Are you set up for E-Rx of Controlled Substances? (EPCS)

By Don Klingen, MD, CMIO

Situation
On October 24, 2019 ACT 96 goes into effect requiring providers to issue electronic prescriptions for Schedule II-V controlled substances (EPCS).

https://www.legis.state.pa.us/cfdocs/legis/li/uconsCheck.cfm?yr=2018&sessInd=0&act=96

Background
Electronic Prescribing of Controlled Substances (EPCS) is a prescriber’s ability to electronically send an accurate, error-free and understandable Schedule II-V controlled substance prescriptions directly to a pharmacy from the point-of-care. EPCS has the potential to minimize medication errors for patients, and reduce prescription forgery, diversion, and theft in Pennsylvania.

EPCS applies to any provider (MD, DO, APP) who write paper prescriptions for controlled substances in the Ambulatory setting or at hospital / procedural discharge today.  EPCS does not apply to controlled substances ordered for patients as part of their inpatient hospital orders.

The DEA has several requirements to set up a provider for EPCS:
– The provider must have their own DEA number (Not an institutional one)
– The provider must have their identity formally vetted by a third party
– The provider must use multifactor authentication when prescribing controlled substances.

Main Line Health supports EPCS today and automatically provisions new medical staff members and employees. However, there remains a group of providers who were not set up as part of our Epic launch that still need set up.

ASSESSMENT
If a provider prescribes controlled substances out of MLH Epic today on paper in the MLH ambulatory office, emergency department, procedural areas or the hospital they need to take steps to get set up to electronically prescribe those medications before October 24th.

RECOMMENDATION
Step 1: Get your Identity formally vetted

  • The DEA requires that we formally vet the identity of our providers who need EPCS.   We’ve been able to partner with our Medical Affairs office to make this as easy as possible

 

  • Bring a formal form of ID (Driver’s license or Passport) and yourself (must be done in person) to the following locations:
    • Bryn Mawr, Riddle, Paoli Hospitals: Medical Affairs office.
      Lankenau: Executive office (1st Floor, MOB South in Suite 100. 484-476-6423)

Step 2: Await email that you’ve been provisioned

  • Once your identity is vetted the Medical Affairs office will kick off the behind the scenes process with MLH IT and Epic. When a provider set up is completed an email will be sent to the provider letting them know the next steps.  Allow 6 business days for this process.

 

Step 3: Download and Install the DUO app per the instructions in the Email

  • After the provider has been set up with EPCS they will receive an email with needed instructions to set up the DUO app.

 

  • DUO is a mobile multifactor authentication application for your smartphone.   It is free to download from the Android / Apple application stores.

*Of Note:
– No security software is required to install these applications they can be downloaded directly from the Android / Apple Stores.
– Downloading the application without first getting vetted by the Med Affairs office will not work- there is internal set up for each individual user that must occur to configure Duo.
– Exceptions to this set up:  Residents who do not have an individual DEA.  Providers who E-Rx out of MyAvatar.  For set up of EPCS out of MyAvatar please open a help desk ticket and be sure to make clear you need EPCS for MyAvatar.

How to e-Rx controlled substances in Epic
Once set up, all controlled substances prescribing default to electronic.  (No change needed by the provider) When a provider writes for a controlled substance at discharge they will be asked for their password.  Once entered – a window will pop up to do the multifactor authentication on their mobile app.  A push notification will go to your phone and when acknowledged the script will go through electronically. This process has been in place since launch and works well.

Additional Information

PA FAQ on e-RX: https://www.health.pa.gov/topics/Documents/Programs/FINAL_EPCS_Public%20FAQ_8-23-2019.pdf

PA Med Society FAQ:
https://www.pamedsoc.org/docs/librariesprovider2/pamed-documents/qc-electronic-prescribing.pdf?sfvrsn=7d2a14e1_6

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