DrFirst Healthcare Technology Blog

Crossing the New Chasm of Electronic Prescribing of Controlled Substances (EPCS)

September 26, 2012

Back in 2001 when DrFirst first developed e-prescribing, we spent a lot of time educating providers about the benefits and patient safety advantages of utilizing technology in their practices. We spent years “Crossing the Chasm” from early adopters to broader adoption. For years, the industry believed the inability to e-prescribe controlled substances (Schedule II – Schedule V), combined with DEA restrictions, was the single greatest barrier to the broad adoption of e-prescribing. Many practices that prescribe large numbers of controlled substances avoided e-prescribing altogether because it fragmented their workflows.

DrFirst spent years working with the DEA and AHRQ in the research, development, and pilot phase of meeting the DEA requirements, in order to remove this obstacle so providers could all benefit from e-prescribing. (http://blog.drfirst.com/drfirst/congratulations-ahrq-grantee-team/). After we successfully went through the difficult process of certification, we hit a lull.

What we didn’t anticipate was that EPCS would have its own “chasm” to cross.

After reading Dr. John Halamka’s blog on where the industry stands on EPCS, we realized that the industry wasn’t aware that many of the barriers have already been removed! (http://geekdoctor.blogspot.com/2012/09/an-update-on-controlled-substance-e.html).

“The primary barriers in my view have been:  the development time and effort the vendors and pharmacies needed to come into compliance with the Interim Final Rule (IFR); the third party-audit (this is a reference to the section required IFR Section 1311 audit, not the Surescripts certification), which is both costly and time-consuming; an incorrect perception that no pharmacies can accept EPCS; vendors’ competing development priorities (Meaningful Use Stage 2, ICD-10, etc.); and having all the docs ID proofed and authenticated in conformance with the Drug Enforcement Agency IFR.”

1) DrFirst experienced first-hand the many hurdles in getting to market with EPCS. In an effort to help the overall industry finally remove THIS barrier to e-prescribing adoption, we created EPCS Gold™ as a platform accessible to any EHR or HIS vendor. With EPCS Gold™, we have removed those obstacles allowing EHRs of all sizes and technical capabilities to offer their physicians a high-quality, scalable, DEA-compliant, fully certified, audited, and low cost solution.

2) Since June, we’ve seen a 25% increase in the number of pharmacies enabled to accept EPCS. This includes over 12,000 pharmacies in 38 states, including several major national chains such as Walgreens, CVS, RiteAid, and Osco. Interestingly, some states have begun adopting legislation requiring real-time prescription monitoring in order to combat prescription drug abuse, such as New York State’s recent I-STOP law, which will make EPCS required by the end of 2014.

3) Vendors no longer have to choose between competing development priorities because EPCS Gold allows them to greatly reduce development costs and effort, and eliminate the effort for audits, certification, and avoid day-to-day system operations, ID proofing and authentication of providers and ongoing security and compliance for constructing and operating a controlled substance e-prescribing system that meets DEA requirements so they can get to market quickly.

DrFirst has removed these barriers to lower the bar because at the end of the day, we recognize that doctors will benefit from this technology and we believe in patient safety, so we’re doing our part to build a bridge across the chasm for the benefit of the entire industry! For more information about DrFirst’s EPCS product, EPCS Gold 2.0, please visit http://www.drfirst.com/e-prescribing-for-controlled-substances.jsp.

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About the Author

Peter Kaufman CMO

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).

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