EMR SURVIVAL. Todd Bergland, MD Kris Kuper, MD Hikmat Maaliki, MD Patrick Morrow, MD Aubrey Remmers, MD Todd Wampler, MD

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1 EMR SURVIVAL Todd Bergland, MD Kris Kuper, MD Hikmat Maaliki, MD Patrick Morrow, MD Aubrey Remmers, MD Todd Wampler, MD

2 EVOLUTION OF OUR PROJECT: 1. There are many different EMR Vendors. Knowing how to assist everyone with their EMR issues was far too expansive of a project to tackle. 2. Web page or support, blog page to assist end-users with questions: Still too many vendors to be effective in such a short period of time. MDs are not IT specialists, we don t have enough IT experience/saaviness to be effective. 3. Resuscitation of the Health Care Information Exchange very complex and expensive task, with numerous stakeholders. Though other states had been successful, Pat Morrow, MD had already been working on it for 5 years and found it to be very onerous. 4. Todd Wampler, MD and Carter Beck, MD expressed concern that pharmacies were refusing to fill controlled substance prescriptions for certain providers. There was quite a discussion about this and that a diagnosis is often required on the prescription for it to be filled. 5. The focus narrowed from there to the subject of E-Prescribing Controlled Substances to simplify the work flow for providers and patients alike.

3 Reasons to change to E-Prescriptions for Controlled Substances: E-Prescriptions go straight to the pharmacy, to potentially decrease misuse. Increase the ability to track prescriptions, to potentially decrease misuse of paper prescriptions. Decreases the burden for patients to obtain the prescription: Avoids traveling to obtain the paper prescription. Avoids temptation to mail the prescription to the patient.

4 MAP OF THE USA WITH MONTANA BEING THE LAST TO PASS. MONTANA AND MISSOURI WERE THE FINAL TWO STATES TO CONSIDER THIS LAW AS OF 3/1/15.

5 COMMITTEES INVOLVEMENT WITH STATE LEGISLATORS : Roger Webb, Republican, Senate District 23, of Billings, MT introduced Senate Bill 8 to allow electronic prescribing of controlled substances on 11/17/14. By the time the MMA leadership class visited the capital, this Bill had passed in the Senate and the first reading had been heard in the House Human Services Committee on 1/26/15. The MMA Leadership class visited the Montana State Legislature on 2/20/15. Dr. Albert Olszewski, Republican, House District 11, Kalispell, MT was a supporter of this bill and he announced our MMA class being present in the chamber balcony during the session. He graciously stated, All physicians work hard, but these physician leaders REALLY know how to WORK! We learned who was on the House Human Services Committee (p. 53 of the Montana Legislative Guide), and that they would be coming into a sub-committee meeting. Our entire group loitered in the hallway, like predators waiting for their prey until these Representatives hurriedly arrived for their meeting. We understood the need to utilize our leadership skills to have meaningful influence in a VERY short period of time. Pat Morrow, MD, and Todd Wampler, MD spoke to Jennifer Eck, Democrat, House District 79, Helena, MT. Kris Kuper, MD, Aubrey Remmers, MD, Todd Bergland, MD, spoke to Art Wittich, Republican, House District 68, Bozeman.

6 LEGISLATION PASSED AND SIGNED ON 4/8/15:

7 RECOMMENDATIONS FOR IMPLEMENENTATION OF THIS NEW LEGISLATION IN YOUR GROUP: MMA has sent a letter to the CEO of each organization updating them so that all are aware of this exciting change. Assess and encourage your local pharmacies to achieve Surescripts certification and complete their third party audits for prescribing of controlled substances. Assess your organizations/emr vendors readiness to adopt this change. McKesson ICChart is ready for the change now. Athena is working on the work-flow, ONLY state certified is New York, we hope to be by the end of this year. Next Gen Aubrey Remmer, MD EPIC Aubrey Remmer, MD Meditech Hikmat Maaliki, MD and Todd Wampler, MD E-Clinical Works Todd Bergland, MD

8 ELECTRONIC PRESCRIBING of CONTROLLED SUBSTANCES: (EPCS) EMR SOFTWARE VENDORS The Federal Drug Enforcement Agency requires that EPCS software meet strict requirements and go through a 3 rd party audit to check that these requirements are met. Surescripts can certify vendors. Vendors appear to be ready for EPCS: McKesson, Next Gen, Athena, EPIC, E-Clinical Works. PHARMACY UPGRADES/REGULATIONS/AUTHENTIFICATION METHODS MOST ARE READY: Local Pharmacies Sam s, Shopko, Albertson s, KMART, Walgreen s. PRESCRIBER must go through an identity proofing and a 2 Factor Authentication process. Sign the prescription using something they know (a password) Sign the prescription using something they have (a token)

9 LESSONS LEARNED: THE LEGISLATIVE PROCESS IS VERY CONDENSED a 4 month session q 2 years. These legislators are just regular, hard-working people, with real jobs and real families to come home to. They do not often have the expertise/knowledge necessary to make informed decisions on the many issues they are asked to vote upon. THIS REQUIRES MORE PRO-ACTIVE PHYSICIAN INVOLVEMENT TO ASSURE ACCURATE INFORMATION AND TIMELY ADOPTION OF LEGISLATION THAT AFFECTS OUR DAILY PRACTICES. Physician leaders are strongly encourage to get involved in key issues, preferably in coordination with the MMA position, since the MMA has very strong advocates working hard with the legislators year round.

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