August 26, 2014


VIDEO: AHRQ Highlights Pioneer Electronic Prescribing of Controlled Substances Study

Several years ago, we embarked on a journey that no other health IT company had taken to date: we participated in a study that dramatically shifted the e-prescribing landscape by adding controlled substances as a capability. I am happy to share that the Agency for Healthcare Research and Quality (AHRQ) released a video about the three-year project.

I’ve talked about our work to bring e-prescribing of controlled substances to market and the current state of the industry in previous blog posts and videos, but I wanted to get into some of the details that surrounded our AHRQ-funded study in Berkshire County, Massachusetts in this post.

Study Background

The DEA issued its Interim Final Rule on electronic prescribing of controlled substances in 2010. Several years before the ruling, we laid the groundwork for electronic prescribing of controlled substances in Berkshire County through an AHRQ-funded study. I had met Donald Burt, MD, a physician at Berkshire Health Systems (BHS), who highlighted some of his grievances with the inability to send controlled substance electronically, which included:

  • Using two systems for prescribing was nonsensical and resulted in disrupted workflow
  • Not only were handwritten prescriptions time consuming, they also put him and other physicians at risk for tampering and diversion
  • Berkshire County had a huge prescription drug abuse problem, exacerbated by an inability to track medications sent. In fact, BHS was funding its own program to monitor all controlled prescriptions

His grievances were not uncommon for physicians then, and today.

The project started to come together when I got Grant Carrow PhD on board. I approached Dr. Carrow, who became the Principal Investigator, to participate in the study because I was impressed with his understanding of the issue as well as his academic background.

At the time of the study, Dr. Carrow was also Director of the Drug Control Program for the Massachusetts Department of Public Health (MDPH). When Dr. Carrow and MDPH agreed to get involved, they put together a high-quality, academically complete project. Dr. Carrow was also instrumental in bringing both BHS and Brandeis University into the study. I am thankful to Dr. Carrow, as his work helped us get AHRQ funding. Other partners included pharmacies, the DEA (who provided a waiver), AHRQ, and Emdeon, the e-prescribing network that transmitted prescriptions between DrFirst and the pharmacies.

Spearheading Industry Transformation

Some people might want to know why we chose Berkshire County to do a pilot study. What better place to do a study on e-prescribing controlled substances than somewhere with a prescription drug abuse problem? Since DrFirst was already communicating with the DEA about possible solutions to e-prescribing of controlled substances, I received the green light from the DrFirst executive team. I then began gathering a team to participate in the study. You can learn more about the project by watching the AHRQ’s video:

I hope you enjoy the video, and please feel free to share your thoughts in the comments section.

Where We Stand: E-prescribing of Controlled Substances Today

We’ve come a long way, but we’re still not at 100% of providers sending, and pharmacies accepting, controlled substances. So, where do we stand now?

  • Over 40% of pharmacies nationwide accept controlled substance e-prescriptions
  • 49 U.S. states have now legalized controlled substance e-prescribing
  • New York’s I-STOP deadline March 27, 2015; The law mandates controlled substance e-prescribing

For more information on controlled substances e-prescribing read our The Evolving Landscape for Electronic Prescribing of Controlled Substances white paper.

The AHRQ’s video reminds me, at a time when controlled substance e-prescribing is gaining momentum, of the real transformation we spearheaded and continue to foster.

About pkaufman

Schooled at MIT, Dr. Kaufman nurtured a strong interest in medical informatics while a Bowman Gray School of Medicine faculty member. After entering private practice he founded PiNK software in 1996 to produce EMR software, later becoming DrFirst’s chief medical officer upon its founding. He lectures nationally on various healthcare IT topics, and as a board certified gastroenterologist, he continues a limited clinical practice. Dr. Kaufman is a member of the Health IT Standards Committee, Privacy and Security Workgroup for ONC (Office of the National Coordinator for Healthcare Information Technology). Representing the American Gastroenterology Association’s (AGA), Dr. Kaufman is a delegate to the AMA and was the co-chair of the Physicians Electronic Health Record Consortium (PEHRC). He has participated on workgroups at CCHIT (stand-alone e-prescribing), HIMSS (e-prescribing), and NCPDP (e-prescribing).