Digital well being instruments that enable 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 essential device for healthcare suppliers in prescribing medicines, however these instruments can be utilized for hurt in addition to good. That’s why federal regulators are very strict in regulating digital prescribing, or e-prescribing.

The Centers for Medicare & Medicaid Services (CMS) established new rules originally of 2023 for Electronic Prescribing for Controlled Substances (EPCS), specializing in Schedule II, III, IV, and V managed substances (together with prescription opioids) lined below Medicare Part D. This mandate requires suppliers to make use of safe prescribing practices geared 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 not too long ago sat down, nearly, with Dan Fabbri, senior vp and chief knowledge scientist at Imprivata and an assistant professor at Vanderbilt University, to elucidate the brand new mandate.

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

Fabbri: The federal Electronic Prescribing for Controlled Substances (EPCS) mandate that went into impact originally of 2023 contains two foremost necessities for healthcare organizations: Multi-Factor Authentication (MFA) and complete reporting to trace prescription occasions. MFA verifies the doctor’s id and ensures they’ve authorization to prescribe a specific treatment, whereas the reporting requirement creates an intensive report of treatment prescriptions as a way to detect any anomalous exercise, reminiscent of drug diversion. These necessities apply to all Schedule II, III, IV, and V managed substances lined below Medicare Part D. To meet the DEA necessities for EPCS, healthcare organizations should have an in depth, extremely collaborative cross-functional undertaking plan that outlines the 5 key phases: evaluation, preparation, testing, enrollment, and transition.

Q. How do these laws cut 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 specific treatment, whereas the reporting permits auditors to seek for irregular exercise reminiscent of drug diversion. 

While these necessities are much-needed steps in the precise route, they’re solely as sturdy because the diploma to which they’re applied. Healthcare organizations should now navigate know-how instruments to satisfy compliance necessities whereas additionally being cautious to not decelerate workflows and compromise affected person care.

By utilizing the correct instruments to make sure solely legitimate physicians are prescribing through MFA and create a digital audit path of prescription exercise to present larger visibility into drug diversion occasions, healthcare organizations can cut back treatment errors, enhance affected person outcomes, and cut back the variety of affected person visits, whereas combating the opioid abuse epidemic. Overall, 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 enable for faster and safer prescribing of managed substances, even when the supplier isn’t on the hospital. This know-how allows sufferers to get treatment as quickly as they want it with out inconveniencing clinicians.

EPCS has additionally been a crucial element of continuous affected person care by means of telehealth in the course of the COVID-19 pandemic, as practitioners had been in a position to serve sufferers by means of accepted real-time video platforms whereas limiting the potential of neighborhood unfold, on account of an exception to the Controlled Substances Act. Proposals have not too long ago been introduced to shut this telemedicine exemption and require in-person prescribing visits with doubtlessly larger clinician and affected person burden.

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

Fabbri: By utilizing 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 functions 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 might help suppliers prescribe treatment sooner and safer with out limiting the effectiveness, effectivity, and efficiency of nursing and doctor employees.

For instance, healthcare organizations typically 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 a wide range 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 standard {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 treatment with out pointless delays.

Additionally, AI-powered drug diversion platforms allow healthcare organizations to flag suspicious habits, reminiscent of an uncommon variety of tablets 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. Overall, leveraging these progressive cybersecurity instruments might help healthcare organizations guarantee compliance with EPCS laws, 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: While 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 reminiscent of IT, scientific management, pharmacy, utility/EHR groups, and compliance/credentialing. Successfully navigating DEA compliance whereas offering streamlined workflows for clinicians might be troublesome, requiring cautious planning and coordination between totally different departments inside a healthcare group.

One of the principle challenges for on-the-floor suppliers to satisfy EPCS compliance is making certain that the necessities don’t decelerate workflows and negatively influence affected person care.  To keep away from this influence, 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 treatment 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, reminiscent of treatment errors on account of illegibility, incomplete or incorrect data, and fraud on account of stolen prescription pads.

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

The use of AI and analytics-based cybersecurity instruments assist healthcare organizations detect suspicious tendencies and outliers which will influence affected person care and enhance scientific outcomes by offering helpful insights into prescribing patterns. For instance, these applied sciences can analyze PHI, together with EHRs and prescription histories, to determine 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 want amongst telehealth advocates to enhance the laws or change them to make the method simpler?

Fabbri: Despite a growth 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 means of cellular units and influence 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 more likely to evolve in a route that requires digital prescribing of all managed substances, no matter payer standing. At the federal degree, EPCS is barely required for managed substances below Medicare Part D. However, many states have already got mandates that require digital prescribing for all managed substances, and the development is more likely to trickle up all the best way to the federal authorities. In reality, a brand new EPCS invoice is making its manner by means of Congress that may broaden the type of managed substances topic to EPCS laws.

To make sure that EPCS continues to satisfy the wants of the healthcare trade, healthcare organizations might want to collaborate with regulators and know-how distributors to concentrate on bettering the know-how and instruments used for digital prescribing, in addition to addressing points associated to privateness, safety, and interoperability. Overall, the nationwide transfer in direction of EPCS is a optimistic step for bettering treatment adherence and scientific outcomes—together with tackling the nation’s opioid disaster— and because the healthcare trade continues to evolve, it can probably turn out to be an more and more essential device for healthcare organizations.