Delay of mandatory eRx doesn't change hospital plans

New York puts I-STOP law on hold, but secure EPCS still on the agenda for many
By Anthony Vecchione
10:23 AM

On March 13, 2015, New York Governor Andrew Cuomo signed a bill that will postpone until 2016 a deadline for physicians to issue only electronic prescriptions, including Schedule II-IV controlled substances. The original deadline was set for March 27 of this year.

[See also: DEA: They want a new drug]

Cuomo and others defend the delay, charging that the federal government has moved slowly in certifying vendors for the program.

Proponents of the bill contend that mandatory prescribing would help to address fraud and abuse of prescription drugs especially opioids.

[See also: eRx rate in NY state to see 'explosive growth']

Despite the postponement, some hospitals are adopting technology that will enable them to shift from paper-based prescriptions to electronic prescribing of controlled substances.

Mike Gillin, assistant director of information services at Southampton Hospital in Southampton, N.Y., said his facility is moving forward with the adoption of Imprivata Confirm ID from Lexington, Mass.-based Imprivata.

Imprivata Confirm ID, simplifies adoption of regulatory requirements for electronic prescribing of controlled substances, helping care providers address the workflow inefficiencies and potential for fraud caused by paper-based prescriptions.

It also integrates with leading electronic health records and offers multiple DEA-approved two-factor authentication options for prescription signing, giving providers a single, consistent e-prescribing experience for all medications.

"Even though the legislation mandating EPCS has been delayed, there was significant investment already put in place, and we didn’t wish to delay the project and lose momentum," said Gillin. "We feel that being set-up and having our practitioners using the system now, and getting comfortable with it, will make it easier when the mandate is in place.”

Southampton Hospital went live with Siemens Soarian information management package in March of 2014. Leading up to that, Gillin said that they had built out desktops on a platform that Siemens provided.

"Sorian information management access package, which is basically a VDI, (virtual desktop infrastructure) system based on VMware with some other programs including Imprivata OneSign. On our inpatient side that’s been the platform that nursing and physicians have been using for awhile now," said Gillin.

According to Gillin, Southampton was approached by Siemens regarding the beta program for e-prescribing of controlled substances and that dovetailed into where they already were with Siemens Sorian with e-prescribing.  The hospital was using the Imprivata One Sign application and had the infrastructure already in place.

"So to move forward with Confirm ID wasn't to much of a stretch to upgrade the service to handle Confirm ID as well," said Gillin.

"On the IS side it's fairly straight forward since it's the same platform as One Sign. It's the same servers you're using, the same directories you're using, so it's not another product that we have to maintain and take care of – that's a benefit to us," said Gillin.

"The other real benefit that we've seen at least in testing and from the feedback that we've gotten from physicians as they've looked at other systems like our ED or our ambulatory systems is the fact that Imprivata provides a biometric solution."

Gillin said that most of the physicians are not crazy about either having to use a soft token or a hard token on their phones.

A hard token, often referred to as an "authentication token," is a hardware security device that is used to authorize a user. One example of a hard token is a security card. A soft token is a software version of a hard token.

"The idea of being able to use the biometric features within Imprivata has been a real bonus," said Gillin.

Sean Kelly, MD, Imprivata's chief medical officer, said Imprivata Confirm ID addresses the national epidemic of drug abuse and diversion, particularly with opioids.

"There's a lot of holes in the system and inconvenience now," said Kelly. "What we do is we try to take technology and actually make it convenient for the provider and efficient but also super secure, according to the credentialing and the regulations."

The e-prescribing requirement is part of the Internet System for Tracking Over-Prescribing/Prescription Monitoring Program, or I-STOP/PMP. Effective Aug. 27, 2013, most prescribers in New York are required to consult the PMP Registry when writing prescriptions for Schedule II, III, and IV controlled substances.

The PMP Registry provides practitioners with direct, secure access to view dispensed controlled substance prescription histories for their patients. The PMP is available 24 hours a day, seven days a week via an application on the Health Commerce System.

According to the New York State Department of Health, patient reports will include all controlled substances that were dispensed in New York State and reported by the pharmacy/dispenser for the past six months. This information will allow practitioners to better evaluate their patients' treatment with controlled substances and determine whether there may be abuse or non-medical use.

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