Many nursing homes may soon find themselves scrambling to coordinate information technology with pharmacy services to ensure they have a working e-prescribing system for controlled substances.
Congress passed the SUPPORT Act in 2018 to address problems caused by the opioid crisis. The act requires electronic prescribing for schedule II-V controlled substances covered under a Medicare Part D or Medicare Advantage prescription drug plan.
Industrywide adoption of e-prescribing has suffered from fits and starts over the years because of consensus issues around technology standards, costs and e-prescribing systems themselves.
Implementation plans stalled because of the public health emergency, and regulators postponed enforcement of the mandate for long-term care facilities until Jan. 1, 2023.
Prescribers have been encouraged to implement e-prescribing systems as soon as possible, while allowing physicians more time to come into compliance without penalty.
“SNF leaders should look for an e-prescribe solution that fits nicely within their physicians’ existing workflows,” advises Keith Cooper, CSPO.
Cooper is a business analyst on the MatrixCare SNF product management team focused on orders and medication management, including electronic prescriptions for controlled substances (EPCS), a system designed to increase safety and minimize fraud and diversion.
He also advises providers to ensure EPCS is embedded in their EHR systems — “something that physicians already use and can securely access from anywhere to decrease delays,” he says. “Another important piece of this may be looking for an EPCS tool that uses soft encryption keys, rather than hard keys that would require physicians to carry an additional device in order to meet two-step authentication and identification requirements.”
“Prescribers do not want a web portal approach, which is what [many] facility EHR vendors are currently providing,” says Gary Schoettmer, R.Ph., managing partner of the NetRx LTPAC Pharmacy Network. Schoettmer also chairs the American Society of Consultant Pharmacists’ Government Affairs Committee and serves as a chair of the LTC workgroup at the National Council for Prescription Drug Programs.
“A new version [of a SCRIPT standard] would negate the need for a web portal, but would require some additional development by the EHR providers,” he adds. “The ball is in CMS’ court.”
