April 4, 2012


Update on E-prescribing of Controlled Substances

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.

At this time, the states available for EPCS are:

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 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).