Londin Mair

Thank you for joining. I’m London Mair and welcome to today’s episode of Think Therapy, exploring e-prescribed regulations and patient safety. Joining me here today is Brian Farley, who has 13 years of experience in product and implementation. Many of you tuning in today may be familiar with Newcrop, which is a therapy brand’s product that streamlines the electronic prescription or e-prescribe process.

Brian is a NewCrop subject matter expert and due to the nature of his role, is very knowledgeable on recent and upcoming regulations and health IT, as well as how those regulations impact patient safety. So we’re excited to have him here with us today. So welcome Brian.

Brian Farley

Thank you, London. It’s a pleasure to be here and discuss this.

Londin Mair

Yeah, for those listening in, you’re most likely aware that the nationwide implementation of e-prescribing technology is growing exponentially and with it the need for e-prescribing laws. Change can be scary, but today we’re going to dive into why these mandates are so important and what happens when we don’t follow them. One in particular that we’ll be focusing on today is the support act that went into effect earlier this year, making the use of EPCS a requirement under the Medicare Part D plan. And for those of you who are unfamiliar, EPCS stands for the electronic prescribing of controlled substances. And it’s a term that you’ll hear often as we discuss mandatory E-prescribe regulations.

So now before we dive into the specifics of the support act, as well as regulatory mandates at the state level, Brian, I’d love to start with why we’re seeing these mandates in the first place.

Brian Farley

So these mandates have expanded over the past several years, largely driven by the opioid epidemic. This epidemic has become significantly problematic over the past 20 years. More than 450,000 people have died from opioid drug overdose. The numbers vary from year to year, but overall this problem continues to exist throughout the entire country. Battling the opioid crisis has been a double-sided coin. On one side, those requiring pain management have to be able to receive the treatment and resources they need to heal, but on the other, these addictive substances have to be brought under tight control to fight the epidemic. That’s why we’re seeing these laws at both the state and federal levels. To protect patients from the accessibility of these drugs and to ensure medication adherence for patient safety.

Londin Mair

Wow, certainly. And are you able to tell us more about how the use of E-prescribe is able to actually keep patients safer?

Brian Farley

Certainly. With electronic prescribing, prescriptions are sent directly from a clinical practitioner to the pharmacy via a secure electronic system. This is going to eliminate the risk of forgery and alterations, but it also helps reduce medication errors that you often see with illegible handwriting. Experts have said that up to 25% of medication errors can be related to illegible handwriting.

ERX software naturally includes other features that are designed to aid clinicians. So during the prescribing process, you’ll receive up-to-date drug information that will alert the clinician of contraindications and potential side effects, as well as tying this in with the prescription drug history for the patient, which we pull in from both the retail pharmacies and from the patient’s health plan. This can prevent overuse, this can prevent misuse, and this can allow the prescriber to understand the various interconnections with other drugs and other prescribers that they might otherwise not be aware of. And that’s just a few. But there’s also the feature that’s most talked about in accordance with the government regulations, and that’s EPCS – the electronic prescribing of controlled substances. EPCS makes the overall prescribing of these drugs safer in legitimate scenarios like pain management or to treat behavioral disorders. And with the medication of treatment, excuse me, the medication assisted treatment of substance abuse disorders.

Due to its ability to communicate with other systems for prescription tracking and patient medication history, EPCS reduces the risk of overdose and helps keep addiction from occurring.

Londin Mair

Well, so it seems like these regulations truly are in place to protect patient safety, which is, I mean, apparently needed when you start talking about these statistics associated with both drug misuse and medication errors. So what is it that these government mandates are actually requiring?

Brian Farley

Well, the Support Act is one of the newer and more significant ones that’s impacting this. This is a federal mandate that requires that at least 70% of all schedule two through five controlled substance prescriptions under Medicare Part B must be submitted electronically. This metric has changed over the years. I think it used to be.

When they first initiated this was 30%, then it went to 50%, now it’s 70%. So the expectation is that if you are a clinical prescriber intending to prescribe a scheduled drug, you need to use EPCS.

Federal regulations to all clinicians are expected to comply, regardless of the state that you practice in. There are a couple of exceptions, such as if the prescriber and the dispensing pharmacy are the same entity. So if you’re doing in-house prescribing, you have your own pharmacy in-house or you have a cabinet of medications that you’re utilizing. Or if the prescriber issues 100 or fewer.

controlled substance prescriptions for Part D drugs each year. And then finally, or if the controlled substances are administered directly to patients dispensed in the healthcare system of the Department of Corrections, or if they’re dispensed to patients under the age of 16. So direct dispensation is also an exempting qualification. But for most prescribers, a real impact of this is that they will be required to at least use 70% of their scheduled medications going through EPCS.

But as a rule of thumb, I always say it’s better to be safe than sorry. Even if you are exempt from this federal mandate, that doesn’t necessarily exempt you from state mandates. And those mandates vary from state to state. So I encourage you to read our blog, E-Prescribing Laws by State, to see how your practice might be affected.

Londin Mair

Thank you, Brian, for sharing that. And again, for those listening in, you can find that blog on therapybrands.com and type into the search bar the blog title, which was E-prescribing laws by state. So Brian, you mentioned it’s better to be safe than sorry, which I tend to agree with myself. But can you touch more on what happens when clinicians don’t comply with these regulations?

Brian Farley (10:19.086)

Sure. Failure to comply with EPCS at the state or federal level can result in penalties for your practice. While the Center for Medicaid Services has not explained how compliance will be enforced, nor what the penalties will be for noncompliance, many states with e-prescribing laws do have such enforcements in place. In addition to the legal ramifications, once again there’s the concern to patient safety when clinicians opt for using handwritten prescriptions over e-prescribe.

Londin Mair

Yeah, definitely. Well, Brian, you’ve shared some very helpful information here today, and I think we all have a better understanding of the benefit EPSC provides to patient safety, the regulations in place, why those regulations are in place, and how we can best comply. Brian, is there anything else you’d like to add as we come to a close?

Brian Farley

Sure, I would just like to add that ePrescribe and EPCS is thought to be the long-awaited solution to combat fraud and abuse of controlled substances. But I’d like to take it a step further and say it’s a long-awaited solution for just general patient safety and medication adherence. Each year, adverse drug events and harm from medication lead to 1.3 million emergency department visits.

350,000 hospitalizations and result in $3.5 billion in excess medical costs. Those numbers are far too large. And if keeping patients out of the hospital wasn’t enough, enhanced communication between clinicians and pharmacists means better provider workflows and smaller pharmacy wait times. E-Prescribed really is a win-win solution.

Londin Mair

It definitely sounds like it. And thank you, Brian, for being here today. It’s definitely been an insightful discussion. For our listeners that are interested in moving forward with ePrescribe software, we encourage you to look into Newcrop’s compliance solution. Newcrop is trusted by over 40,000 prescribing physicians and 200 EHR partners to maintain regulatory compliance and improve patient safety.

Our software meets the highest health IT standards, is ONC Health IT certified, high trust certified, and has been awarded by SureScripts for prescription accuracy. To learn more about NewCrop, you can schedule a free personalized demo today by visiting therapybrands.com and searching NewCrop. Thank you again for listening in.