From the blog a couple stories on the latest DEA efforts to work with e-prescribing..states basically that they are in support of the process, but want to ensure the proper tracking is in place... according to the latest congressional testimony...and I guess we can stay tuned.
Physicians will be able to date a prescription for a fill date in the future on some controlled drugs..."Do not fill until______", which will be a big help in not forcing patients to return for an additional office visit when it is not warranted with the medical condition. BD
Although not in effect until 30 days from the date of the final ruling on "Issuance of Multiple Prescriptions for Schedule II Controlled Substances," this rule change allows physicians to write three separate prescriptions with staggered fill dates. Patients can still be given the equivalent of a 90-day prescription for schedule II controlled substances when medically appropriate. Schedule II drugs are those that have recognized medical uses as well as a potential for dependence and abuse. Consequently, these drugs are carefully controlled and regulated by the DEA. The DEA now allows physicians to use their professional judgment to carefully control the amount of a controlled substance issued to a patient at one time.
Statement from the DEA regarding Electronic Prescribing before the Senate Judiciary Committee...BD
DEA is keenly aware that pharmaceutical controlled substances are vital tools for the medical community. DEA also is aware that various public and private entities are striving to leverage modern-day technology to streamline its business practices. DEA supports the responsible adoption of electronic prescriptions for controlled substances in a manner that will meet statutory obligations and minimize the risk of diversion. However, in the absence of appropriate controls, allowing electronic prescriptions for controlled substances would certainly exacerbate a growing epidemic of prescription drug abuse in the United States. It is essential that the rules governing the electronic prescribing of controlled substances do not undermine the ability of federal, state, and local law enforcement to identify and prosecute those who engage in diversion and put our citizens at risk. It is critical that the technology and standards to be employed include adequate security that incorporates authentication, nonrepudiation, and integrity in the record keeping process. These three security-related elements are necessary to ensure that DEA can fulfill its obligations under the Controlled Substances Act (CSA). DEA supports the use of technology to reduce medical errors, streamline the medical process and increase efficiency.
DEA is keenly aware that pharmaceutical controlled substances are vital tools for the medical community. DEA also is aware that various public and private entities are striving to leverage modern-day technology to streamline its business practices. DEA supports the responsible adoption of electronic prescriptions for controlled substances in a manner that will meet statutory obligations and minimize the risk of diversion. However, in the absence of appropriate controls, allowing electronic prescriptions for controlled substances would certainly exacerbate a growing epidemic of prescription drug abuse in the United States. It is essential that the rules governing the electronic prescribing of controlled substances do not undermine the ability of federal, state, and local law enforcement to identify and prosecute those who engage in diversion and put our citizens at risk.
It is critical that the technology and standards to be employed include adequate security that incorporates authentication, nonrepudiation, and integrity in the record keeping process. These three security-related elements are necessary to ensure that DEA can fulfill its obligations under the Controlled Substances Act (CSA).
DEA supports the use of technology to reduce medical errors, streamline the medical process and increase efficiency.
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And the date of implementing e-prescribing for controlled substances is.......
Gosh darn, still no date yet.
They have been 'looking at this' for over 5 years.
Good thing we aren't holding our breath on this one.
Perhaps we can start a gambling pool on this, and guess what month we can start prescribing a Tylenol #3 by e-prescribing.
I want January 2014, December 2015, and January 2017. I'll send my $3 by PayPal.
Reddy
William "Reddy" Biggs, MD Endocrinology Amarillo, Texas
Unbiased and independent, YES!
"Live on eClinicalWorks since 2/1/2007" http://tinyurl.com/ywqd49
The big one here is eliminating the DEA ban on e-prescribing for controlled substances. Many physicians who currently e-prescribe have complained about this being one big drawback for the entire process, and rightly so. As difficult as it has been to get new physicians to “buy in”, the DEA process only further complicates matters with implementation on a larger scale. As always, there’s a link on the blog to the free NEPSI e-Prescribing program in the right hand column. BD
Two new reports stress the benefits of electronic prescribing and the need to accelerate physician adoption of the technology. The report examines such obstacles to e-prescribing as financial burdens, workflow changes, connectivity issues and the need for better medication histories. Recommendations include replicating and expanding successful incentive programs, eliminating the Drug Enforcement Administration’s ban on e-prescribing for controlled substances, and creating a public-private e-prescribing advisory board. The report is available at ehealthinitiative.org. On another note, social security and hospital pilot program for EHRs... EHRs go beyond treatment – Social Security Pilot Program with Beth Israel Deaconess Hospital in Boston
Two new reports stress the benefits of electronic prescribing and the need to accelerate physician adoption of the technology.
The report examines such obstacles to e-prescribing as financial burdens, workflow changes, connectivity issues and the need for better medication histories. Recommendations include replicating and expanding successful incentive programs, eliminating the Drug Enforcement Administration’s ban on e-prescribing for controlled substances, and creating a public-private e-prescribing advisory board. The report is available at ehealthinitiative.org.
On another note, social security and hospital pilot program for EHRs...
From the blog, what the DEA wants...
This is what the DEA is recommending for their report on E-Prescribing. The portion about confirming the physician’s authority though is not a bad idea at all in view of the Medicare Fraud this week involving “dead doctors” who were still prescribing medical equipment, an audit process that one might have thought should have been in place a long time ago. The tricky part comes to item number 3 below, and this is where the software vendor programs and offerings come in. BD
*Physicians must undergo "identity proofing" processes conducted by an authority such as a hospital credentialing office or a state licensing authority; * Pharmacies must confirm weekly that the physician's authority to prescribe has not been revoked, must have system audit controls in place, and must engage auditors to audit those system controls; * All participants in the e-prescribing process must maintain records of the transactions, with off-site backups; and * Security breaches involving e-prescription information must be reported to the DEA.
*Physicians must undergo "identity proofing" processes conducted by an authority such as a hospital credentialing office or a state licensing authority;
* Pharmacies must confirm weekly that the physician's authority to prescribe has not been revoked, must have system audit controls in place, and must engage auditors to audit those system controls;
* All participants in the e-prescribing process must maintain records of the transactions, with off-site backups; and
* Security breaches involving e-prescription information must be reported to the DEA.
From the blog...
6 months is not that long, so I would think any physician who is not presently e-Prescribing might want to seriously take a look and think hard about it. A little practice and learning curve ahead of time can’t hurt. Many offices already have electronic records that integrate this service for them, but for those who do not and have not made the transition yet, or need some additional time, you can sign up for free for e-Prescribing right now, yes it is free.
On the right hand side of this page is a link that will take you to the enrollment page for NEPSI. It only takes a few minutes to sign up and go through a small training module on how to use it. So again, if your office is not set up electronically yet, this might prove to be the solution until a full integrated records set is created. I don’t know of any office that would not welcome an additional 2% in their Medicare reimbursement rates, so the incentive is there! About 4 times a year I have made a post relative to the free e-Prescribing program and maybe now it might take hold. BD
Here's an update from Beth Israel and their pilot program, a year away it appears for the DEA...and they want to use Smart Cards and have a 2 minute time out for each script before it goes through, getting more complicated from the DEA by the minute.
The hospital has a pilot program ongoing, so this is a good resource to check and see how things are evolving. This has been a real tough spot with providers "that like e-prescribing" and dislike the idea of pulling out the paper pad for these types of prescriptions, which you can't blame them. It is a hassle and goes back the old paper record methodologies.
Read the entire article, and if you are a physician, see what you think, is this more complicated than paper? There are a couple good points, like no printing and logs, which from a security stand point is not bad, but smart cards, tokens, something you have to carry around with you instead of authenticated log ons and certificates? It appears the DEA doesn't think certificates as used by the rest of the world are enough, like Microsoft for a simple example with a Live ID. In a year's time though we might think about what technology advances will be out there too that do not exist today, so it just makes me ponder a bit if when approved, will some of it be outdated before the ball gets rolling and will the 2% incentive from Medicare be enough to make any difference to furthering e-prescribing?
Well I guess the jury will be out for a while on this topic, and in the meantime, keeps those 4 part paper pads handy. BD
In order for a prescriber to access the system and write electronic prescriptions, the practitioner must authenticate using a two-factor authentication process, which means using something that you have (a smart card, token or thumb drive containing a digital certificate) plus something that you know (a strong password). This process will have to be used each time the practitioner wants to sign a controlled substance prescription.