both providers and patients, not against them; the last thing most providers want is another electronic system to work with. Not all technology is created equal. The good news is that there are systems available that are usable, scalable, affordable and actually make it easier for administrators, IT staff, and prescribers to do the right thing.

The best way to achieve these positive outcomes is to advocate for and abide by legislation and standards that providers can adhere to – and ones that patients can count on. EPCS promises to save lives by ensuring that opioids are prescribed more securely and appropriately. And it has been shown to save money by reducing costly prescription errors, fraud, diversion, and mistreatments.

National healthcare and corporate leaders are leading the charge, but we should all recognize the emerging truth about EPCS: that implementing prescribing strategies that work for patients and physicians can help address the massive opioid epidemic invading our communities. Lives are depending on it, and federal and state legislators are the latest leaders to act accordingly. Most of the time, the medical community dreads regulatory burden, but in this case, it is necessary, and I am supportive. Take it from a practicing ER doctor, we need to do everything we can to fight this epidemic. EPCS is a crucial tool for doctors and patients alike to fight the opioid crisis, and I look forward to its continued rollout across the country.