2015 User Conference

Electronic Prescribing of Controlled Substances (EPCS) April 25, 2015

Presented by:

Peter MinioProduct Manager, Pediatric and Primary Care SolutionsRoom Monitor:

Jeanette JonesServices Support

EHR Session

2015 Office Practicum User Conference

Learning Objectives

● Background information about EPCS and I-STOP.

● Readiness for EPCS.● Identity-Proofing (IDP).● How OP has implemented EPCS.

2015 Office Practicum User Conference

Background

• 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.

2015 Office Practicum User Conference

Benefits of EPCS

• 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.

2015 Office Practicum User Conference

Readiness

• 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.

2015 Office Practicum User Conference

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.

2015 Office Practicum User Conference

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.

2015 Office Practicum User Conference

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):■ 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.

2015 Office Practicum User Conference

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.

2015 Office Practicum User Conference

IDP Process

• 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.

2015 Office Practicum User Conference

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.

2015 Office Practicum User Conference

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.■ 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.

2015 Office Practicum User Conference

NADEAN

● Certain drugs require a Narcotics Addiction DEA (NADEAN) Number (e.g., Suboxone) to be included in the pharmacist notes.

2015 Office Practicum User Conference

HGB

● Drugs that contain gamma-Hydroxyburtric acid (e.g., Xyrem) must contain a reason for prescribing in the pharmacist notes.

2015 Office Practicum User Conference

Questions?

2015 Office Practicum User Conference

We want your feedback!