E-prescribing now permitted for controlled substances
APhA collaborates on comments
to DEA; software could take months, years.
Under DEA regulations that took
effect June 1, e-prescribing of controlled substances is now permitted
in the United States. All the dust has not yet settled, however; APhA
joined with other pharmacy associations to suggest ways that the process
could be improved. In addition, software developers may need at least a
year to make the updates to computer systems that will allow
prescribers to transmit scheduled medication orders, intermediaries to
process the prescriptions, and pharmacies to receive them.
DEA has been moving for years
toward allowing e-prescribing of controlled substances. The latest push
began in June 2008 when the agency announced its intention to create an
alternative to manual prescriptions. After the February 2009 economic
stimulus act created incentives for increased use of health information
technology by physicians, pressure increased for DEA to offer a
structure for e-prescribing.
On March 31 of this year, DEA
issued a set of interim
final regulations. While these became effective June 1, the
“interim” status means that DEA sought input from interested
parties about the details. With new suggestions, DEA will later issue
final regulations that are really the last word on how the process will
work.
APhA joined with the American
Society of Consultant Pharmacists, American Society of Health-System
Pharmacists, and the National Community Pharmacists Association
to offer
comments on the DEA regulations. The groups asked DEA to make sure
that the final regulations:
- Provide additional clarification
on changes to electronic prescription orders and communications of these
changes between a pharmacist and a registrant practitioner
- Provide additional clarification
on the use of digital signatures and the responsibilities associated
with verification of a digital signature
- Provide additional guidance and
work in conjunction with the pharmacy industry to standardize internal
code number systems added to the standard nine-digit DEA registration
format
- Ensure that an appropriate number
of certification or audit entities exists to meet the needs of pharmacy
systems in all types of patient care practice settings (e.g., acute
care, long-term care, community/retail)
- Provide additional clarification
on rerouting and transferring of prescriptions
- Provide additional clarification
on workflow procedures for long-term care settings
- Consider additional options for
emergency fill procedures
Pharmacists may not see their
first electronic prescription for a Schedule II, III, IV, or V drug
product for some time. Reprogramming of e-prescribing systems will take
up to 18 months, said Kevin Nicholson of the National Association of
Chain Drug Stores in an article
in MedPage Today. Pharmacy computer systems could be ready
in 6 months, he said. In addition, the final DEA regulations could
mandate further tweaks, and CMS will need to change some of its
requirements to facilitate e-prescribing of these agents.
Watch for more information on
e-prescribing of controlled substances in the “Washington
Insider” column of the July issue of Pharmacy Today. DEA
also provides online
information about the new regulations, including advice for
prescribers, pharmacies, and software providers and
intermediaries.
Related resources on www.pharmacist.com:
L. Michael Posey, BPharm (mposey)
Posted June 11, 2010, 11:00 am EDT
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