Home Forums Discussions General Discussion e-prescribing

I am relatively new at e-prescribing and am wondering if anyone can shed some light on if and when one will be able to e-prescribe scheduled drugs?
It gets really frustrating on a typical day having to prescribe other than e-prescribe, not to mention more time consuming. The most nonsensical scenario is someone with bronchitis and the zpack goes fine and then you have to Updox the cough syrup with codeine--not that big of a deal but just several more steps of inefficiency.
Also just wondering--we have an air base pharmacy that refuses to eprescribe or receive faxes for meds, only handwritten or printed out scripts. Any similar experiences???
Its quite frustrating that I have already received my penalty for not eprescribing by June 30 of last year, and there are governmental agencies and programs keeping me from eprescribing because of their own policies, and impairing my ability to achieve the meaningless use percentage for stage l for eprescribing. sorry about the rant--jimmie

The DEA regs for eRx of controlled meds were released in 2010. The more absurd of 62 pages of regulations include initial face-to face meeting between the practitioner and a representative of an ?authorized entity,? and use of a ?hard token? such as a smart card together with a password or biometric such as a fingerprint which can only be used by him/her, no staff. The EMR must require authentication (password & token) before each eRx and will sign off if the doctor does not use the system for more than two minutes. The system must generate a log of all electronic prescriptions for controlled substances prescribed and he/she must certify the log monthly, and retain the record for five years. The token/biometric system must be audited prior to first use, and annually thereafter. The prescriber must have a separate DEA number for controlled drugs.

DEA estimated annual cost of complying to be $62 to $266 per practitioner. EMR company costs were estimated $36,700 per EMR for initial programming and $25,000 to $100,000 for annual third party audits.

Understandably, no EMR now in place meets DEA requirements. Comments from medical organizations were uniformly critical. As far as I have heard, there has been no action to implement the program.

But anyone can fax or call in a prescription to a pharmacy for the same drugs with essentially no verification.

Our tax dollars at work.

We are "spoiled" in California that we can e-prescribe any schedule 3 narcotic, but need a securitized written prescription for schedule 2 drugs.

So part of the problem can be solved within your state, in regard to codeine and hydrocodone. That would probably cut your difficulties by 90%.

We have a local Navy base, which only takes written prescriptions, but e-prescribing, at least outside of AC (I have been using a third party vendor), can print written prescriptions that they will take. Just switch the pharmacy to Print Prescription. A lot of people want this for their 3 month mail in prescriptions to save money.

The several times a week I have to handwrite a prescription for a schedule 2 drug, like Percocet, I write the patients ID on the top and scan it to my nurses computer from inside the exam room. Fujitsu makes a small scanner, model 1100, that is perfect for this. My nurse transfers the image into the right folder for the patient to save me time.

I can scan quick notes I write on my Rx pad or on my note pads, or any papers the patient brings in, and give them back to the patient, cause I don't want no stinking papers anymore.

I don't know how the NewCrop e-Rx inside AC handles the need for printed Rxs, but I assume it does that. Hopefully, a user can comment.

Dan

This is again where the govt throws the baby out with the bathwater. I had to fire a nurse for calling Vicodin, but the DEA, local police and DA couldn't care less. Thee is no reason why we shouldn't be able to ePrescribe morphine, fentanyl or whatever. They could certainly track it better.

Just give each prescriber a stupid password or token or both and let it be. A simple password would be enough. Change it every three months. It's stupid to print Vicodin, then fax it like that is more secure. And, of course, each state is different.

As it is now, I just received a call from a pharmacist that a patient took their tamper-proof scripts to two pharmacies. VERY SECURE. With ePrescribe, the secure angle is endless.

Here we HAVE to set up a narcotic contract after one month of scheduled drugs. How simple it would be to have it like Accutane, albeit simpler, where the patient would be entered into the database, receive a card, then have to go to the same pharmacy and agree to pill counts and urine counts. All through the same system. Call it ePrescribe Schedule II.

Jimmie I find this a little annoying too.
I ERx the z-pak, then print the Robitussin AC.
I briefly explain to the patient "The federal law requires me to ERx whenever possible. Since they don't allow controlled substances to be ERX, I'm printing one for you to personally take to the pharmacy."

They always understand and don't give me grief. It is dumb however, I completely agree with everyone on this thread. We can call in or fax most of the controlled drugs (on plain white paper in Maine CIII-C-V), and we can snail-mail C-II's. Heck a friend or relative of the patient can even pick up the C-II at some pharmacies. The ERx requirement of C-II's with tokens, 2-min timeouts, and biometric devices is stupid.

It is stupid, but that's government. DEA is for prescribing controlled substances.

Just as an FYI, unless I am prescribing four or five meds that can be ePrescribed, I tend to print all the scripts to paper, either regular paper and fax or tamper-proof. It does save a step, albeit a small one, plus it is inviting problems when the pharmacy receives scripts in two different ways, e.g. fax and ePrescribe. I have the added burden (again, not much) of making sure the patient picks up both scripts.