eRx of controlled substances now legal in 50 states

'Throwing out the prescription pad' is key to preventing fraud and abuse
By Mike Miliard
10:57 AM

With e-prescribing of controlled substances now legal nationwide, providers and pharmacies are empowered with a new technological tool in the fight against prescription painkillers.

Deaths from prescription painkillers have quadrupled since 1999. Nearly 2 million Americans abused or were dependent on opioids as of 2013, and that year. more than 16,000 died from them.

"E-prescribing is viewed as a way to reduce the abuse of controlled substances, which continues to be an important public health issue," according to The National Law Review. "Regulations authorizing e-prescribing in all 50 states may also encourage the development of new and more accessible e-prescribing technologies for providers and pharmacies."

Still, there's some progress yet to be made on this front. NLR points to statistics that show that while approximately one-third of pharmacies were equipped to handle eRx of controlled substances as of the end of 2013, just 1 percent of prescribers were able to do so.

In a news release Friday, Surescripts pointed to its efforts to educate physicians about EPCS. Its new website,, offers guidance on assessing the certification status of electronic health records software, obtaining identity proofing and signing credentials, and setting access controls.

"Care providers, pharmacies and government officials are working together to combat the prescription drug abuse epidemic that plagues our nation," said Surescripts CEO Tom Skelton in a press statement. "Throwing out the prescription pad and opting for an electronic process makes it easier for patients to get the medications they need while helping to prevent fraud and abuse."

In just the half of 2015, Surescripts processed 4 million electronic prescriptions for controlled substances, officials say – more than double the 1.6 million processed in all of 2014.

There have been lots of advances on this front in the past several years. In 2013, Healthcare IT News spoke with officials from Cerner and Imprivata about the complex processes required to make EPCS happen.

The capability is "something that a lot of our clients are interested in," says Matt Moore, senior strategist at Cerner, at the time. "Depending on who you ask, 20 percent of all prescriptions are for controlled substances."

But DEA's rules for prescribing them electronically are exacting, and its certification process is rigorous.

"Very few people are doing it today, because very few of the EHR systems are certified," said John Clark, then senior product manager at Imprivata, which was helping Cerner deal with the "50 pages of detailed technical requirements" to get its systems DEA certified.

As the technologies have evolved, more and more health systems are making the capability available to their physicians. Earlier this month, for instance, Cambridge Health Alliance announced it was deploying Confirm ID, a technology from Imprivata that integrates directly with its Epic electronic health record, to enable secure EPCS.

"As part of a robust strategy to curb prescription drug abuse, we need to give providers the best tools available to help them make sound decisions when prescribing controlled substances," said Arthur F. Ream III, CHA's director of IT applications and chief information security officer, in a press statement.

"We view EPCS as essential because it greatly reduces the risk of fraud and drug diversion while also ensuring that patients with chronic pain can more easily get the medications they need," he added. "As an early adopter of a comprehensive electronic medical record system, we are uniquely positioned to implement these solutions, the combination of which will drive swift adoption of EPCS across our health system and puts us in a better position to tackle this epidemic."