E-prescribing Can Become a Tool to Enhance Flexibility
E-prescribing is one small way that physicians can help improve patient care and respond to the opioid crisis — for example, by writing shorter-duration pain-management e-prescriptions, physicians can avoid having patients pick up multiple paper ones.
An initial prescription could be provided for a three-day supply, and a follow-up could be issued at the end of that period to cover ongoing pain management. Also, e-prescriptions go directly to pharmacies and have less likelihood of being altered or amended.
Many physicians are unsure about the rules for e-prescribing of federally controlled substances. The Drug Enforcement Administration’s (DEA) 2012 Interim Final Rule dropped the federal prohibition on electronic prescribing and allowed physicians to e-prescribe Schedule II through Schedule V controlled substances, with some restrictions.
Before e-prescribing Schedule II drugs, the DEA requires that there be an independent, third-party verification of the prescriber — so called ‘identity proofing’ — and a two-factor authentication of each prescription.
It is possible to e-prescribe Schedule II through V electronically in Massachusetts, but the physician and the pharmacy must meet the DEA’s verification and authentication requirements. The software must also meet the requirements. Generally, systems are set up to be in compliance and as certified software. Many big-system software programs are currently certified for use.
Once using a certified system, the prescriber must also use an approved second factor, such as a one-time password token, or the recently emerging biometric factors, such as a fingerprint for each prescription.
E-prescribing is still underused in Massachusetts, even though the Commonwealth had the first pilot project in the nation to test it out. This project ran with a DEA waiver from 2008 to 2011. Despite this fact, many pharmacies have no experience with e-prescriptions for controlled substances and do not provide this service for patients. –
