Healthcare Informatics: Is Electronic Prescribing of Controlled Substances Around the Corner?

If there were ever an area of healthcare informatics that could truly be called a “work in progress” it’s e-Prescribing of controlled substances (EPCS).

For starters, it was only in 2010 that EPCS actually became legal, when the Drug Enforcement Agency (DEA) issued its interim final rule (IFR) on the activity. Until then, it was a no-go.  Since then, while the process has received an uptick in adoption (428 percent over the last six months of 2012, according this vendor-provided study), it’s still very much an area ripe with both security and technical barriers.

Just meeting the DEA’s measures for EPCS requires a significant investment of time and resources into authentication. The final rule required providers to use two factor authentication protocols when prescribing a controlled substance electronically. This part of the rule, according to a research survey that appeared in a 2012 edition of the Journal of the American Medical Informatics Association, was unpopular with care providers, one-third of whom said this would discourage their adoption.

Some provider leaders, like Todd Richardson, are just beginning to dip their toes in EPCS’ uncertain waters. Richardson is the CIO of Aspirus Health in Wausau, Wisc., a six-hospital health system with one main 250-bed campus in Wassau, Wisc. and five critical access hospitals (CAHs) throughout Wisconsin and Michigan.

Under Richardson, Aspirus has made a strong commitment to health IT. Its main hospital has been an Epic Systems (Verona, Wisc.) shop since 2003-2004 and is at “pretty full deployment,” he says. It attested to Stage 1 of meaningful use under the Health Information Technology for Economic and Clinical Health (HITECH) Act and is on track for Stage 2 as well as the transition to ICD-10, he says.

Along with those commitments to IT, Aspirus has begun e-Prescribing for non-controlled substances. Understanding the philosophy behind this swift evolution towards an electronic environment is a big part of Aspirus’ intrigue with EPCS.  HCI Associate Editor Gabriel Perna spoke with Richardson about the possibilities and challenges of EPCS and the organization’s specific plans. [Keep reading for] excerpts from that interview.