State Legislative Conference 2016

1. AAFP State Legislative Conference:
Electronic Prescribing for Controlled
Substances (EPCS) Update
Ken Whittemore, Jr., R.Ph., MBA
VP, Professional & Regulatory Affairs
October 28, 2016

2. 2 Copyright © 2016 by Surescripts, LLC. All rights reserved.
Unrivaled in
scale
• 1.41 Billion electronic prescription
transactions annually
• Access to over 240 Million covered
lives
• Over 700,000 health transactions
and 160,000 e-prescriptions
routed every hour
Protected and
secure
• Electronic Healthcare Network
Accreditation Commission (EHNAC)
Accreditation and Federal
Information Processing Standards
(FIPS) encryption provides
pharmacies with data security and
protection
• 99.96% network reliability
Connected to
care delivery
• PHYSICIANS: 7 out of 10 office-
based physicians use our network
every day
• EHRs: Integrated with over 700
certified EHR applications
• PATIENTS: 3 Million patients get
their prescriptions routed over our
network each day
Over the past 15 years, we have built a health
information network that is…

3. We provide secure, reliable communication exchange
across a vast national network of partners
3 Copyright © 2016 by Surescripts, LLC. All rights reserved.
Prescriber
Communications
Pharmacy
Communications

4. EPCS Regulatory Highlights
Background
 After 12 years of deliberation, the DEA issued an interim final rule (IFR) allowing EPCS on
03/31/2010, effective 06/01/2010
 Allowed prescribers the option of signing and transmitting prescriptions electronically
 Permitted pharmacies to receive, dispense and archive controlled substance prescriptions
totally electronically
Governing rules
 The DEA’s EPCS IFR did not preempt state rules, so the most restrictive rules govern
 Early EPCS rule challenges:
 Most of the original 19 states that permitted EPCS in 2010 allowed all schedules II—V, but some only
allowed schedules III—V
 Some drugs were scheduled in the states but not by the DEA (e.g., carisoprodol, tramadol,
pseudoephedrine)
 Prior to all states aligning their rules with the DEA’S EPCS IFR, in order for EPCSs to cross state
lines, they had to be permitted in both locales
4 Copyright © 2016 by Surescripts, LLC. All rights reserved.

5. 2008: DEAfirst proposes rule to allow e-prescribing of
controlled substances (EPCS)
EPCSnotpermittedanywhere.
5 Copyright © 2016 by Surescripts, LLC. All rights reserved.

6. 2010: DEAregulation allows e-prescribing of
controlled substances
Staterulesalsohadtopermitthetechnologybeforeitsuse.
Bytheendof2010,EPCSwaslegalin19states.
6 Copyright © 2016 by Surescripts, LLC. All rights reserved.

7. 2015: EPCS permitted in all 50 states and DC
InAugust,Vermontbecamethe50th statetoadoptrulestoallow
EPCSforallschedulesofcontrolledsubstances.
7 Copyright © 2016 by Surescripts, LLC. All rights reserved.

8. Surescripts Network Enables Pharmacy and Prescriber
SoftwareApplications for EPCS
 Provides standards for EPCS implementation
 Certifies software applications for secure EPCS transactions
 Connects pharmacy and prescriber software through a trusted
national health information network
Prior to certification, pharmacy system and physician EHR
software companies must take additional security and technology
steps to comply with the Drug Enforcement Administration's
Interim Final Rule (IFR) and state board of pharmacy regulations.

9. Local Provider Actions
 ID Proofing Setup
 Two-Factor Authentication Setup
 Set Access Controls
 Training
Local Pharmacy Actions
 Set Access Controls
 Training
Vendor Updates Software
 EPCS Certification
 Verified Audit
 Rollout update to local pharmacy
Pharmacy IT Vendor
Vendor Updates Software
 EPCS Certification
 Select Identify Proofing
 Verified Audit
 Rollout update to local practice
Ready to receive EPCS
Ready to send EPCS
EHR
Provider EHR Vendor
KeyActions for EPCS systems connect to Surescripts
network to enable EPCS
PMS

10. Utilization of EPCS is growing rapidly as more
prescribers and technology vendors get certified
10 Copyright © 2016 by Surescripts, LLC. All rights reserved.
 64 pharmacies and pharmacy vendors are certified
 100+ prescriber vendors are certified
12.8 Million EPCS transactions were sent across the Surescripts network in
2015. Over 30.8 Million have already been sent through September 2016.
37,000 330,000
1,600,000
12,800,000
30,800,000
2012 2013 2014 2015 2016 YTD
AnnualEPCS
Transactions

11. Status of EPCSAdoption – September 20161
11 Copyright © 2016 by Surescripts, LLC. All rights reserved.
 Nationally 63% of all prescribers sent an e-prescription in the last 30 days
 Nationally 13% of all prescribers are enabled2 to send EPCS
 71% EPCS adoption in New York
Prescriber Adoption
Pharmacy Adoption
 Nationally 96% of all pharmacies received an e-prescription in the last 30 days
 Nationally 88% of all pharmacies received an EPCS in the last 30 days
 97% EPCS adoption in New York
1. Please note that adoption stats for all states are available on the More Details page of getEPCS.com.
2. “Enabled” means a prescriber has software that is capable of sending EPCS, but practice level setup may not be complete.

12. New York I-STOPhas been an unprecedented driver
of provider adoption
I-STOP has been a tremendous success that can potentially spill
over to the rest of the nation.
 I-STOP drove the EPCS certification of over 100 EHRs and counting
 New York ranks first in the nation for1:
 Active e-prescribers with 88% (national average is 63%)
 EPCS enabled prescribers with 71% (North Dakota is 2nd with 27%)
 E-Prescribing volume representing 10% of US total
 EPCS volume representing 41% of US total
12 Copyright © 2016 by Surescripts, LLC. All rights reserved.
1. Surescripts network data, September 2016

13. Thank You
Ken.Whittemore@surescripts.com
(703) 921-2114
Copyright © 2016 by Surescripts, LLC. All rights reserved.