EHRs for E-Prescriptions and Drug Monitoring Programs

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EHRs for E-Prescriptions and Drug Monitoring Programs

ehrs for e-prescriptions

Electronic Prescriptions (or e-prescriptions) allow prescribers to write prescriptions digitally. Digital prescriptions can save prescribers time and energy and lower the risks of prescription errors, drug reactions, and dosage miscalculations that send 1.3 million Americans to the emergency room annually. E-prescriptions are now federally mandated in most states with the last states scheduled to begin this requirement by January 2022. There are now state-regulated Prescription Drug Monitoring Programs (PDMPs) too. If your health agency is considering adopting or switching to a new Electronic Health Record system (EHR), consider EHRs integrated for e-prescriptions and drug monitoring programs compliance.

The DEA created the Electronic Prescribing of Controlled Substances (EPCS) proposal to make a federal law regulating prescriptions and targeting opioid abuse. Their compliance requires the use of e-prescriptions. All states now have Prescription Drug Monitoring Programs (PDMPs) for controlled substance prescriptions also. Those require monitoring of all patients in each state that is prescribed a controlled substance. In some states, it is mandated that pharmacies send that information to the PDMP within 24 hours. With the use of an Electronic Health Record solution, all data is already electronic. That can help healthcare agencies simplify and speed up the process of sending data to your state’s PDMP to stay in compliance with state regulations. If the e-prescription tool is integrated into your EHR, it saves extra steps and prevents having to use another piece of software in keeping with federal regulations as well.

EHRs can…

  • Connect to the Prescription Drug Monitoring Programs
  • Alert limits on Controlled Substance Prescriptions
  • Offer Clinical Assessment Tools
  • Improve Patient Engagement and Education
  • Provide tools for Community Outreach

All of these features can help clinicians battle the opioid epidemic that is rampant across the United States. An integrated EHR supporting e-prescriptions and connecting to PDMPs can prevent adverse drug reactions and streamline administrative burdens while doing so, making it good for both patients and doctors. Clinicians are already time-stressed and many experience digital burnout. Having more tools adds technological burdens to their workflows. Integration-ready EHRs help eliminate one more tool your clinicians have to use. This will help them focus on the most important aspect of their jobs – their quality of care.

Contact us to schedule a demo and learn more about how Patagonia Health EHR supports EPCS and PDMP requirements.

North Carolina Requires Opioid E-Prescribe

The North Carolina Medical Board recently released a new mandate for the Strengthen Opioid Misuse Prevention (STOP) Act of 2017. Starting in January, North Carolina agencies prescribing opioids and narcotics will be required to submit prescriptions electronically. This e-prescribe requirement is for targeted controlled substances, which include Schedule II and Schedule III opioids and narcotics. Targeted controlled substances is a category originally created by the STOP Act in 2017. The NC Medical Board created a complete list of substances requiring electronic prescriptions.

What is the STOP Act?

Signed by Gov. Roy Cooper in 2017, the STOP Act was intended to address the opioid crisis in North Carolina. The state hoped this act would reduce excessive and inappropriate opioid prescribing. Primary components of the STOP Act include prescribing limits and requirements for the NC Controlled Substances Reporting System (CSRS). Other provisions mandated in the act impact licensed professionals who prescribe controlled substances. For example, Physician Assistants and Nurse Practitioners must consult with a superior physician before prescribing a targeted controlled substance.

Statistics of Opioid Use in North Carolina

In order to understand the STOP Act, the opioid crisis in North Carolina must also be understood. According to the North Carolina Department of Health and Human Services, here are some statistics on the issue:

  • 445,002,000 opioid pills were dispensed to North Carolina residents in 2018
  • 1,718 NC residents died from an unintentional opioid overdose in 2018
  • 5 North Carolinians died each day in 2018 from unintentional opioid overdose
  • More than 14,500 people in NC died because of an unintentional opioid overdose from 1999 to 2018

https://injuryfreenc.shinyapps.io/OpioidActionPlan/

Exemptions for E-Prescribe

The STOP Act notes multiple instances where the e-prescribe requirement will be exempt. The following exemptions are specified:

  1. A clinician (other than a pharmacist) who dispenses to an ultimate user
  2. Clinicians who prescribe controlled substances administered in a hospital, nursing home, hospice facility, outpatient dialysis facility, or residential care facility.
  3. A clinician that experiences technological outages or failures. In this instance, clinicians must document the reason for exemption in the client’s medical record.
  4. A clinician who prescribes medication dispensed by a pharmacy on federal property. In this instance, clinicians must document the reason for exemption in the client’s medical record.
  5. Professional who practices veterinary medicine

These are the only exemptions for the e-prescribe requirement. If a practitioner does not currently e-prescribe, they must start in January 2020. The NC Medical Board does not find it acceptable for any practitioner to refer a patient to a hospital emergency room in January because they did not receive e-prescribe capabilities. Therefore, anyone who prescribes targeted controlled substances must begin the e-prescribing by the beginning of the new year.

How to E-prescribe Controlled Substances

Electronic Prescribing for Controlled Substances (EPCS) allows professionals to prescribe Schedule II-V controlled substances directly from point-of-care to pharmacy. E-prescribing is accurate, comprehensive, and secure. Under the Drug Enforcement Administration’s (DEA) regulations, EPCS has strict requirements. DEA’s strict rules work to verify prescribers and avoid errors to patients. Verification is conducted through identity proofing and 2nd-factor authentication. Although these rules make e-prescribing more complex, they work to decrease opioid misuse.

Often, electronic prescribing services are available within the prescriber’s EHR. When selecting an EHR, it is important to consider how its e-prescribing functionality meets the DEA’s complex regulations for EPCS. Consider asking about and researching your EHR’s electronic prescribing service. Patagonia Health integrates EPCS in our easy-to-learn solution. To learn more about how Patagonia Health can help you comply with the STOP Act, contact us today.

Do you qualify for Meaningful Use exclusions or hardships?

CMS offers exclusions and hardship exceptions for Meaningful Use Stage 2 when Broadband Internet is not available

 

Meaningful use stage 2 has several objectives that require the use of broadband internet; ePrescribing (eRx), Patient Electronic Access, Summary of Care, and Electronic Messaging. However, internet service is not always available to the patient, the facility, or both. So how can otherwise eligible providers (EPs) meet all the Attestation requirements?

 

The Centers for Medicare and Medicaid Services (CMS) has recognized this issue and offers Meaningful Use exclusions and hardship exceptions for such cases. Measures for secure electronic communications from patients without internet may be excluded by the provider. According to CMS “Eligible professionals who conduct 50 percent or more of their patient encounters in a county in which 50 percent or more of its housing units do not have availability to 3Mbps broadband (according to the latest information available from the FCC) on the first day of the EHR reporting period may exclude these measures.” Providers can check patient access to broadband (or lack of) online at the National Broadband Map.

 

In the case where the facility is in an area without secure internet coverage or there are severe barriers for establishing broadband access (such as extreme costs) the providers may apply for hardship exceptions. They will of course have to provide proof to qualify for the hardship.

 

To find out more details on payment adjustments and exceptions visit http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html.