Pharmacy Leads the Way with eprescribing of Controlled Substances. March 24, 2015 Pharmacy Town Hall Series

Transcription

1 Pharmacy Leads the Way with eprescribing of Controlled Substances March 24, 2015 Pharmacy Town Hall Series

2 Presentation Description The majority of pharmacies are now capable of receiving electronic prescriptions for controlled substances (EPCS). Find out why EPCS utilization by prescribers is low and what is being done to advance progress. Explore current initiatives and practical approaches to start (or enhance) your EPCS activities.

3 About NCPDP Founded in 1977, NCPDP is a not-for-profit, ANSI-accredited, Standards Development Organization with nearly 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 eprescribing, 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.

4 About Surescripts Surescripts is committed to unleashing the potential of American healthcare by creating a more connected and collaborative healthcare system. Our nationwide health information network connects doctor s offices, hospitals, pharmacists, and health plans through an integrated and technology neutral platform. For more information, go to and follow us at twitter.com/surescripts

5 About HIMSS HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology. HIMSS leads efforts to optimize health engagements and care outcomes using information technology. Vision Better health through information technology.

6 Today s Speaker Patricia Hale, M.D., Ph.D., FACP, FHIMSS Associate Medical Director, Informatics Albany Medical Center Patricia L. Hale M.D., Ph.D., FACP, FHIMSS, Associate Medical Director for Informatics, Albany Medical Center. Dr. Hale has over 20 years of clinical experience in Internal Medicine as well as clinical application of medical informatics. She is board certified in Internal medicine and subspecialty board certified in Clinical Informatics. Dr. Hale has lead EMR implementation projects for eprescribing, data exchange, physician order entry, clinical decision support and clinical documentation. Previously, Dr. Hale was Deputy Director of the Office of Health Information Technology and Transformation at the New York State Department of Health where she helped direct a state wide strategy for health information technology implementation. Dr. Hale is a member of the HIMSS board of directors and she has been active in many national informatics initiatives. She is co-author of several textbooks and reports on electronic health records and electronic prescribing as well as editor of a book on electronic prescribing for clinicians published by HIMSS. She continues part-time clinical practice in Internal Medicine.

7 Today s Speaker Ken Whittemore, Jr., R.Ph., MBA Senior Vice President, Professional & Regulatory Affairs Surescripts, LLC Ken Whittemore, Jr., R.Ph., MBA, Senior Vice President, Professional & Regulatory Affairs, Surescripts, LLC. 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 (NCPA) 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.

8 HIMSS & NCPDP 2015 Pharmacy Informatics Town Hall Webinar Series, sponsored by Surescripts Please insert all questions in the Q&A box located on the bottom right of your screen A copy of the recording, slides and CPE forms will be available for download within 24 hours on the HIMSS Pharmacy Informatics webpage

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) uploaded to CPE Monitor within 60 days after the program date. Please provide accurate NABP number. ACPE program numbers are: H03-P & H03-T

10 Learning Objectives Describe the national status of EPCS state regulations and technology readiness to meet these requirements. Examine EPCS readiness requirements for local pharmacies and medical practices. Illustrate real-word experience with EPCS and provide practical approaches to keep patient safety and quality at the forefront.

11 Pre-test Questions 1) How is electronic prescribing of controlled substances (EPCS) beneficial? 2) Regulations supporting EPCS are approved in how many states? 3) What is a key barrier to EPCS utilization?

12 Controlled Substances are an Important Medication Option 13 % of all prescriptions Narcotics, opioids and psychoactive medications Regulated to 5 schedules of abuse potential 1. National Association of Chain Drug Stores (NACDS) 2013 dispense data for all new prescriptions, refills, and renewals in the US.

13 Misuse of Controlled Substances has Become an Epidemic 4.8% 1.2M 3X 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

14 The Health Care Threat is Growing Drug Overdose Death Rates

15 Paper Prescriptions for Controlled Substances: Additional Risk & Work 3% - 9% Of diverted drugs for abuse are tied to fraud and forgery of paper prescriptions¹ MANY States Require special paper Rx pads and records² DUAL Work When both paper Rx pads and eprescribing are used³ Pharmacies and prescribers are intervention points, also subject to investigations and loss of license 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: ALSO, Rosenblum A, Parrino M, Schnoll SH, et al. Prescription opioid abuse among enrollees into methadone maintenance treatment. Drug Alcohol Depend 2007; 90: Agency for Healthcare Research and Quality (AHRQ), Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs, Publication # Economic Impact Analysis of the Interim Final Electronic Prescription Rule, DEA, U.S. Department of Justice, March 2010

16 Electronic Prescribing of Controlled Substances (EPCS) Can Reduce Risks Lower fraud and abuse Secure electronic records Improved safety & patient care DEA, U.S. Department of Justice, Economic Impact Analysis of the Interim Final Prescription Rule, March 2010

17 EPCS Legislation is Established in All States, Except for Two Pending

18 New York State Will Mandate EPCS 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 eprescribing mandatory for both controlled and non-controlled substances as of 03/27/16 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

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

20 EHR & Pharmacy Software Systems get certified and connected by Surescripts Pharmacy Physician EHR enabling the exchange of electronic prescriptions of controlled substances PBM

21 Software Application Certification for EPCS Pharmacy software status major chains are ready most pharmacy system vendors are certified Provider EHR software status Top 10 companies have at least some of their applications certified o Representing the market majority Hundreds of applications are still not in the queue for EPCS Once certified, enablement and activation may take months

22 Nationally, Over 70% of Pharmacies are Enabled for EPCS

23 Provider/EHR Enablement for EPCS Significantly Trails Pharmacy at 3-5% setup requirements for doctors is more complex

24 Many Doctors and Some Pharmacist are Still Not Aware EPCS is Legally Available I wish I could electronically prescribe controlled substances. I m not sure if we are able to accept EPCS

25 EPCS Adoption Barriers Cost Concerns Competing Workload Priorities 3 rd Party Audits for Software Uncertain action steps Pharmacy & Provider Software Updates False Knowledge Changing regulatory requirements Fear of non-compliance / legality Limited provider / pharmacy coordination Provider Practice DEA Requirements for setup DEA Practice Identify Level proofing Requirements Identify proofing Two-factor authentication Setting access controls Two-factor authentication Access controls Education Gaps Limited Time Gaps between pharmacy and provider readiness Providers have more required setup steps than pharmacies.

26 Industry Experts Collaborated to Create Simple Education on Key Actions Providers Need to Get EPCS EHR EHR Software Update Identify Proofing Two Factor Authentication Set Access Security

27 getepcs.com Offers Education, Videos and Guidance Designed for You to Share Embed education module to sit on your own webpage Post on LinkedIn Tweet EHR status action steps

28 getepcs.com Let s You Watch Each Step and Look Up EHR Software Status

29 Go Online to See Who is Getting EPCS Today

30 Other Medical Practice/EHR Tips for Successful Rollout of EPCS Create cross functional project team o IT, App Team, Clinical, Pharmacy, Compliance Identify physician champions o o o Ensure clinical adoption Review workflows for ease of use Biometrics and Tokens Reach out to local pharmacies before EPCS goes live Establish the right team to make key decisions, especially with respect to clinical workflow requirements Prepare Clinical Users o o o Develop training materials Educate users on DEA requirements Train users on new workflows

31 EPCS Contributes Value Saves time with electronic renewals Supports safer medication decisions Reduces manual record keeping requirements Supports attainment of meaningful use Increases patient convenience and care

32 Educate, Communicate, Collaborate to Realize the Full Value of EPCS

33 Post-test Question #1 1) How much of the CDC reported drug overdose deaths were related to dispensed prescriptions? a) 5% b) 10% c) 35% d) More than 50%

34 Post-test Answer #1 1) How much of the CDC reported drug overdose deaths were related to dispensed prescriptions? a) 5% b) 10% c) 35% d) More than 50%

35 Post-test Question #2 2) How many states have legislation in support of EPCS? a) 5 b) 10 plus the District of Columbia c) 46 d) 48 plus the District of Columbia

36 Post-test Answer #2 2) How many states have legislation in support of EPCS? a) 5 b) 10 plus the District of Columbia c) 46 d) 48 plus the District of Columbia

37 Post-test Question #3 3) Nationally, what percent of prescribers have EHR systems enabled for EPCS? a) 1-2% b) 3-4% c) 5-6% d) 10%

38 Post-test Answer #3 3) Nationally, what percent of prescribers have EHR systems enabled for EPCS? a) 1-2% b) 3-4% c) 5-6% d) 10%

39 Post-test Question #4 4) What actions must be completed before a prescriber s EHR system is set-up to legally send electronic prescriptions for controlled substances? a) Electronic health records (EHR) software update and certification for EPCS b) Establish identity proofing and signing credentials with twofactor authentication c) Set-up access control to ensure system security d) All of the above

40 Post-test Answer #4 4) What actions must be completed before a prescriber s EHR system is set-up to legally send electronic prescriptions for controlled substances? a) Electronic health records (EHR) software update and certification for EPCS b) Establish identity proofing and signing credentials with twofactor authentication c) Set-up access control to ensure system security d) All of the above

41 Post-test Question #5 5) How can you determine who in your local community are enabled for EPCS and help provide guidance for getting EPCS established with medical practices? a) Call or local doctors b) Share educational support found on c) Post educational information on your website d) All of the above

42 Post-test Answer #5 5) How can you determine who in your local community are enabled for EPCS and help provide guidance for getting EPCS established with medical practices? a) Call or local doctors b) Share educational support found on c) Post educational information on your website d) All of the above

43 Q&A

44 Save the Date Future Town Halls Pharmacy s Role in Interoperability May 14, :00 pm central Pharmacy, Leadership and the Optimization of eprescribing Quality June 4, :00 pm central Register Today!

45 See you at HIMSS15 April

46 Register Today NCPDP