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Electronic Prescribing of Controlled
Substances: Future Opportunities &
Real-Life Experience
Ken Whittemore, Jr. | SVP, Su...
Presentation Description
Electronic prescribing of controlled substances (EPCS) is legal in all but 2
states, and represen...
About NCPDP
Founded in 1977, NCPDP is a not-for-profit, ANSI-accredited, Standards
Development Organization with over 1,60...
About Surescripts
Surescripts is a nationwide health information network that connects, exchanges
and activates health inf...
Today’s Speaker
Ken Whittemore, Jr. R.Ph, MBA
Senior Vice President, Professional & Regulatory Affairs
Surescripts, LLC
Ke...
Today’s Speaker
Rick Camp
Director, Customer Marketing
Surescripts, LLC
Rick Camp, is Director, Customer Marketing at Sure...
Today’s Speaker
Melissa Kotrys, MPH
Chief Executive Officer
Arizona Health-e Connection
Melissa (Rutala) Kotrys is Chief E...
Faculty Disclosures
• Ken Whittemore, Jr., Rick Camp, and Melissa Kotrys report no
actual or potential conflicts of intere...
Accreditation Statement
The Institute for Wellness and Education is accredited by the
Accreditation Council for Pharmacy E...
Learning Objectives
1. Define state regulatory status, requirements and anticipated changes
2. Describe EPCS benefits to p...
Pre-Test Questions
1. What are the benefits of EPCS?
2. How many states have regulations allowing EPCS?
3. What is the nat...
E-Prescribing for Controlled Substances:
Regulatory Progress & Prognosis
Ken Whittemore, Jr. R.Ph, MBA
Senior Vice Preside...
Controlled Substances are an Important
Medication Option
• Narcotic and psychoactive medications
• Regulated according to ...
Misuse of Controlled Substances: Epidemic
and growing health threat
of the U.S. population has used an
opioid pain relieve...
3%- 9%
Of diverted drugs
for abuse are tied to
fraud and forgery
of paper
prescriptions¹
States
MANY
Require special
paper...
Electronic Prescribing of Controlled
Substances (EPCS) Can Reduce Risks
• Reduced fraud and abuse
• Secure electronic reco...
DEA’s Interim Final Rule (IFR) for EPCS1
1 Drug Enforcement Administration (DEA) issued an interim final rule (IFR) allowi...
EPCS Regulatory Status in 2010
Surescripts and NACDS Collaborated to
Align State EPCS Rules with the DEA
• Reviewed state rules related to EPCS
• NACDS’s...
Now in 2014, Only 2 States Do Not Yet
Permit EPCS in Some Form
Data through April 2014
Special State Considerations - Georgia
Georgia Drugs and Narcotics Agency (GDNA) EPCS Policy*
• Application vendors must s...
Special State Considerations - New York
Internet System for Tracking Over-Prescribing (I-STOP)*
• Designed to address pres...
In Spite of Tremendous Regulatory
Progress, Many Still Think EPCS is Illegal
I wish I could electronically
prescribe contr...
E-Prescribing for Controlled Substances:
National Landscape, Perspectives, Opportunities
Rick Camp
Director, Customer Mark...
Barriers Impeding EPCS Adoption
• Education
o Low awareness of legality and availability of EPCS
o Unclear requirements / ...
Certified EPCS Software / Limited RolloutPharmacyCompanies
ProviderEHRCompanies
0
EPCS Enabled Pharmacies: Nationwide Scale
 More than 40% of total
pharmacies are EPCS enabled
o Five States over 60%: D...
EPCS Enabled Providers: EHRs Trail Pharmacy
Provider Enablement
March 2014 data
 More than 2% of providers
are EPCS enabl...
Geographic Disparity Between Pharmacy /
Provider Enablement Hinders EPCS Adoption
March 2014 data
Pharmacy enablement
by N...
10 States Represent 50% of National Controlled
Substance Volume: Greatest Need for EPCS
Top 10
States
40 Other
States
Nati...
EPCS Utilization Potential Varies by
Medical Specialty
Controlled substances as a percent of total prescriptions
1Suescrip...
Providers Interested in EPCS
1 2010 Internal Survey of 1375 prescribers
2 2013 Black Book Survey of 80,000 e-prescribing d...
Providers Using EPCS Report Benefits
1 Journal Am Medical Info Assoc., June 2013, Early experience with electronic prescri...
“We want the prescription to be something
people don’t question. When there is concern
about misuse or improper medicines,...
Dr. Sumner on E-Prescribing of Controlled
Substances
“It’s reliable. Once I send it electronically, I never have to
visit ...
Positive Pharmacy EPCS Experience
• Stronger security reduces fraud risks of paper Rx
• Improves safety with more accuracy...
EPCS Enhances Medication Management
for Providers, Pharmacies, Patients
1 DEA, U.S. Department of Justice, Economic Impact...
EHR Vendor / Provider IT Vendor / Pharmacy
EHR Updates Software
• EPCS Certification
• Select Identify Proofing
• Verified...
Know the Facts About EPCS
Access Online Resources www.surescripts.com/epcs
Found 314 pharmacies within 50 miles of Scottsd...
Collaborate to Realize the Full Value of EPCS
Collaboration Case Study:
Driving EPCS Success in Arizona
Melissa Kotrys, MPH
Chief Executive Officer
Arizona Health-e Con...
Arizona Health-e Connection (AzHeC) exists to
Convene, Coordinate and Communicate
for health information infrastructure im...
AzHeC Programs & Initiatives
HIT HIE
REC: Helping Arizona providers meet their health IT goals
HIE Marketplace : viable HI...
Arizona eRx Initiative - An Overview
Outreach,
Education and
Resources
EPCS Program
Provider &
Pharmacy
Technical
Assistan...
Arizona EPCS Initiative
AzHeC established an advisory committee, conducted a
needs assessment and implemented four key pro...
193 More Arizona Pharmacies Became
EPCS Enabled Through the Campaign
March 2014 data
262
455
0
50
100
150
200
250
300
350
...
209 Arizona providers Were EPCS Enabled
Through the Campaign
March 2014 data
16
225
0
50
100
150
200
250
May 2013 March 20...
AZ EPCS Program Grew Provider Enablement
and Transaction Volume
20 14 11
494
2,718
3,113
3,311
3,546
4,070
3,454
3,723
49 ...
AZ EPCS Prescriber (EHR) Vendor Progress
March 2014 data
3
70
42
5
48
57
225
3 0
19
2
12
49
85
0
50
100
150
200
250
Allscr...
AZ State Pharmacy EPCS Connectivity
Pharmacy EPCS Enabled
Stores
eRX Enabled
Stores
% EPCS
Enablement
Chain Pharmacies 403...
Considerations & Next Steps for AZ
What we learned: What we can do:
Many prescribers and
pharmacists still believe EPCS
is...
Considerations & Next Steps for AZ (cont.)
What we learned: What we can do:
Additional training needed
for pharmacy staff ...
2014 Arizona eRx and EPCS Efforts
• Continue to track EPCS adoption – both by providers and pharmacies
• Develop proposal ...
Summary: Realize the Full Value of EPCS
• Efficiency
• Safety
• Accountability
• Minimize fraud and abuse
Collaborate for ...
2. What are the key benefits EPCS can provide for patient care
management?
 Reduced fraud and abuse of paper prescription...
4. In general, to e-prescribe controlled substances, a prescriber must?
 Have E-Prescribing software certified for EPCS
...
6. Once pharmacy software is certified for EPCS, is staff education needed?
 Yes
 No
Post-Test Questions
5. Obstacles pr...
Q & A
Upcoming SlideShare
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E-Prescribing Controlled Substances: Opportunities and Experiences - May 2014 NCPDP Annual Conference

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Electronic prescribing of controlled substances (EPCS) is legal all but a few remaining states and represents opportunity to lessen fraud, improve care efficiency and support patient safety. Gaps in awareness and education have hindered necessary industry adoption and collaboration Knowledge of the facts, real-life experience and techniques provides a road map for adoption and success.

For more current information, check out www.getEPCS.com

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E-Prescribing Controlled Substances: Opportunities and Experiences - May 2014 NCPDP Annual Conference

  1. 1. Electronic Prescribing of Controlled Substances: Future Opportunities & Real-Life Experience Ken Whittemore, Jr. | SVP, Surescripts Rick Camp | Marketing Director, Surescripts Melissa Kotrys | CEO, AZ Health-e Connection May 6, 2014
  2. 2. Presentation Description Electronic prescribing of controlled substances (EPCS) is legal in all but 2 states, and represents an opportunity to reduce fraud and abuse, improve care efficiency and support safety. Despite increasing adoption, gaps in awareness and education result in lost opportunities. Knowledge of the facts, real-life experience and effective approaches provide a roadmap for future adoption and success.
  3. 3. About NCPDP Founded in 1977, NCPDP is a not-for-profit, ANSI-accredited, Standards Development Organization with over 1,600 members representing virtually every sector of the pharmacy services industry. NCPDP members have created standards such as the Telecommunication Standard and Batch Standard, the SCRIPT Standard for e-Prescribing, the Manufacturers Rebate Standard and more to improve communication within the pharmacy industry. Our data products include dataQ®, a robust database of information on more than 76,000 pharmacies, and HCIdea®, a database of continually updated information on more than 2.3 million prescribers. NCPDP's RxReconn® is a legislative tracking product for real-time monitoring of pharmacy-related state and national legislative and regulatory activity. www.ncpdp.org
  4. 4. About Surescripts Surescripts is a nationwide health information network that connects, exchanges and activates health information between pharmacies, payers, pharmacy benefit managers, physicians, hospitals, health information exchanges and health technology firms. By providing information for routine, recurring and emergency care, Surescripts is committed to saving lives, improving efficiency and reducing the cost of health care for all. For more information, go to www.surescripts.com and follow us at twitter.com/surescripts.
  5. 5. Today’s Speaker Ken Whittemore, Jr. R.Ph, MBA Senior Vice President, Professional & Regulatory Affairs Surescripts, LLC Ken Whittemore, Jr. is Senior Vice President, Professional & Regulatory Affairs at Surescripts. He works with federal and state laws and regulations pertaining to health information technology and serves as the liaison to pharmacy boards and associations. Formerly, Ken worked at the National Community Pharmacists Association and also co-owned a successful independent pharmacy in Maryland. Ken is a graduate of the University of Maryland School of Pharmacy, is licensed to practice pharmacy in Maryland, and holds an MBA degree from Mount Saint Mary’s University.
  6. 6. Today’s Speaker Rick Camp Director, Customer Marketing Surescripts, LLC Rick Camp, is Director, Customer Marketing at Surescripts. He has over 20 years of experience working in healthcare after receiving his BA in Economics & Business Administration from Ursinus College. Formerly, he was a brand director at Merck Pharmaceuticals, senior director of strategy & analytics consulting group at Epsilon and senior director of marketing strategy at Healthcare Resources Online. Rick leads all e-prescribing related healthcare technology market strategies and identifies new opportunities to increase efficiency and innovation for physicians, pharmacies, PBMS and IT companies. In 2002, Rick’s work was featured in Pharmaceutical Executive and Product Management Today. In 2011, his team’s work won two eHealthcare Leadership Awards for overall website design and best healthcare content.
  7. 7. Today’s Speaker Melissa Kotrys, MPH Chief Executive Officer Arizona Health-e Connection Melissa (Rutala) Kotrys is Chief Executive Officer of Arizona Health-e Connection, the non- profit that advances the adoption and optimization of health IT and health information exchange in Arizona. AzHeC operates Arizona’s regional extension center and leads ePrescribing efforts, Arizona’s HIE marketplace, and recruitment for the statewide health information organization (HIO). Melissa serves as interim CEO for the Health Information Network of Arizona. Ms. Rutala holds a Masters in Public Health from The George Washington University with a concentration in health policy, and a Bachelor of Arts from The University of North Carolina at Chapel Hill.
  8. 8. Faculty Disclosures • Ken Whittemore, Jr., Rick Camp, and Melissa Kotrys report no actual or potential conflicts of interest associated with this presentation, OR • Ken Whittemore, Jr., Rick Camp, and Melissa Kotrys report no: » Grant/research support » Consultant Interest » Speaker’s bureau member compensation
  9. 9. Accreditation Statement The Institute for Wellness and Education is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Attendees who participate in the interactive portion and submit the completed evaluation form at the conclusion of the program will have credit for 1.0 hour(s) of continuing pharmacy education (0.10 CEU(s)) uploaded to CPE Monitor within 60 days after the program date. ACPE program numbers are 0459-0000-14-033-L04-P&T. Initial release date is 05/06/2014.
  10. 10. Learning Objectives 1. Define state regulatory status, requirements and anticipated changes 2. Describe EPCS benefits to patients, providers and technology vendors 3. Outline the national landscape trends and obstacles 4. Categorize opportunities for broad adoption for EPCS 5. Employ effective techniques to stimulate adoption 6. Explain real-life experience of EPCS and a vision for the future
  11. 11. Pre-Test Questions 1. What are the benefits of EPCS? 2. How many states have regulations allowing EPCS? 3. What is the national percentage of community pharmacies that are enabled for EPCS?
  12. 12. E-Prescribing for Controlled Substances: Regulatory Progress & Prognosis Ken Whittemore, Jr. R.Ph, MBA Senior Vice President, Professional & Regulatory Affairs Surescripts, LLC
  13. 13. Controlled Substances are an Important Medication Option • Narcotic and psychoactive medications • Regulated according to 5 schedules of abuse potential 13% of all prescriptions 1. National Association of Chain Drug Stores (NACDS) 2013 dispense data for all new prescriptions, refills, and renewals in the US.
  14. 14. Misuse of Controlled Substances: Epidemic and growing health threat of the U.S. population has used an opioid pain reliever non-medically Emergency Department visits related to substance abuse in 2009 increase in drug overdoses since 1995 4.8% 1.2M 3X • Laws are emerging to allow broad availability of opioid antidote • Pharmacies and prescribers are intervention points, also subject to investigations and loss of license Drug Overdose Death Rates
  15. 15. 3%- 9% Of diverted drugs for abuse are tied to fraud and forgery of paper prescriptions¹ States MANY Require special paper Rx pads and records² Work DUAL When both paper Rx pads and e-prescribing are used³ 1. Butler SF, Budman SH, Licari A, et al. National addictions vigilance intervention and prevention program (NAVIPPRO): a real-time, product-specific, public health surveillance system for monitoring prescription drug abuse. Pharmacoepidemiol Drug Saf 2008;17:1142–54. ALSO, Rosenblum A, Parrino M, Schnoll SH, et al. Prescription opioid abuse among enrollees into methadone maintenance treatment. Drug Alcohol Depend 2007; 90:64–71. 2. Agency for Healthcare Research and Quality (AHRQ), Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs, Publication #01-0020 3. Economic Impact Analysis of the Interim Final Electronic Prescription Rule, DEA, U.S. Department of Justice, March 2010 Paper Prescriptions for Controlled Substances Add Additional Risk and Work
  16. 16. Electronic Prescribing of Controlled Substances (EPCS) Can Reduce Risks • Reduced fraud and abuse • Secure electronic records • Improved safety and patient care DEA, U.S. Department of Justice, Economic Impact Analysis of the Interim Final Prescription Rule, March 2010
  17. 17. DEA’s Interim Final Rule (IFR) for EPCS1 1 Drug Enforcement Administration (DEA) issued an interim final rule (IFR) allowing electronic prescribing of controlled substances (EPCS) on 03/31/2010, effective 06/01/2010 Aims to ensure secure and auditable EPCS transactions to reduce the risk for drug fraud, diversion and abuse • Establishes new security requirements for prescribers, pharmacies and systems that support electronic transmission • Requires provider EHR and pharmacy management software updates are independently certified as compliant • Allows prescribers the option of signing and transmitting, and pharmacies to receive, dispense and archive, controlled substance prescriptions totally electronically • However, the DEA’s EPCS rule does not preempt any state rules
  18. 18. EPCS Regulatory Status in 2010
  19. 19. Surescripts and NACDS Collaborated to Align State EPCS Rules with the DEA • Reviewed state rules related to EPCS • NACDS’s state directors communicated with state authorities o Asked to validate resulting assessments with respect to their EPCS rules • Found both positive and negative variances • Resulted in a roadmap for action - reliable, validated compilation of state EPCS rules o Where necessary, urged local authorities to begin legislative and regulatory processes to bring their rules into alignment with those of the DEA • Industry wide collaboration facilitated steady regulatory progress
  20. 20. Now in 2014, Only 2 States Do Not Yet Permit EPCS in Some Form Data through April 2014
  21. 21. Special State Considerations - Georgia Georgia Drugs and Narcotics Agency (GDNA) EPCS Policy* • Application vendors must submit their Part 1311 EPCS audits to GDNA • GDNA doesn’t evaluate said audits, but accepts at face value • GDNA posts a list of all of the approved vendors on its website http://gdna.georgia.gov/ • Pharmacies not required to maintain any audit reports o Instead, GDNA collects and is responsible for keeping and posting a list of approved vendors • EPCS can begin when o Vendors email their audit reports to Mr. Rick Allen, Director, Georgia Drugs and Narcotics Agency at rallen@gdna.ga.gov * 09/16/13 edited
  22. 22. Special State Considerations - New York Internet System for Tracking Over-Prescribing (I-STOP)* • Designed to address prescription drug abuse and diversion, providing law enforcement and medical professionals tools to stop abuse and diversion before it occurs o Allowed EPCS in the state and makes e-prescribing mandatory for both controlled and non-controlled substances as of 03/27/15 o Created a prescription drug monitoring program (PDMP) for New York that requires real-time reporting of PDMP information o NY State Department of Health, Bureau of Narcotic Enforcement (BNE) released required packets for pharmacies and prescribers to register their certified electronic prescribing applications *I-STOP bill announced, introduced, passed and signed in 2012
  23. 23. In Spite of Tremendous Regulatory Progress, Many Still Think EPCS is Illegal I wish I could electronically prescribe controlled substances. I’m not sure if we are able to accept EPCS
  24. 24. E-Prescribing for Controlled Substances: National Landscape, Perspectives, Opportunities Rick Camp Director, Customer Marketing Surescripts, LLC
  25. 25. Barriers Impeding EPCS Adoption • Education o Low awareness of legality and availability of EPCS o Unclear requirements / credential verification & authentication o Uncertainty around on-going costs of compliance (third party audits) • Competing Priorities o IT vendor workload for 10.6, MU2, ICD-10, etc. o Pharmacy /provider responsibilities limit time for EPCS training • Lack of Critical Mass o Pharmacy vendors and EHRs waiting to see progress first o Geographic disparity of EPCS capable pharmacies and providers
  26. 26. Certified EPCS Software / Limited RolloutPharmacyCompanies ProviderEHRCompanies
  27. 27. 0 EPCS Enabled Pharmacies: Nationwide Scale  More than 40% of total pharmacies are EPCS enabled o Five States over 60%: DE, MA, NH, IL, RI o EPCS mail order enabled: Express Scripts Home Delivery March 2014 data
  28. 28. EPCS Enabled Providers: EHRs Trail Pharmacy Provider Enablement March 2014 data  More than 2% of providers are EPCS enabled o Top States: FL (23%), MI (10%), CA, WY, AZ o Top EPCS volume: MA, CA, MI, IL, AZ
  29. 29. Geographic Disparity Between Pharmacy / Provider Enablement Hinders EPCS Adoption March 2014 data Pharmacy enablement by NY county Provider enablement by NY county 30% disparity between pharmacy and provider EPCS enablement in NY  30% EPCS enabled  1352 locations  62 counties  <1% EPCS enabled  274 prescribers  13 counties
  30. 30. 10 States Represent 50% of National Controlled Substance Volume: Greatest Need for EPCS Top 10 States 40 Other States National CS Prescription Volume CALIFORNIA TEXAS FLORIDA NEW YORK PENNSYLVANIA OHIO TENNESSEE MICHIGAN NORTH CAROLINA GEORGIA 1. National Association of Chain Drug Stores (NACDS) 2013 dispense data for all new prescriptions, refills, and renewals in the US.
  31. 31. EPCS Utilization Potential Varies by Medical Specialty Controlled substances as a percent of total prescriptions 1Suescripts 2010 Internal Survey of 1375 prescribers 0% 20% 40% 60% 80% 100% Primary Care Pain Specialist Psychiatrist 1 - 20% 21 - 60% 21 - 60%
  32. 32. Providers Interested in EPCS 1 2010 Internal Survey of 1375 prescribers 2 2013 Black Book Survey of 80,000 e-prescribing doctors Interest highest in practices with 40% or more of total Rx for controlled substances 87% expect to see reductions in o Doctor shopping o Prescription fraud o Drug overdoses2 80% say they are very much or extremely interested1
  33. 33. Providers Using EPCS Report Benefits 1 Journal Am Medical Info Assoc., June 2013, Early experience with electronic prescribing of controlled substances in a community setting 2 American Institutes for Research - CHCF Pilot , November 2013 http://www.chcf.org/projects/2013/epcs-pilot and Surescripts Experience Saves time for provider and patient with less steps, less driving to office for renewal, less waiting at pharmacy2 Better prescription monitoring and pharmacy coordination1 70% Say o Easy to use from any EPCS enabled computer o Improved accuracy and less errors1 Eases security concerns with improved records / tracking2 Saves Money with less use of watermarked paper and secure printers for wet signature2
  34. 34. “We want the prescription to be something people don’t question. When there is concern about misuse or improper medicines, it’s easy to just look into the electronic records. It’s all secure, and if it’s in there, it was prescribed by me. That’s 100 percent accountability for me and the patient. We all gain confidence” Dr. Larry Sumner Family Practitioner Tahlequah Medical Associates An Experienced EPCS Doctor Shares…
  35. 35. Dr. Sumner on E-Prescribing of Controlled Substances “It’s reliable. Once I send it electronically, I never have to visit it again. In other words, the pharmacist is not going to call me and ask what it says.” “Convenience and accountability with EPCS is good, but the number one benefit of electronic prescribing is that it has helped us to reduce our medication errors to virtually zero. This safety benefit is the most important reason that lead us to begin e-prescribing in the first place.”
  36. 36. Positive Pharmacy EPCS Experience • Stronger security reduces fraud risks of paper Rx • Improves safety with more accuracy / less errors • Saves time by eliminating rekeying and manual paper processes • Lowers cost of call backs and paper record storage • Easy to use, similar to regular e-prescribing Collaborate Early for Success “We’ve had a lot of communication keeping each other informed…that has been very helpful.” - Pharmacist Surescripts Experience and American Institutes for Research Pilot , November 2013 http://www.chcf.org/projects/2013/epcs-pilot
  37. 37. EPCS Enhances Medication Management for Providers, Pharmacies, Patients 1 DEA, U.S. Department of Justice, Economic Impact Analysis of the Interim Final Prescription Rule, March 2010 and Surescripts Analysis FEWER Callbacks between pharmacy and providers with less risk of fraud1 ONE Workflow, secure and efficient for all prescriptions1 $700M Reduction in annual healthcare costs of calls and record keeping1 Up To
  38. 38. EHR Vendor / Provider IT Vendor / Pharmacy EHR Updates Software • EPCS Certification • Select Identify Proofing • Verified Audit Key Steps for EPCS Transactions Vendor Updates Software • EPCS Certification • Verified Audit Step 1 Step 2 Systems connected to Surescripts network for secure EPCS transactions Enable Pharmacy Systems • Access Controls Set • Training Enable Provider EHR Systems • ID Proofing Setup • Dual Authentication Device • Training EHR Prescriber ready to send EPCS PMS Pharmacist ready to receive EPCSStep 3
  39. 39. Know the Facts About EPCS Access Online Resources www.surescripts.com/epcs Found 314 pharmacies within 50 miles of Scottsdale, AZ 85254 Find E-Prescribing Pharmacies Enabled for EPCS Find E-Prescribing Healthcare Providers Enabled for EPCS
  40. 40. Collaborate to Realize the Full Value of EPCS
  41. 41. Collaboration Case Study: Driving EPCS Success in Arizona Melissa Kotrys, MPH Chief Executive Officer Arizona Health-e Connection
  42. 42. Arizona Health-e Connection (AzHeC) exists to Convene, Coordinate and Communicate for health information infrastructure improvements that affect every Arizonan.
  43. 43. AzHeC Programs & Initiatives HIT HIE REC: Helping Arizona providers meet their health IT goals HIE Marketplace : viable HIE solutions for providers Policy development: leading legislative efforts eRx Initiative: increasing adoption Consumer Outreach: education, awareness & engagement HINAz Provider Outreach: Recruitment & Enrollment Arizona’s Health IT Roadmap 2.0: 2-3 year plan for HIT/HIE in Arizona
  44. 44. Arizona eRx Initiative - An Overview Outreach, Education and Resources EPCS Program Provider & Pharmacy Technical Assistance Pharmacy Incentive Program
  45. 45. Arizona EPCS Initiative AzHeC established an advisory committee, conducted a needs assessment and implemented four key programs between May and December 2013 Key EPCS Program Strategies: • Provider and pharmacist focused education and outreach • Encouraged pharmacy chains to get EPCS-enabled • Worked collaboratively with EHR vendors to support EPCS • EPCS incentive program to reimburse providers for their identity proofing costs
  46. 46. 193 More Arizona Pharmacies Became EPCS Enabled Through the Campaign March 2014 data 262 455 0 50 100 150 200 250 300 350 400 450 500 May 2013 March 2014 EPCS Enabled Pharmacies 74% Growth
  47. 47. 209 Arizona providers Were EPCS Enabled Through the Campaign March 2014 data 16 225 0 50 100 150 200 250 May 2013 March 2014 EPCS Enabled Providers 1306% Growth 119 78 12 4 4 7 1
  48. 48. AZ EPCS Program Grew Provider Enablement and Transaction Volume 20 14 11 494 2,718 3,113 3,311 3,546 4,070 3,454 3,723 49 54 96 119 144 215 218 220 223 225 225 40 90 140 190 240 290 340 390 440 490 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 #ofActiveEPCSPrescribers NewRXEPCSVolume NewRx EPCS Volume # of Enabled EPCS Prescribers
  49. 49. AZ EPCS Prescriber (EHR) Vendor Progress March 2014 data 3 70 42 5 48 57 225 3 0 19 2 12 49 85 0 50 100 150 200 250 Allscripts Cerner DrFirst NewCrop NextGen RxNT Total AZ Enabled and Active EPCS Prescribers Enabled Prescribers Active Prescribers
  50. 50. AZ State Pharmacy EPCS Connectivity Pharmacy EPCS Enabled Stores eRX Enabled Stores % EPCS Enablement Chain Pharmacies 403 888 45% Independent Pharmacies 52 113 46% Total 455 1001 45% Arizona (45%) is above the national average of 40% EPCS enablement March 2014 data
  51. 51. Considerations & Next Steps for AZ What we learned: What we can do: Many prescribers and pharmacists still believe EPCS is not legal! Continue educational efforts • Keep the subject alive in newsletters, AzHeC speaking opportunities, forums, etc. EPCS remains a low priority for many provider vendors Maintain software vendor relationships to help them understand how EPCS benefits them • Encourage certification for Tier 1 endorsement Prescriber and pharmacy communities have strong interest in doing EPCS Keep EPCS in front of providers and pharmacies • Attend meetings, invite them to contact us with questions or concerns, etc.
  52. 52. Considerations & Next Steps for AZ (cont.) What we learned: What we can do: Additional training needed for pharmacy staff after pharmacy is certified for EPCS Maintain relationships with corporate pharmacy contacts. • Encourage ongoing training with staff and solicit their help in addressing store by store problems. Prescribers need a place to go for issue resolution or they may drop the use of the technology Continue to work with DTAPS to keep them involved and helping with EPCS related issues. • Use the AzHeC website, meetings , etc., to continue offering help. EPCS is part of the bigger need for prescribers to adopt ePrescribing technology In efforts to increase Arizona’s status for SafeRx, incorporate the benefits of EPCS as part of the rationale for using ePrecribing systems.
  53. 53. 2014 Arizona eRx and EPCS Efforts • Continue to track EPCS adoption – both by providers and pharmacies • Develop proposal to have Medicaid health plans support ongoing eRx and EPCS promotion and adoption • Continued online education for EPCS at www.azhec.org
  54. 54. Summary: Realize the Full Value of EPCS • Efficiency • Safety • Accountability • Minimize fraud and abuse Collaborate for Successful Adoption
  55. 55. 2. What are the key benefits EPCS can provide for patient care management?  Reduced fraud and abuse of paper prescriptions  One streamlined electronic workflow for all e-prescriptions  Improved safety and patient care  All of the above Post-Test Questions 1. What is the estimated annual cost savings potential to U.S. pharmacies based on EPCS reduction on callbacks and paper record keeping?  $50 million  $500 million  $700 million
  56. 56. 4. In general, to e-prescribe controlled substances, a prescriber must?  Have E-Prescribing software certified for EPCS  Have ID proofing set up  Use a two factor authentication method (ie. FOB, mobile app, biometric)  Have pharmacies ready for EPCS  All of the above 3. How many states have legislation for EPCS?  34 states  40 states  48 plus DC Post-Test Questions
  57. 57. 6. Once pharmacy software is certified for EPCS, is staff education needed?  Yes  No Post-Test Questions 5. Obstacles preventing prescribers use of EPCS include?  Unclear on legality  Pharmacy and EHR software readiness  Confusion around credentialing and authentication  All of the above
  58. 58. Q & A

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