Home Forums Discussions General Discussion Calling all pediatricians from New York State for EPCS

Ok, it can be FP from New Mexico. It's just that I know New York has been obligated to do EPCS for around four years now? And, given pediatricians do more ADHD meds and less opioids but still do the latter, I had some questions.

We see all CII patients every three months. One scrips and two scripts they give to the pharmacy. If a patient is doing great, they just tell my CMA and all three, six or whatever are on the chart for my signature. It really catches me up. We are a little more hands on with the narcotics with the PMP and MME, etc.

Also, no matter how much we set it up where they come in every three months, for whatever reason there are patients who need to pick them up. So, there may be 12 to sign. Four patients times three. I can glance through them and sign off 12 in less than a minute. These same 12 would make me go back to my office, do the PMP (OK, fine), then do each one on EPCS. That will take considerably more time.

Just throwing out things that I know. I know many offices have a 24-hour rule as well. But, that doesn't always change the logistics. I guess I am looking at those things, but I am also looking at how individual offices, especially solo, are handling them? Are you using NewCrop. One of the pharmacists here was talking about a queue, where the staff who can handle controlled substances can load them in a queue, and you go in and click them off. Would also be great if the patient linked directly to their PMP.

Thanks for any input.

Yes I am also interested in hearing of EPCS, hopefully we have some users with that experience.

EPCS question as to how to do many at one time. Is there no one forced to do this?

Hi Bert.
Our pediatric practice does EPCS via NewCrop for our ADHD patients in Brooklyn NY. The 2 step verification is time consuming, and running PMP checks adds to the fun, but.......... We don't prescribe more than a 30 day supply at a time. If the script hasn't changed, it is not very hard to create a refill from the previous month. Not too many patients, however, and we don't have any opioid prescriptions to fill .
I don't think that there is an option to run batch PMP checks, but I haven't had the need. Feel free to ask about particulars, I always appreciate you posts
Marc

The problem is (and I don't know why), especially since with ADHD meds we do three at a time, I may do 20 over and above the ones I do in the room.

I don't mind EPCS, but what used to take literally two minutes will now take 15 minutes at best. I will have to go to my office, sit down, and start sending them. I guess I will just have to say no more picking them up. That is the norm. But, sometimes it just happens.

we don't prescribe more than a few /month
good luck
Marc

NewCrop EPCS specialist isn't a New York State pediatrician, but she is an EPCS genius. She walked me through how to queue. And, get rid of a click. And, some other stuff. And, they are working on a bunch of stuff.

We should never complain about eRx and NewCrop. Did you know that many EMRs using NewCrop use it in the "front?" In other words, they don't eRx from within their EMRs, they click on the NewCrop window and do all their prescribing from there. For AC, NewCrop is in the back. You don't know it is there.

Of course, that is different with EPCS. They are working on saving the username again. And, keyboard, approval of sending script. They are actually quite good and get way too much [censored] on the board.

Not a pediatrician, primary care. We have been using amazing charts (newcrop, really) for controlled substances for 10 months. Time consuming, infrequent failures. You have to pay Verizon Identity Services 120 dollars a year. What a rip off!

Hi rajendran,

Not sure what state you are from. It sounds like you have been "forced" to use it for 10 months. We have had similar issues although the failures have been very infrequent.

The problem is time consuming. In some ways it is improving our cash flow, because we now do not print a tamper-proof script for someone to pick up or give more than one.

It is interesting, because Maine was scheduled to "go live" on the regulated used of EPCS July 1, 2017. So, now all patients on benzos and opioids MUST have a one month appointment. But, the July 1st date has correlated with the state of Maine's huge law changes in the prescribing of opioids, which are extremely complicated.

Sorry, this post is sort of all over the place. But, if we are going to write a script for oxycodone for someone with IBD or Dermatomyositis and HAVE to include the ICD-10 code (not the diagnosis) but looking up the code, the MME -- Morphine Milligram Equivalent -- the lookup on the PMP and including the possible reason for being over, plus documenting a note, this will need to be compensated.

But, the tough ones, again, are the ADHD meds. We are just not going to make parents whose children use Vyvanse come in monthly. And, as stated above, there are just reasons that patients need to pick them up at the office before an appointment.

Therefore, the need for the MAs to be able to "queue" the meds. Which I am getting closer to learning how to do. I suppose the learning curve will come not just from reading about the law but from pharmacies turning down scripts, etc.

I think, if this setup is going to work like I think, this will be the first time where I will be forced to tell pharmacies that since you will not work with the way we prescribe the medication, the patient will be forced to go elsewhere. It sounds as though pharmacies like WalMart will not wish to work with the three-script prescriptions. And, we are not going to have patients call wanting a refill script. So, we will have to tell them to either come in monthly for their current prescriber or come in quarterly for Walgreen's.

I am interested in hearing more of the experience of EPCS with AC and NewCrop; Connecticut is talking about the same regulations of only eprescribing controlled substances.
Of course being the contrarian show me the data that this is an effective strategy/law.
There are many more heroin deaths in my area than there are prescribed narcotic OD's.
To me it seems like politicians just 'having to do something'.

Hello Bert,
We are in New York indeed. You are right about 'forced', we would not have chosen this willingly. But we have had no trouble with pharmacies, Wal-mart is not the chosen pharmacy for most of our patients.

At the end of the day, if this scheme makes even a small dent in the huge narcotic abuse problem, it would have been worth the time sacrifice.

Thanks.

It is important to differentiate the two situations. For months, HAVING to EPCS has been on the horizen. That was what this thread was for. Thank you for your feedback. I am little by little learning from NewCrop how the nurses can prescribe on NewCrop. Just as they printed the tamperproof script, and I signed, they can now enter the scripts, and I can OK them. But, still much MORE time for the MAs. And, difficult if with say, nine scripts. When I say nine, I mean three of Concerta 36 mg, three of methylphenidate 10 mg at noon and three of methylphenidate 5 mg at 3 pm. We do three months at a time.

This will mean much more work in NewCrop and not in AC or with paper scripts.

The other situation, which may involve NY or Koby or no one are the new state laws to combat heroin overdoing. This has nothing to do with EPCS and everything to do with PMP and MME. All scripts under 100 Morphine Milligram Equivalents and all scripts being cross checked with PMP. All scripts having an ICD-10 code if over 100 (not a diagnosis like ADHD, but F90.0). These do carry over to NewCrop, unfortunately all 15 carry over.

So, in Maine, when you combine all of the new laws with the EPCS mandate, it is difficult.