E-Prescribing Controlled Substances – A Promising Future?

Controlled substances are drugs or chemical substances whose manufacture, possession, or use is regulated by the government. With the advent of modern technology, the doctor is just a click away, but is a doctor’s prescription for controlled substances a possibility outside the doctor’s chamber? Read on to find out!

What is E-Prescribing?

It is estimated that approximately 3 billion paper-based prescriptions are written annually within the United States. The concept of e-prescribing started years back when patients began to buy over the counter drugs online. If patients could procure medicines from the comfort of their homes, e-prescribing was just a logical step forward.

E-prescribing enables a physician, nurse practitioner, or physician assistant to electronically transmit a new prescription or renewal authorization to a pharmacy. Electronic prescribing is the process of computer-based electronic generation, transmission, and filling of a medical prescription, which ultimately has the ideology of replacing paper or faxed prescriptions.

As per latest data provided by SureScripts, the largest e-prescribing network in the US, about 317,000 office-based physicians now e-prescribe in the United States. This represents nearly half of all US office-based physicians, according the number of physicians reported by the American Medical Association for the US.

History of E-prescribing Controlled Substances (EPCS)

When it comes to e-prescribing controlled substances (schedule II-V drugs), legal issues should be considered seriously due to the inherent nature of these drugs to incite abuse. Amidst the latest developments and trends in e-prescribing, the big question is if marketing and sales of OTC drugs and other non-control drugs online is legal and being promoted, then persons requiring controlled substances for therapeutic use should rightfully be provided with the same facility of obtaining prescriptions online. But, many hurdles hindered the implementation of such a revolutionary idea. There were legal issues to be dealt with, and steps to curb abuse of such controlled substances.

The DEA (Drug Enforcement Administration), a component of the Department of Justice, approved and legalized the electronic delivery of prescriptions for controlled substances on June 1, 2010. Pharmacies were permitted to receive, dispense, and archive these electronic records and they could be easily called up using the search feature. The Electronic Prescription for Controlled Substances (EPCS) rule provided practitioners with the option of writing and transmission of prescriptions for controlled substances electronically.

Processes and Parties Involved in E-prescribing

E-prescribing involves a prescriber, a transaction hub, a pharmacy benefit manager, a pharmacy and of course, a patient. A typical e-prescribing system functions sequentially in the following steps:

1. The prescriber, typically a physician, will sign into the system as a user and finds the patient’s details using search. Once the correct patient file is found, the prescriber updates new prescription information to the medical file.
2. Transaction hub consists of a master patient index and a list of pharmacies. Once a prescriber updates prescription information of an individual, the data is verified against the patient index at the transaction hub.
3. The transaction hub will then automatically send the relevant information to the Pharmacy Benefit Manager (PBM), who will then respond with necessary information on patient eligibility, formulary and medication history and return the same to the transaction hub.
4. The transaction hub then sends the data to the prescriber who completes and authorizes the prescription.
5. Finally, the authorized prescription is sent from the transaction hub to the pharmacy from which the patient usually gets his/her medications. A confirmation message is sent back to the transaction hub, while the pharmacy also has the ability to communicate with the prescriber.

Is E-prescribing of Controlled Substances Advantageous?

E-prescribing of Controlled Substance can be advantageous for both the doctor and the patient, while being a great resource for the pharmacies.

Some of the benefits of e-prescribing are as follows:

1. Improving patient safety and quality of care: Illegibility of handwriting is taken care of while also providing checks about various patient related variables such as allergies and correct dosing. It also increases the access to patients’ data.
2. Reduces time spent on phone calls and call-backs to pharmacies: Avoiding the pitfalls of illegibility and mistaken prescription can save time and improve efficiency.
3. Reduces time spent faxing prescriptions to pharmacies: How can one forget illegible writing being botched up by the fax machine into incomprehensible discrete blobs of text.
4. Automating the prescription renewal request and authorization process: This saves time and improves efficiency of both the prescriber and the pharmacist.
5. Increasing patient convenience and medicine compliance: Reducing obstacles to patient compliance can greatly improve patient outcome.
6. Improving formulary adherence permits lower cost drug substitutions: Providing easy substitutions based on the patient’s health cover can make for greater compliance on the part of the patient while providing cost-effective healthcare.
7. Allowing great prescriber mobility: The availability of e-prescribing systems on the go makes them highly adaptable to all people.
8. Improving drug surveillance/recall ability: The automatic analytic tools available in an E-prescribing system enable finding of various statistical and drug-related information, which would be impossible with paper-based system.

The Future of E-prescribing

E-prescribing is now becoming commonplace and might even replace paper as the most common mode of prescribing in the very near future. Paper prescriptions for controlled substances might become obsolete as more and more prescriptions are being electronically generated and maintained. E-prescriptions can be useful for both the practitioner and the patient in being convenient, nature-friendly, authentic and effective. In the near future, integrated healthcare data will be easily accessible providing for a highly integrated healthcare management. The future seems bright for E-prescribing!

A Final Note

[box type=”note”]A clear winner in this field is DrFirst, a pioneer in the field of E-Prescribing which has developed EPCS Gold 2.0, which is United States’ First Certified Solution to Prescribe Controlled Substances. EPCS Gold 2.0 has passed the stringent requirements set by DEA and passed SureScripts certification as well.[/box]