Electronic prescribing of controlled substances: an overview of our success

Prescribing controlled substances is as easy or difficult as you want to make it.

Getting started

Three years ago, when my group of nine family doctors considered starting electronic prescribing of controlled substances (EPCS), a healthy debate ensued on the pros and cons of the new workflow. On one hand, we had the advancing technology, which streamlined processes, resulted in less paper, and provided easy access for patients. On the other hand, we had concerns that an easier process for patients and doctors might enhance abuse and overuse and reduce oversight.

Indeed, the Texas legislature and medical board recognized these concerns from doctors across the state and focused on using technology for tracking and improving accountability when it came to e-prescribing controlled substances. They focused on technology use to reduce illicit use, redirection, and the rising number of prescription drug deaths in our state. They have been successful in meeting these goals with electronic prescribing of controlled substances, so our practice decided to move forward.

Our experience with EPCS

To summarize our experience with electronic prescribing of controlled substances:

• All nine of our providers wholeheartedly accept that this has been a win-win for our practice and patients, and a huge process improvement.
• Yes, we find it easier to get prescriptions out the door to pharmacies and they are more accurate, more easily validated, tracked, and monitored via the state reporting system.
• Yes, most of us prescribe only one month’s medication at a time and we do that every month if needed.
• Yes, I could prescribe three different months with delayed fill dates in the notes field as I did with paper secured scripts, but it’s so quick and thoughtful to manage a monthly renewal, chart any orders or concerns, and then process the renewal with our new process that doing three months at a time no longer saves work.
• For those of us that require patient to return for every new script, we still follow our new EPCS process and prescribing is far eaiser. For those of us that require every six-month visit, we still operate similarly and prescribing is easier.
• Yes, my pharmacy colleagues love the revised systems of tracking, reporting, and filling that EPCS provides. It is far easier and they feel that redirection and abuse is dramatically declining.

After three years, electronic prescribing of controlled substances is a huge win for our practice. In the course of talking with other physicians, there is a natural trepidation about the change, particularly because there is so much additional responsibility we as physicians feel about prescribing controlled substances. Although it is entirely right for physicians to question and verify the electronic process before proceeding, this is a change which has turned out to be very good.

Dr. Eric Weidmann is a Chief Medical Officer for CompuGroup Medical and a practicing physician.