April 4, 2012

Colin Banas, MD

Update on E-prescribing of Controlled Substances

UPDATE: How to Comply with State Mandates

E-prescribing has grown rapidly since the DEA published its Interim Final Rule on electronic prescribing of controlled substances (EPCS) in June 2010, not only because the technology has improved, but because of the substantial benefits for patients and physicians. Every state in the U.S. now allows e-prescribing, and many states are mandating EPCS and prescription drug monitoring programs (PDMPs) for all controlled substances. See how DrFirst can help you comply with state mandates.

See our original post below.

An update on e-prescribing of controlled drugs –finally electronic prescribing is now available for ALL medications!
When the DEA published the “Interim Final Rule” regarding electronic prescription of controlled substances (EPCS) in June of 2010, it also sent a letter to all prescribers with DEA licenses informing them that EPCS was now available. Well, due to very stringent and complex regulations, it wasn’t all that simple. It has taken a while to get the industry up to speed, but DrFirst is the first vendor that is DEA compliant to send controlled drug prescriptions electronically. Unfortunately, it took a little longer for the pharmacies to complete development and receive certification, but at least three of the largest pharmacy chains and one pharmacy software vendor to independent pharmacies are now certified and are activating pharmacies in multiple states.

Learn more about the states available for EPCS.

In order to send EPCSs to certified pharmacies, a physician needs to go through a strict identity proofing (IDP) to receive a two-factor authentication token (which can be a hardware token or software on a smartphone) which is used in conjunction with the provider’s password in compliant systems such as EPCS Gold from DrFirst.
There are some caveats. Once a provider is fully enabled for EPCS, controlled drug prescriptions can be sent to enabled pharmacies through the fully electronic connection. However, controlled substance prescriptions cannot be faxed directly by a computer, even as a back-up if the electronic prescription can’t be transmitted electronically due to system failure. If the prescription fails, the provider will be notified in Rcopia that the prescription has NOT been sent. It’s not too difficult for Schedule III-V medications – these can be printed out, wet signed, and manually faxed to the pharmacy. However, Schedule II drugs (like Percocet, fentanyl patches, Adderall, and others) cannot be faxed to the pharmacy or even wet-signed. These controlled substance prescriptions must be printed out and handed to the patient. Lastly, some states have not changed their statutes to allow EPCS – 16 states as of the beginning of March 2012. Hopefully, these states will soon legalize EPCS.
If you are interested in EPCS, contact DrFirst to get the process rolling!

About Colin Banas, MD
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Colin Banas, M.D., M.H.A., is Chief Medical Officer of DrFirst, and former Internal Medicine Hospitalist and former Chief Medical Information Officer for VCU Health System in Richmond, Virginia.