How Suppliers Ought to Use Know-how to Meet the EPCS Mandate

Digital well being instruments that permit suppliers to electronically prescribe managed medicines can enhance care administration and curb drug misuse in the event that they’re used accurately.

Digital well being know-how has been hailed as an necessary instrument for healthcare suppliers in prescribing medicines, however these instruments can be utilized for hurt in addition to good. That is why federal regulators are very strict in regulating digital prescribing, or e-prescribing.

The Facilities for Medicare & Medicaid Companies (CMS) established new rules firstly of 2023 for Digital Prescribing for Managed Substances (EPCS), specializing in Schedule II, III, IV, and V managed substances (together with prescription opioids) lined underneath Medicare Half D. This mandate requires suppliers to make use of safe prescribing practices aimed toward stopping drug diversion, together with multi-factor authentication and complete reporting that tracks prescription occasions as they happen.

The mandate might be difficult to grasp, however it additionally provides suppliers an avenue to e-prescribing that may enhance care administration and outcomes. HealthLeaders just lately sat down, nearly, with Dan Fabbri, senior vice chairman and chief information scientist at Imprivata and an assistant professor at Vanderbilt College, to elucidate the brand new mandate.

Q. Underneath present rules, what should healthcare suppliers do to nearly (electronically) prescribe medicines?

Fabbri: The federal Digital Prescribing for Managed Substances (EPCS) mandate that went into impact firstly of 2023 contains two essential necessities for healthcare organizations: Multi-Issue Authentication (MFA) and complete reporting to trace prescription occasions. MFA verifies the doctor’s id and ensures they’ve authorization to prescribe a selected remedy, whereas the reporting requirement creates an intensive report of remedy prescriptions as a way to detect any anomalous exercise, corresponding to drug diversion. These necessities apply to all Schedule II, III, IV, and V managed substances lined underneath Medicare Half D. To fulfill the DEA necessities for EPCS, healthcare organizations should have an in depth, extremely collaborative cross-functional venture plan that outlines the 5 key phases: evaluation, preparation, testing, enrollment, and transition.

Q. How do these rules scale back the prospect of misuse or drug diversion?

Fabbri: Implementing MFA and complete reporting required by the federal EPCS mandate has the potential to stop and mitigate drug diversion by asking healthcare organizations to create a report of what medicines are being prescribed, why they’re being prescribed, when they’re being administered, and who’s prescribing and administering them. MFA confirms a doctor’s id and their proper to prescribe a selected remedy, whereas the reporting permits auditors to seek for irregular exercise corresponding to drug diversion. 

Whereas these necessities are much-needed steps in the correct path, they’re solely as sturdy because the diploma to which they’re carried out. Healthcare organizations should now navigate know-how instruments to fulfill compliance necessities whereas additionally being cautious to not decelerate workflows and compromise affected person care.

Through the use of the right instruments to make sure solely legitimate physicians are prescribing by way of MFA and create a digital audit path of prescription exercise to offer higher visibility into drug diversion occasions, healthcare organizations can scale back remedy errors, enhance affected person outcomes, and scale back the variety of affected person visits, whereas combating the opioid abuse epidemic. General, EPCS enhances accountability and creates room for enchancment in prescribing, permitting suppliers to make better-informed selections and decreasing the prospect of dependancy.

Q. How do they have an effect on telehealth and digital well being applications?

Fabbri: There are Drug Enforcement Administration (DEA) compliant instruments that permit for faster and safer prescribing of managed substances, even when the supplier is just not on the hospital. This know-how permits sufferers to get remedy as quickly as they want it with out inconveniencing clinicians.

EPCS has additionally been a crucial part of continuous affected person care by telehealth through the COVID-19 pandemic, as practitioners have been capable of serve sufferers by accepted real-time video platforms whereas limiting the potential of group unfold, resulting from an exception to the Managed Substances Act. Proposals have just lately been introduced to shut this telemedicine exemption and require in-person prescribing visits with doubtlessly higher clinician and affected person burden.

Q. How can healthcare suppliers use know-how (cyber options) to make this course of safer and simpler?

Fabbri: Through the use of digital id options, healthcare organizations can adjust to DEA requirements rapidly and effectively whereas bettering visibility into who has been prescribed what, when, and why. By implementing applied sciences and purposes that combine with their present digital medical report (EMR) programs, healthcare organizations can obtain EPCS compliance with out creating extra burdens on healthcare professionals or IT groups. Digital id instruments can assist suppliers prescribe remedy sooner and safer with out limiting the effectiveness, effectivity, and efficiency of nursing and doctor employees.

For instance, healthcare organizations usually use multi-factor authentication (MFA). With the most recent digital id know-how, medical doctors can effectively and securely prescribe wanted medicines when they’re away from the hospital whereas nonetheless complying with EPCS guidelines. New digital id instruments present customers with quite a lot of methods to implement MFA, custom-built for the fast-paced supplier workflow.  There are a number of DEA-compliant choices suppliers can select from – hands-free authentication, push token notifications, fingerprint or facial biometrics, or typical {hardware} and software program tokens. These choices make the authentication course of much less tedious and time-consuming than typing in a password every time, permitting sufferers to get their remedy with out pointless delays.

Moreover, AI-powered drug diversion platforms allow healthcare organizations to flag suspicious habits, corresponding to an uncommon variety of capsules being pulled from a cupboard. This know-how additionally detects much less nefarious habits that raises the danger of drug diversion, like leaving a cupboard open to keep away from slowdowns in care. By using MFA and single sign-on options in tandem with AI monitoring, healthcare organizations can have higher visibility over all prescribing exercise within the organizations, additionally decreasing drug diversion.

These options empower healthcare organizations to stop fraudulent actors from acquiring and abusing opioids, whereas making the EPCS course of safer and extra manageable for employees. General, leveraging these modern cybersecurity instruments can assist healthcare organizations guarantee compliance with EPCS rules, and broaden their capabilities for detecting, stopping, and remediating drug diversion – all bettering affected person care.

Q. What are the challenges or limitations that suppliers have to beat to make use of this know-how?

Fabbri: Whereas the advantages of EPCS compliance are clear, the complexity of the DEA necessities and certification course of could make it a frightening job. The implementation of EPCS additionally requires a big variety of tactical steps involving varied departments corresponding to IT, scientific management, pharmacy, utility/EHR groups, and compliance/credentialing. Efficiently navigating DEA compliance whereas offering streamlined workflows for clinicians might be tough, requiring cautious planning and coordination between completely different departments inside a healthcare group.

One of many essential challenges for on-the-floor suppliers to fulfill EPCS compliance is making certain that the necessities don’t decelerate workflows and negatively impression affected person care.  To keep away from this impression, it will likely be essential for healthcare organizations to strategically select know-how that meets compliance mandates whereas concurrently bettering workflows and affected person care.

Q. Can these applied sciences/processes enhance remedy adherence and scientific outcomes?

Fabbri: Aided by know-how, digital prescribing ensures that prescriptions are precisely and effectively transmitted to pharmacies with out the potential for errors that may happen with handwritten paper-based programs, corresponding to remedy errors resulting from illegibility, incomplete or incorrect data, and fraud resulting from stolen prescription pads.

By automating the prescription course of and integrating AI instruments, suppliers can scale back the potential for human error, and digital programs might be cross-referenced with scientific choice assist instruments to alert suppliers of potential drug interactions or contradictions.

Using AI and analytics-based cybersecurity instruments assist healthcare organizations detect suspicious traits and outliers that will impression affected person care and enhance scientific outcomes by offering precious insights into prescribing patterns. For instance, these applied sciences can analyze PHI, together with EHRs and prescription histories, to establish sufferers who’ve been prescribed opioids for an prolonged interval or at excessive doses, or who’ve a historical past of substance abuse. By figuring out these sufferers, healthcare suppliers can take proactive measures to stop overprescribing, which in flip reduces healthcare prices, and mitigates authorized and reputational dangers.

Q. Is there a necessity or a need amongst telehealth advocates to enhance the rules or change them to make the method simpler?

Fabbri: Regardless of a increase in telemedicine, patchwork legal guidelines and insurance coverage protection within the US has hindered telehealth entry for years. A repeal of coverage that protects telemedicine will restrict developments in offering care by cell gadgets and impression affected person outcomes.

Q. How ought to this course of evolve? What’s on the horizon for digital prescribing of medicines?

Fabbri: The EPCS course of is prone to evolve in a path that requires digital prescribing of all managed substances, no matter payer standing. On the federal degree, EPCS is barely required for managed substances underneath Medicare Half D. Nevertheless, many states have already got mandates that require digital prescribing for all managed substances, and the pattern is prone to trickle up all the best way to the federal authorities. In actual fact, a brand new EPCS invoice is making its method by Congress that might broaden the sort of managed substances topic to EPCS rules.

To make sure that EPCS continues to fulfill the wants of the healthcare business, healthcare organizations might want to collaborate with regulators and know-how distributors to deal with bettering the know-how and instruments used for digital prescribing, in addition to addressing points associated to privateness, safety, and interoperability. General, the nationwide transfer in the direction of EPCS is a constructive step for bettering remedy adherence and scientific outcomes—together with tackling the nation’s opioid disaster— and because the healthcare business continues to evolve, it’s going to possible turn out to be an more and more necessary instrument for healthcare organizations.

Eric Wicklund is the Innovation and Know-how Editor for HealthLeaders.

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