Tag Archives: EPCS

Have You Adopted Electronic Prescriptions for Controlled Substances?


Post by Jaimin Patel


Vice President IAM Program Management, Caradigm

When regulations for Electronic Prescriptions for Controlled Substances (EPCS) were introduced in 2010, more than 12 million people reported using prescription painkillers non-medically, and the number of painkillers being prescribed could have medicated every American adult for a month straight. [1] In response to the volume of both the abuse and prescribing of controlled substances, the Drug Enforcement Agency (DEA) set several regulatory requirements for healthcare practitioners and organizations that want to prescribe controlled substances by electronic means.

Initially, many providers were concerned about the strict security mandates. To be able to prescribe controlled substances electronically, the DEA requires a secure, auditable chain of trust for the entire process. In addition, the financial and IT resources required to implement the appropriate solutions for EPCS can be challenging for smaller organizations.

With only 1% of e-prescribers being enabled for EPCS as of December 2013, adoption was a concern as prescription abuse remained a prominent societal issue. [2] In 2014, almost 50,000 people died of drug-induced causes in the United States. [3] In 2015, opioids alone killed more than 33,000 people. [4] The unavoidable reality of opioid abuse in society led to additional state laws and regulations following the DEA mandate in 2010, which resulted in broader EPCS adoption. As of September 2016, 20.2% of e-prescribing providers were enabled for EPCS. [5]

Caradigm offers an integrated and comprehensive solution for EPCS workflows that is a seamless extension of our industry-leading Identity and Access Management (IAM) portfolio. Caradigm’s Multi-Factor Authentication (MFA) solution for EPCS offers a variety of integrated authentication options ranging from biometric fingerprints, hard & soft token authentication, as well as mobile authentication. These options allow your organization to implement the best authentication solution to meet your prescribers’ needs.

The DEA requires identity proofing for prescribers that access EPCS controls within an electronic medical record (EMR). Caradigm Provisioning Identity Management ensures that appropriate checks and balances are applied for an organization before granting a prescriber EPCS rights within an EMR. Further, when the prescriber no longer needs EPCS privileges, Caradigm Provisioning Identity Management can seamlessly update these permissions in the EMR while notifying appropriate members in the organization. This integrated solution ensures that no unauthorized access is granted for prescribers.

Caradigm’s EPCS solution has been deployed at number of sites where users are benefiting from integrated Single Sign-On for fast and efficient access into their applications and MFA for EPCS workflows.

Overall, it’s hard to argue that EPCS is anything but a positive for the healthcare industry, and any organizations that have not adopted a solution for EPCS should act now. E-prescribing is a tool that increases efficiency, prevents the likelihood of fraud, and reduces the risk of controlled prescription errors. For additional information, please visit our EPCS page.

[1] http://www.cdc.gov/VitalSigns/PainkillerOverdoses/index.html

[2] http://www.ajmc.com/journals/issue/2014/2014-11-vol20-sp/adoption-of-electronic-prescribing-for-controlled-substances-among-providers-and-pharmacies

[3] https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf

[4] https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

[5] https://www.healthit.gov/opioids/epcs

 

The Rise in Electronic Prescription of Controlled Substances (EPCS)


Post by Mike Willingham


Vice President of Quality Assurance and Regulatory Affairs, Caradigm

Healthcare organizations are facing a serious societal problem that has become more pronounced in the last 15 years – the widespread abuse of prescription drugs. Controlled substances now account for approximately 10% to 11% of all prescriptions in the United States.[1] Deaths from prescription painkillers have quadrupled since 1999, killing more than 16,000 people in the United States in 2013.[2] Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013.[3] More than 12 million people reported using prescription painkillers non-medically in 2010 (i.e. without a prescription or for the feeling they cause).[4] The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years.[5] High profile news stories involving prescription drug abuse (e.g. Brett Favre, Heath Ledger) have also seemingly become more common.

In response to the rapid increase in both the prescribing and abuse of controlled substances in recent years, the Drug Enforcement Agency (DEA) has set a number of regulatory requirements for healthcare practitioners and organizations that want to prescribe those controlled substances by electronic means. In order to be able to prescribe controlled substances electronically, the DEA requires a secure, auditable chain of trust for the entire process. In addition, several states are mandating the use of EPCS, including Ohio, Florida and New York (with its I-STOP law).

Overall, it’s hard to argue that EPCS is anything but a positive for the healthcare industry. E-prescribing is a tool that increases efficiency and reduces risk of fraud and errors. A study has estimated that e-prescribing resulted in a decrease in the likelihood of prescription errors by 48%.[6]

So far though, healthcare providers have been slow to adopt EPCS thus far because most states have not had a mandate for it yet, and there are no penalties for non-compliance. However, it is inevitable that more mandates are coming, and I believe that EPCS will inevitably become the de facto standard of prescribing controlled substances. While overall adoption is currently low, it is growing fast as an average of 287 clinicians are adding this capability every month.[7]

Caradigm offers a comprehensive EPCS solution that is a seamless extension of our industry leading Identity and Access Management portfolio. We are actively working with our customer base to help them address EPCS, and are looking forward to partnering with more organizations to help them do their part in tackling this important societal issue. In a follow-up blog post, I will dive deeper into the technical solutions required for EPCS. For additional information, please visit our EPCS page.

[1] Meghan Hufstader Gabriel, PhD; Yi Yang, MD, PhD; Varun Vaidya, PhD; and Tricia Lee Wilkins, PharmD, PhD, Adoption of Electronic Prescribing for Controlled Substances Among Providers and Pharmacies. The American Journal of Managed Care. 11.17.14. http://www.ajmc.com/journals/issue/2014/2014-11-vol20-sp/adoption-of-electronic-prescribing-for-controlled-substances-among-providers-and-pharmacies
[2] Centers for Disease Control and Prevention. National Vital Statistics System mortality data. (2015) Available from URL: http://www.cdc.gov/nchs/deaths.htm.
[3] Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series
[4] http://www.cdc.gov/VitalSigns/PainkillerOverdoses/index.html
[5] https://www.atrainceu.com/course-module/2270162-118_oregon-pain-module-11
[6] Radley DC, Wasserman MR, Olsho LE, Shoemaker SJ, Spranca MD, Bradshaw B. Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. J Am Med Inform Assoc. 2013; 20(3):470-476.
[7] Meghan Hufstader Gabriel, PhD; Yi Yang, MD, PhD; Varun Vaidya, PhD; and Tricia Lee Wilkins, PharmD, PhD, Adoption of Electronic Prescribing for Controlled Substances Among Providers and Pharmacies. The American Journal of Managed Care. 11.17.14. http://www.ajmc.com/journals/issue/2014/2014-11-vol20-sp/adoption-of-electronic-prescribing-for-controlled-substances-among-providers-and-pharmacies