WASHINGTON – A pending Drug Enforcement Agency rule permitting the electronic prescribing of controlled substances is expected to give healthcare providers added incentives to adopt health IT systems once the rule goes into effect on June 1.
The new rule could overcome a barrier that has kept many providers from adopting health IT altogether: the requirement that providers maintain a separate paper-and-fax-based workflow to prescribe controlled substances.
For many physicians, it has been easier to simply avoid e-prescribing and stick with a single - and simpler - workflow.
"We know there were some people who could not adopt because they were high prescribers of controlled substances ... but didn't want to have two different systems in place," said Jodi Daniel, director of the national coordinator for health IT's policy and planning office.
Daniel spoke at a meeting of the federal Health IT Standards Committee on April 28, where the DEA made a presentation on its new e-prescribing policy.
The new DEA rule - although it requires additional technical precautions - aims to make prescription workflows for controlled and standard drugs more seamless.
The DEA downplayed difficulties the technical requirements of its plan would impose on physicians and pharmacists. Those include identity proofing of the e-prescriber with two-factor authentication, audit trails and certification of e-prescribing software.
Those controls need not be feared, said Michelle Ferritto, chief of the regulatory drafting unit in the Drug Enforcement Administration's (DEA) Office of Diversion Control. "It's not that much more difficult than using your ATM," she said.
To withdraw cash, individuals enter their pin number and insert their ATM bankcard, an example of two-factor authentication. "We would probably be very uncomfortable if anyone could walk up to an ATM and just punch in a 4-digit code, and money is spit out. That's our same concern on electronic prescribing of controlled substances," Ferritto said.
John Halamka, MD, the co-chair of the committee and the CIO of Beth Israel Deaconess Medical Center, said he believes "physicians will adopt e-prescribing much more rapidly when there is a singular workflow – whether it's Lipitor or Valium."
The DEA rule will go into effect at about the same time the Office of the National Coordinator finalizes its criteria for EHR certification, which providers must comply with in order to receive federal health IT incentives.
The timing will provide an additional impetus for physicians who are upgrading their systems in order to qualify for financial incentives to also purchase e-prescribing systems, Daniel noted.
ONC will also watch how providers put the DEA's tougher security policies into practice and consider how those lessons can apply broadly to electronic health records, she said.
