Transcript Electronic Prescribing of Controlled Substances (EPCS

2015 User Conference
Electronic Prescribing of Controlled Substances (EPCS)
April 25, 2015
Presented by:
Peter Minio
Product Manager, Pediatric and Primary Care Solutions
Room Monitor:
Jeanette Jones
Services Support
EHR Session
Learning Objectives
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Background information about EPCS and I-STOP.
Readiness for EPCS.
Identity-Proofing (IDP).
How OP has implemented EPCS.
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Background
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The Controlled Substances Act of 1970 mandated
a high level of governance over controlled
substances in order to prevent illegal uses.
ePrescribing controlled substances (Schedule II-V)
was made legal by the DEA in 2010.
○ Adopted to further reduce fraud and abuse.
○ Stringent requirements to address concerns in
an electronic environment.
○ Not mandated on the federal level.
○ States have right to further regulate.
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Benefits of EPCS
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Reduce fraud and abuse.
Improve patient safety.
Single workflow for all medications with more
efficient record keeping.
Reduce the cost of regulatory compliance.
Be audit-ready.
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Readiness
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Software providers (e.g., OP) must implement the
capabilities, but also complete both a certification and
a third-party audit.
Many EHR vendors and pharmacies are not
ready.
○ As a result, provider adoption is low.
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State Readiness
● Currently 48 states and the
District of Columbia allow
ePrescribing.
○ Missouri and Montana do
not permit EPCS.
○ Vermont does not permit
Schedule II drugs to be
transmitted electronically.
● More than 70% of
pharmacies nationally are
certified for EPCS.
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I-STOP - New York
● Mandates ePrescribing for both legend drugs (any
drug that requires a prescription) and controlled
substances by March 27, 2015.
o On March 13, 2015 Governor Cuomo signed into law a bill
which delays implementation until 2016.
● Requires providers check the Prescription Monitoring
Program (PMP) and obtain a confirmation number
before prescribing a controlled substance.
● On March 13, 2015 Governor Cuomo signed into law
a bill which delays implementation until 2016.
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Prescriber Requirements
●Prescribers must go through a form of electronic
authentication, otherwise known as identity-proofing
(IDP).
●Each provider must be issued “two-factor
authentication” credentials.
○ Two-factor authentication is when a user provides
two forms of identification (something they know
and something on them):
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Password.
Hard or soft token.
Biometric (fingerprint scan).
Example: ATM card and PIN number.
●Credentials to each user are granted access with
logical access controls.
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What is OP Doing About EPCS?
● Office Practicum has partnered with DrFirst to deliver
EPCS functionality.
○ DrFirst uses Experian (a major credit reporting
bureau) for IDP.
● Each provider will need to complete an IDP process
through Experian.
● On March 13, 2015 Governor Cuomo signed into law
a bill which delays implementation until 2016.
○ Additional charges apply.
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IDP Process
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Sign an add-on agreement and provide necessary
additional information:
o Unique email address per provider.
o DEA#, NPI, Address
A hard token will be issued to each provider.
o You may also download a soft token.
 Important Note: Per DEA regulations,
soft tokens must be utilized from a different
device than the device prescribed from.
IDP is a 7 Step process performed online.
o Must provide personal information
such as Social Security Number, DOB.
o Must answer 3-4 questions pertaining to
personal financial history.
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Example of Financial Questions
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Step 7 of IDP
● Once Step 6 is completed, Experian will send a
confirmation code to the provider’s home address.
● The provider must log back into the IDP system and
enter the confirmation code in order to complete Step
7.
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Logical Access Control (LAC)
● LAC will be available from within OP for
administrative users only.
● Used to make a provider that has completed the IDP
process either active or inactive.
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Provider Dashboard
● A dashboard will be available from OP where
providers may enable/disable hard/soft tokens and
biometric devices.
● Prescribers are allowed to have more than one
device associated with their identity.
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Rx Signing Screen
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New Rules
● A controlled substance:
○ Can only be sent electronically to a pharmacy or
printed for dispensing once.
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Exception: If the transmission failed.
○ If printed after being sent or previously printed, it
will be marked as a copy and instruct the
pharmacist not to dispense.
● Once a controlled substance is sent or printed, it
cannot be edited.
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NADEAN
● Certain drugs require a Narcotics Addiction DEA
(NADEAN) Number (e.g., Suboxone) to be included
in the pharmacist notes.
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HGB
● Drugs that contain gamma-Hydroxyburtric acid (e.g.,
Xyrem) must contain a reason for prescribing in the
pharmacist notes.
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Questions
?
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We want your feedback!
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