There were over 70,000 deaths caused by drug overdose in 2017— this is according to the United States Center for Disease Control and Prevention. Among that number, two-thirds comprised prescription and illicit opioids. The lack of accountability or audit trail and sometimes simple errors can play a role in these fatalities.
The ongoing opioid epidemic and other patient safety and accessibility concerns have led to increasing government regulation when it comes to prescribing medication and prescribing medication electronically. From Electronic Prescriptions for Controlled Substances (EPCS) to Meaningful Use and Interoperability, there is a lot for prescribing practitioners and the tools and software they use must be aware of.
Certified systems that stay up to date on all the different electronic prescribing regulations can relieve a huge burden from healthcare organizations and technologies. When an e-prescribe vendor takes the responsibility of compliance, tech systems and EHRs/EMRs can better focus on improving their product offering, helping prescribing physicians redirect their energies back to what matters most, patient care.
Here are the key electronic prescribing regulations prescribers encounter and how the plethora of accountability measures the right e-prescribe vendor can offer to ensure compliance and quality of care.
Electronic Prescriptions for Controlled Substances (EPCS)
Quality Systems Tick the Boxes of Your Compliance Checklist
EPCS is a hot topic for prescribers. With the upcoming Support Act deadline approaching, maintaining compliance is a top priority for healthcare technology systems and organizations. Quality systems are in high demand and the ideal EPCS system should be easy to access, integrate with other EHR tools, and be certified.
The Drug Enforcement Agency (DEA) designed the Electronic Prescription Controlled Substances rules back in 2010. These rules provide a clear basis for clinics, pharmacies, hospitals, and IT vendors to develop and utilize the system.
For a system to be considered DEA compliant, it should incorporate these aspects:
- EPCS Certified: The electronic health technology record should be EPSC certified. You can ascertain this either from your vendor or a qualified third-party audit. Alternatively, you can have the system reviewed and approved by an approved certified group. NewCrop is a trusted, certified and award winning EPCS provider.
- Identity Proofing: You’ll need to either present yourself physically or online to an approved credential service provider or certification authority company. The agencies will verify your medical license and a government identification document with your photo. It’s also crucial to have your utility bill to aid in the verification exercise.
- Two-Factor Authentication: The system should have the option to create a username, password, and six-digit unique pin. The role of the extra layer of protection ensures only you can sign in and send the prescription to a pharmacy.
- Secure Access Control: For secure access, the system requires two levels of access. One needs to be DEA registered, approved, and with the two-factor authentication. The other person can be a colleague in practice or within the health care institution. Institutions with IT departments can tap on that expertise to allocate these security controls.
- Report of Compliance: This is a document that shows the steps taken towards fulfilling the DEA requirements. The report is instrumental for capturing any possible breaches of the process.
How Different States Apply the Mandate
Governor Ducey signed an amendment to Arizona Opioid Epidemic Act to include electronic prescription. To that end, with effect from Jan 1, 2020, any provider must prescribe any controlled substance in Schedule II electronically.
The Iowa mandate was enacted together with the 2018 Iowa Acts under House Files 2377. The act allows health providers to electronically transmit prescriptions through a computer using secure software to a pharmacy.
These are some of the clauses specific to Iowa:
- Prescriptions for substances under Schedule II cannot be issued once a six-month window lapses.
- Pharmacies should always report to Iowa Prescription Drug Monitoring Program within one business day after issuing the prescribed medication.
- The Good Samaritan Law offers one offense immunity to those who make errors while implementing the mandate.
Effective on Jan 1, 2020, the mandate requires providers to prescribe electronically all substances found in Schedule II-III. Before prescribing a narcotic or opioid, the provider must check a 12-month history at the Controlled Substance Reporting System.
These checks must continue every three months and a year summary kept as long as they are under medication.
Nonetheless, here’s a list of exceptions:
- Providers who deal directly with patients
- Providers that are experiencing temporary technological hitches
- Prescriptions from a pharmacy located in a federal institution
- Licensed veterinarians
Prescription Drug Monitoring Programs
The Electronic Prescription mandate also requires all healthcare providers to evaluate the patients’ drug records — these records are available in the PDMP database. The PDMP (Prescription Drug Monitoring Program) database can be accessed throughout the prescription process. As such, the process becomes faster, accurate, and verifiable.
To access the records, health care providers must register with the respective state’s government agency. The reduction of prescription abuse and opioid misuse are some of the direct benefits of the system.
With an up-to-date electronic prescribing tool, the process of PDMP enrollment and reporting is handled for you.
According to the Centers for Medicare & Medicaid Services (CMS) rule, Medicare Part D health plans must implement real-time benefit tools. This aims at fast-tracking the utilization of electronic Real-Time Benefit Tools (RTBT) and necessitates embracing of one or more RTBTs capable of integrating with at least one prescriber’s e-prescribing system or electronic health record (EHR).
Electronic prescription solutions with RTBTs are capable of informing prescribers when lower-cost alternative therapies are available under the beneficiary’s prescription drug benefit. This can help minimize beneficiary out-of-pocket costs, lower prescription drug costs, and improve medication adherence.
Meaningful Use is the utilization of certified EHR technology in a meaningful manner (for instance, electronic prescribing). This includes making sure the certified EHR technology can connect in a way that allows a seamless exchange of electronic information to improve the quality of care. Any provider who uses certified EHR technology is required to submit to the Secretary of Health & Human Services (HHS) information on the quality of care and other measures.
This concept is based on these pillars of health outcomes policy priorities:
- Improve care coordination
- Improve efficiency, safety, quality, and reduce health discrepancies
- Improve population and public health
- Involve patients and families in their health
- Guarantee adequate privacy and security protection for personal health information
- Enlisting a trusted e-prescribe partner can free up your team to focus on innovating your EHR product.
The Pricing Transparency Rule necessitates hospitals share pricing information publicly. The mandate requires hospitals to publish their standard charges for items and services offered in connection with an outpatient-department visit or inpatient admission. The hospital is obligatory to include, among other things, the service and service package, a description of each item, and any code (NDC, CPT, DRG, etc.) used for billing or accounting. As such, health systems must strive to bring patient coverage data to their EHR. Luckily, RTBT solutions within electronic prescribing tools are meeting this need and are increasingly gaining popularity across the country.
The interoperability (interconnectivity) between electronic prescriptions and EHR software gives providers the ability to monitor and track patient prescription fills, adherence, and usage expediently with numerous EHR features. Increased interoperability helps eliminate the risks associated with e-prescribing. For e-prescribing services to be as safe, pharmacies and providers need to have access to up-to-date interoperability methods to increase patient data and drug usage accuracy.
Help Your Organization Adapt and Stay Compliant
A growing number of states have already enacted supporting legislation in the electronic prescription field. As such, Electronic Health Record providers must embrace the solution and quickly adapt.
Besides compliance reasons, health providers will benefit from accurate prescriptions, monitor patients, and contribute to solving national issues like the opioid epidemic.
That said, it’s essential to acquire an electronic prescribing system like NewCrop Rx that’s fully compliant, certified, and functional.
At NewCrop, we have over 15 years of medical record system experience. We are driven by a unique depth of understanding of the quality and efficiency of electronic prescribing. Schedule a demo today of our e-prescribe services and to see how we can help your organization maintain compliance, so you can focus on creating a quality product and optimizing patient care.