Written By: Cheryl Reifsnyder, PhD
Electronic prescribing, or e-prescribing, is the electronic transmission of a medication prescription directly to the pharmacy using EHR technology or via standalone electronic prescribing software.1 e-Prescribing has been mandated in an increasing number of states for providers prescribing controlled substances. In fact, electronic prescribing of controlled substances (EPCS) will soon be required for all providers who are prescribing controlled substances covered under Medicare Part D.2, 3
These laws have largely been motivated by the goal of preventing opioid misuse and diversion, by making it easier to identify patients who might be “doctor shopping.”2 EPCS requirements are often coupled with regulations requiring providers to check state-run databases that track all controlled substance prescriptions (also known as Prescription Drug Monitoring Programs, or PDMPs), prior to issuing a controlled substance prescription. Together, EPCS and PDMPs are effective tools to help combat the opioid epidemic.4, 5
However, e-prescribing can bring numerous benefits to your practice beyond helping you better monitor prescriptions for controlled substances.
In this article, we’ll look at five compelling reasons to make e-prescribing a part of your dental practice—reasons that can help your practice run more smoothly, efficiently, safely, and, most importantly, will help you provide a higher quality of care to your patients.
1. Stay up to date and compliant with EPCS laws
EPCS mandates originated from the desire to make it easier to track prescriptions for controlled substances. EPCS reduces the likelihood of overprescribing by recording all of a patient’s prescriptions within their chart. It also makes it easier to spot signs of “doctor shopping,” such as:5-9
- Patients with prescriptions from multiple physicians
- Patients filling prescriptions at multiple pharmacies
- Prescriptions from a prescriber located outside the pharmacy’s usual geographic area
- Patients from outside the pharmacy’s usual geographic area
EPCS also makes it easier to identify patients who are potentially misusing or diverting controlled substances. It makes it easier to spot signs, such as patients who:6-8, 10-13
- Over-utilize a controlled substance
- Request early refills
- Appear overly sedated or intoxicated when delivering their prescription
- Request a medication by the drug’s street name, color, or identifying marks
It’s important to know your state’s requirements for prescribing controlled substances. Currently, EPCS is required in twenty-seven states; however, the precise requirements for EPCS vary from state to state.9 Some require EPCS only for opioids; others require it for schedule II or schedule II and III drugs; others require it for “all controlled substances”. Some states require EPCS for all prescriptions, both controlled and non-controlled.14
Although twenty-four states don’t currently require providers to use EPCS, two already have future dates when EPCS mandates will go into effect:9
- Michigan will require EPCS beginning October 1, 2021
- Indiana will require EPCS beginning January 1, 2022
In addition, no matter what the individual state mandates are regarding EPCS, the Centers for Medicare and Medicaid Services (CMS) plans to begin enforcing its EPCS requirement on January 1, 2022.3, 15 Whatever your location, if you practice dentistry in the United States, you will need to have an e-prescribing system in place by then to stay compliant with federal regulations.
It’s also important to note that compliance with EPCS regulations requires use of certified e-prescribing software, such as Veradigm ePrescribe™. Veradigm ePrescribe integrates directly with state PDMPs, allowing you to fulfill state requirements for checking the PDMP directly from your prescribing workflow. It also helps ensure you are in compliance with your state’s PDMP documentation requirements.16
In addition to state and CMS requirements, e-prescribing is required for eligible clinicians to meet the requirements of CMS’ Merit-Based Incentive Payment System (MIPS).1, 17 Specifically, e-prescribing is a required element for achieving the Promoting Interoperability Performance Score portion of MIPS.18, 19
To count toward the Promoting Interoperability score for your dental practice, e-prescribing must be performed with certified e-prescribing technology that meets the 2015 Edition Cures Update for certified electronic health record technology.19 Some EHR systems satisfy these certification requirements, but many do not.2 Veradigm ePrescribe™ is one of those specifically certified to the criteria listed in the 2015 Edition Cures Update.
3. Operate more efficiently
Another important benefit of e-prescribing is that it can help your dental practice run more efficiently, saving you and your staff time and energy. It streamlines prescribing. Providers save time by prescribing electronically from within their clinical workflow, rather than writing prescriptions manually. Since e-prescriptions are delivered directly to pharmacies’ computer systems, your practice staff will spend less time calling or faxing pharmacies to clarify orders. When Veradigm surveyed healthcare providers using ePrescribe, more than half of respondents reported that ePrescribe has helped them reduce communication between pharmacies and their practice.16
Veradigm ePrescribe is designed for ease of use. It can be used from any internet-connected device, including your mobile device. The mobile application delivers a single workflow from desktop to mobile device, enabling you to move through patient information efficiently and effectively. ePrescribe Mobile provides efficient real time access through single-touch user identification.16, 20
ePrescribe also features automated updates, enabling you to stay current with continually evolving regulatory requirements without any disruption to your workflow.20
4. Improve patient safety and quality of care
Use of e-prescribing has another important benefit: it has the capacity to improve both patient safety and quality of care for your dental practice.17, 21 One reason for this is that e-prescribing improves accuracy in filling prescriptions.1, 17, 21 Pharmacists are less likely to misinterpret electronic prescriptions than those that are handwritten.1, 17, 21 e-Prescribing software enables you to send error-free, easy-to understand prescriptions directly to the pharmacy.
Veradigm ePrescribe offers additional tools to help improve quality of care. For example, the software provides easy access to medication safety information and provides access to drug allergy history. It also displays patients’ medication histories and formularies during the e-prescribing workflow. Using that information, it automatically checks prescribed medications against other medications the patient is taking, then provides warnings of potential drug interactions. Checking against other prescribed medications helps providers to identify potential duplicate therapies as well.1, 16, 17, 21
5. Improve medication adherence
Another way e-prescribing helps dentists improve quality of care is by helping to improve medication adherence. Patients’ nonadherence to prescribed medications is a major public health problem.22 Up to 50% of medications are not taken as prescribed; about 140 million prescriptions—valued at approximately $2.8 billion—go unfilled annually in the United States today.22, 23
One key cause of medication nonadherence is when patients fail to pick up their prescriptions. Use of e-prescribing, however, has been shown to increase the first fill of a prescription by 10%.17, 24
Sometimes a patient’s failure to pick up their prescription is related to insurance issues. However, Veradigm ePrescribe provides electronic prior authorization, allowing you to automate submission of prior authorization requests as part of your e-prescribing workflow. This can help reduce the wait time for insurance approvals from days or even weeks to minutes.16
Cost is another frequent reason patients fail to pick up their prescriptions. Research shows a direct correlation between higher out-of-pocket costs for prescription medications and the risk of prescription abandonment.24 Studies also show that 33% of patients have purposely missed filling a prescription due to high cost.25
Veradigm ePrescribe provides a tool to help patients avoid cost issues: Veradigm RxTruePrice™. This prescription price transparency solution was designed to help address the increasing number of patients who don’t pick up, discontinue, or substitute for their prescribed medication. Veradigm RxTruePrice allows you to access patient-specific drug price information at the point-of-care. It provides users with information such as:16, 20, 26
- Prescription drug plan formularies
- Discounted health plan or pharmacy benefit plan pricing
- Cash pricing information
- Therapeutic alternatives
- Competitive pricing options at local and mail-order pharmacies
- Available coupons and patient financial assistance
All of this information is patient-specific and is easily accessible within your e-prescribing workflow. With it, you can help reduce patients’ out-of-pocket costs and, as a result, increase their adherence to their prescribed medications.16, 26
Six out of ten Veradigm RxTruePrice users reported that patient medication adherence improved when they began using this solution.27
e-Prescribing and Your Practice
e-Prescribing is already mandated in numerous states and will soon be required by federal law as well, making it a requirement in every dental office. However, today’s dentists expect more from e-prescribing software than a simple program that delivers paperless prescriptions. You need certified e-prescribing software that will provide prescription price information, real-time benefit information, therapeutic alternatives, product safety information, financial assistance programs, digital coupons, EPCS, the ability to interface with state PDMPs, and more.
Certified e-prescribing software such as Veradigm ePrescribe will allow you to stay on top of the new prescribing requirements while simultaneously saving your practice time and energy. Even more important, it will help you provide safer, higher quality care for your patients.
Veradigm ePrescribe is used by more than 140,000 prescribers for hundreds of millions of transactions every year.16 Click here if you would like to learn more about how Veradigm ePrescribe can help you run your practice more smoothly and effectively.
- American Psychiatric Association. e-Prescribing (eRx). American Psychiatric Association. Accessed June 14, 2021, https://www.psychiatry.org/psychiatrists/practice/practice-management/health-information-technology/e-prescribing.
- Jameson H. Don’t Panic Over Mandated E-Prescribing of Controlled Substances Laws. Academy of General Dentistry. Updated August 10, 2020. Accessed August 18, 2021, https://www.agd.org/publications-and-news/newsroom/newsroom-list/2020/08/10/don-t-panic-over-mandated-e-prescribing-of-controlled-substances-laws.
- CMS Delays Federal EPCS Compliance Enforcement To 2022. RXNT. Updated February 17, 2021. Accessed August 9, 2021, https://www.rxnt.com/cms-delays-epcs-compliance-enforcement-to-2022/.
- COE Briefing: Mandating PDMP participation by medical providers: current status and experience in selected states, Revision 1. February 2014. Accessed August 6, 2021. https://www.ojp.gov/pdffiles1/bja/247134.pdf.
- Prescription Drug Monitoring Programs (PDMPs). https://www.cdc.gov/drugoverdose/pdf/PDMP_Factsheet-a.pdf.
- State of Ohio. When to Check OARRS - Pocket Card - Prescribers and Pharmacists. https://www.pharmacy.ohio.gov/Documents/LawsRules/RuleChanges/OARRSRules/When%20to%20Check%20OARRS%20-%20Pocket%20Card%20-%20Prescribers%20and%20Pharmacists.pdf.
- Buchmueller TC, Carey C. The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare. NBER Working Paper Series. February 2017. Accessed August 13, 2021. https://www.nber.org/system/files/working_papers/w23148/w23148.pdf.
- About the Texas PMP. Texas Prescription Monitoring Program. Accessed August 10, 2021, https://txpmp.org/about.
- State PDMP Profiles and Contacts. Prescription Drug Monitoring Program Training and Technical Assistance Center. Updated July 7, 2021. Accessed August 19, 2021, https://www.pdmpassist.org/State.
- Idaho PDMP. Idaho State Board of Pharmacy. Updated December 16, 2020. Accessed August 6, 2021, https://bop.idaho.gov/idaho-pmp/.
- NC Controlled Substances Reporting System. North Carolina Department of Health and Human Services (NCDHHS). Accessed August 6, 2021, https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-abuse/north-carolina-drug-control-unit/nc-controlled-substances-reporting-system.
- Ohio Automated Rx Reporting System. Ohio Automated Rx Reporting System (OARRS). Accessed August 6, 2021, https://www.ohiopmp.gov/.
- Prevent Opioid Misuse and Abuse in Arizona: Prescriber Requirements for Compliance with Arizona’s Controlled Substance Prescription Monitoring Program (PMP) (Arizona Medical Association (ARMA)) (2017).
- HIMSS Electronic Health Record Association. Prescription Drug Monitoring Program State-by-State Landscape: State Mandates.5. Accessed August 24, 2021. https://www.ehra.org/sites/ehra.org/files/EHRA%20PDMP%20-%20EPCS%20-%20State%20Landscape%20June%202018.pdf.
- CMS formally delays EPCS enforcement. National Community Pharmacists Association. Updated December 4, 2020. Accessed August 22, 2021, https://ncpa.org/newsroom/qam/2020/12/04/qam-ad-cms-formally-delays-epcs-enforcement.
- ePrescribe–Automate and Empower Your Prescribing Success. Veradigm. Accessed August 26, 2021, https://veradigm.com/eprescribe/.
- e-Prescribing benefits. Practice Fusion. Accessed August 18, 2021, https://www.practicefusion.com/e-prescribing/benefits/.
- MIPS Measures Relevant to Dentistry. MD interactive. Accessed August 23, 2021, https://mdinteractive.com/MIPS-Dentistry.
- E-Prescribing, MIPS PI Measures for 2021 Reporting. MD interactive. Accessed August 23, 2021, https://mdinteractive.com/mips_pi_measures/e-prescribing-mips-pi-measures-for-2021-reporting.
- Veradigm ePrescribe Integrated–Your Ideal Solution for Advanced, “Plug-and-Play” e-Prescribing. Veradigm. Updated 2021. Accessed August 26, 2021, https://veradigm.com/eprescribe-software/.
- Schueth A, Topor L, Hillblom D. E-prescribing for Specialty Medications: The Time Is Right. Specialty Pharmacy Times. Updated August 11, 2015. Accessed June 16, 2021, https://www.pharmacytimes.com/view/e-prescribing-for-specialty-medications-the-time-is-right.
- Ngoh LN. Health literacy: A barrier to pharmacist–patient communication and medication adherence. Pharmacy Today. August 2009;15(8):45-57.
- Sabaté E. Adherence to Long-Term Therapies: Evidence for action. 2003:194. 2003. Accessed August 23, 2021. http://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf?sequence=1.
- Study: e-Prescribing Shown to Improve Outcomes and Save Healthcare System Billions of Dollars. Surescripts. Updated February 1, 2012. Accessed August 18, 2021, https://surescripts.com/news-center/press-releases/detail/212_eprescribing.
- Hamm N. How High Drug Prices Affect Patients. Managed Healthcare Executive. May 6, 2019;29(5).
- Veradigm RxTruePrice helps drive higher medication adherence. Veradigm; March 12, 2020. Accessed August 26, 2021. https://veradigm.com/veradigm-news/veradigm-rxtrueprice-release/.
- Results of Veradigm ePrescribe User Survey. Data on File: Veradigm.