Home Forums Discussions General Discussion Escribing Controlled Substances

Anyone have an update on this? From what I can see not really feasible to do with AC currently. Can a different program be used? Something directly with Surescripts?

David Lee, MD
IM
Dallas, TX

I think it is up to each state. I doubt a 3rd party program could be used. Plus, it would bypass AC's records. I understand though.

I've been e-prescribing for the past 3 weeks. It's working well--a little cumbersome but manageable.

Did I read you have to inactivate all meds then prescribe the controlled substance then reactive them???

David Lee, MD
IM
Dallas, TX

Where did you read that? That would certainly make it not doable.

The other thing is I don't believe your MA could refill Norco or ADHD meds. So, they would have to message me to do this. I wonder if, in the end, it just won't be easier to stay with the tamper-proof scripts?

I was just going off the previous thread below. I've never done it, so not exactly sure what they were talking about to be honest... Maybe someone successfully doing it could explain the process/steps involved with the current system.

David Lee, MD
IM
Dallas, TX

Okay folks... I heard from AC tech support and here is their response and mine:

From: Eric Fusco
Sent: Thursday, May 21, 2015 11:25 AM
To: eadavison@verizon.net
Cc: Jerreth Cerina
Subject: EPCS

Good Morning,

I have read over what you have sent us. The dispense numbers all need to have a value and the sig needs to be there. So if you are entering from the current medications screen it will give you the option for a sig but you will need to go to the write scripts screen and find the medication and then add a value and click prescribe. Please do not click transmit. This process will change the dispense number to allow you to access that screen. I have included one of my tier 2 techs in on this email and we went through the process and this is the only way to access that screen. If you have any other questions please feel free to email us.

Dear Mr. Fusco,

That solution is not acceptable. I have elderly patients who come in with 15 to 20 medications from another prescriber which have to be entered into the chart. Neither my staff nor I have the time to go through the whole list and pretend to prescribe them, just so the dispense field has a value in it. That value should be entered when the medication is recorded in the med entry section of the chart. This MUST be addressed with the development team and fixed with a formal update, because the workaround that you are describing is ludicrous.

Ed Davison

From: Jerreth Cerina
Sent: Thursday, May 21, 2015 1:48 PM
To: Eric Fusco ; eadavison@verizon.net
Subject: RE: EPCS

We have already entered this issue as a critical Bug. In a future release this will get fixed unfortunately for now in order to get to the Newcrop screens you will need a Dispense #.

Thank you

Dear Mr. Cerina,

Thank you. As long as this is being formally addressed, we will try to deal with it as best we can.

Dr. Davison





_________________________
Ed Davison, MD
Ophthalmology
Saratoga Springs, NY

Do you mind describing the process of escribing controlled substances in AC?
David Lee, MD
IM
Dallas, TX

David,

Here's how I do it:

1. Open the e-rx page.
2. Here I will prepare and prescribe the script for the controlled drug if it not new. (I do this here, because the New Crop Screens are difficult to navigate.
3. At this time, I also check to see that every active medication in the patient's list has a quantity of greater than 0. If not, I put in a 1 or 30, prepare the script, and prescribe.
*Note: I do not print or transmit.
4. The e-rx screen goes away and I open up the e-rx screen again.
5. Next, at the top left corner of the screen select "e-Prescribing" and then "Manage through New Crop Screens."
6. On the new crop screen, check the box of the controlled drug you wish to e-prescribe then hit "select."
7. Then hit "transmit" - assure that that correct pharmacy has been selected. If the pharmacy is able to receive an EPCS medication, the pharmacy will be in green and there will be an e-rx with a large "C" around it for controlled.
8. Next you will be asked for a one time passcode which is your user name and password created when you enrolled for the EPCS.
9. After the password has been entered, you will then be given a 6 digit code to enter. You can either be called on your approved personal cell phone device, or texted, or receive an ID token.
10. I just simply open up the Verizon Universal ID app which has a passcode that changes every 60 or 90 seconds. I then swipe upward sending the code displayed to the cloud.
11. On the NewCrop screen the code is automatically accepted and the rx goes through.

Sounds like a lot, but this has been working really well for me. It also works on the weekends or after hours very well using LogMeIn. I am able to log in remotely and then toggle to the Verizon Universal ID app and send in the token.

But, we are still in the situation where each state has to allow it?

Yes, that is my understanding. I'm in Texas and it's definitely allowed, but QUITE DIFFICULT USING AC/NEWCROP! I still can't figure out how to send a 3 month supply of Adderall, since you can't have refills, and I don't see a place to put "earliest fill date" in Newcrop. I don't want to send a 90 day supply, rather three 30 day supplies. Anyone else had this issue?

Thanks for the info GatorDoc!

David Lee, MD
IM
Dalls, TX

David,

One work around on the Adderall is to send in a 90 day supply to their mail order pharmacy (if the patient has that option) which will accept a 90 day supply on a schedule 2 drug.

Otherwise, I am afraid you'll have to set reminders.

Bert,

The NewCrop system is pretty good about alerting the prescriber if a controlled drug can be sent to a particular pharmacy, no matter the state. Because it is a federal program, I believe any provider that is able to send via EPCS can send to any pharmacy that is able to receive.

For example, from Florida I have not historically been able to call or fax in a controlled drug for my patients who are traveling there. This morning I sent in Ambien via EPCS to a Rite Aid in Troy.

Why can't you write the "Do not fill before September 1, 2015" in the comment section when you first write the script? Would it not populate in the script when it shows up in the NewCrop screen?

___________

This whole thing reminds me of when we were in elementary school and someone would write something bad on the black board, and the entire class would be punished if the person who did it, didn't own up. Because of those who abuse the controlled substances or divert them, we are forced to go through these crazy steps. It would seem like a username and password followed by a quick PIN or even no PIN should suffice.

The medication should be able to be sent via ePrescribe. The code is just one extra step. I say that if one of my patients or even someone who is not is able to somehow access one of my computers at work or download AC and get an activation code, then somehow know my username and password, then more power to him.

Bert,

You can write that in the comment section on the New Crop screen. The question will be whether the pharmacist will hold that e-prescription in queue until said future date. My brother is a pharmacist and I will ask him if his company permits him to hold the e-scripts.

My experience has been that if the pharmacy does not have a particular medication in stock, say Adderall 10mg, then they cancel the e-script, and I have to e-prescribe it to another pharmacy (or have the patient come back and pick up a paper script).

For the ADHD meds, I have not been e-prescribing but printing out the scripts as normal because of pharmacy supply issues.

I got set up for controlled erx at ACUC 2016 this past weekend. It takes about an hour to get set up. The newcrop windows are not intuitive, but eventually can be conquered.

Note that newcrop charges $120/year on top of included e-prescribing from amazing charts. (payable direct to newcrop via paypal)
I don't like paying yet another fee, but it is so worth it from the patient's perspective. This is especially true for my assisted living facility (ACLF) patients. It is difficult to sync up the pharmacy, the ACLF, and my visits.

I'll still print out my schedule prescriptions for the most part (much faster), but the ER controlled will be helpful in certain situations.

Hey Ken,

Where did you go to sign up for EPCS?

Thanks,

Pete

P sundwall,
I see you already got your question answered re where to sign up, but for others,
on the new crop screens, goto the admin tab then one will see
"Electronic Prescribing of Controlled Substances (EPCS)
Set-Up
"

Time saving Tip for entering the 6 digit one time passcode from your phone (VerizonUnivID App) for controlled substance eprescribing.

On the phone swipe up from the 6 digit code to the cloud icon and the code will automatically be entered on the newcrop screen (you don't have to type the number)

This was in the newcrop monthly newsletter. I never would have figured that timesaver out. I just tested it. Works.

You can also just double tap on the number.

Hi,

Does the password for electronic Rx for controlled substances expire?

I had to reset because I was locked out. Lost an hour of work. AC tech told me its valid for a year. I registered 3 months ago. I received no email warning.