E-prescribing of controlled substances: FAQs


E-prescribing of controlled substances (EPCS) has been rapidly on the rise, making it a hot topic and also triggering questions about regulations, adoption rates and more.  Here are a few questions I’ve been asked frequently that will hopefully help shed some light on this important topic.

Is EPCS allowed in my state?

The short answer? Yes, unless you live in Montana.  EPCS was legalized at the national level by the Drug Enforcement Agency (DEA) in 2010 but is still subject to regulatory approval on the state level.  The DEA rule is high-level and simply gives the option for providers to prescribe controlled substances electronically, so state laws and regulations that are more specific supersede the DEA rule.  Montana has not yet finalized rules that allow for electronic prescribing of controlled substances.  Vermont only allows electronic prescribing for Schedule III – V controlled substances, while all other states allow the prescribing of all schedules of controlled substances.

What’s the pharmacy adoption rate for EPCS?

Nearly 40 percent of retail pharmacies in the Unites States accept electronic prescriptions for controlled substances including major players like CVS, Walgreens and Rite-Aid – an increase of 115 percent in just under two years (source: 2014 DrFirst Industry Briefing The Evolving Landscape of Electronic Prescribing of Controlled Substances). I have no doubt that this rate of adoption will continue, resulting in most U.S. pharmacies accepting EPCS within the next two to three years.

What are the clinical benefits?

From a clinical perspective, there are very real benefits to electronically prescribing both controlled and non-controlled medications.  The combination of electronic prescribing with other clinical decision support tools such as drug monographs and dosing calculators can reduce medication errors.  And when electronic prescribing and clinical decision support tools are embedded into the workflow of an EHR like EV™, the benefits are even greater because the power of this information is available to the clinician within their existing workflow.

Another key clinical benefit is patient safety and satisfaction: sending prescriptions electronically makes it as easy as possible for patients to fill and take their prescribed medications. A 2012 Surescripts study found that e-prescribing significantly increases the first-fill medication rate and could result in up to $240 billion in health care savings and improved outcomes over the next 10 years.

Controlled substances come with a unique set of challenges due to the high potential for fraud and abuse.  By prescribing controlled substances electronically, the prescription goes directly from the provider to the pharmacy eliminating most avenues for abuse associated with paper prescriptions such as theft, forgery and modification.

What’s the future of electronic prescribing?

Electronic prescribing will help reduce medication errors and lower the probability of fraud and abuse and I predict wide adoption by states, clinicians and pharmacies within the next few years.  The state of New York has mandated that all prescriptions, including controlled substances, be prescribed electronically by March 27, 2015 and it’s only a matter of time before other states start to follow suit.

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About the Author

Robin Shannon

Robin Shannon is responsible for helping maintain the core clinical content and intuitive workflow design in T-System’s documentation solutions, and leveraging those core competencies to drive performance-enhancing solutions for emergency departments. She manages cross-functional teams to deliver high-quality and high-value solutions that improve outcomes for clinicians, hospitals and patients. Prior to joining T-System, Robin held a variety of leadership roles in the healthcare industry, including owning her own physician practice management consulting firm. She was the director of Heart Center Methodist Hospitals of Dallas and physician practice administrator for North Texas Cardiovascular Associates. She has expertise in managing responsibility for financial outcomes and revenue cycle optimization. Her clinical background includes serving as a RN in the trauma ICU and as the clinical transplant coordinator for Oregon Health Sciences University. Robin is a member of the Quality, Value and Performance Committee for EDPMA.

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