e-Prescribing 101, Part II: Controlled Substances

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To continue our e-Prescribing 101 blog series, we shine light on controlled substances. What they are, their relationship to e-Prescribing, as well as the correlation between prescription drugs and the current opioid epidemic.

What is a controlled substance?

A controlled substance is a drug or chemical, such as illicitly used drugs or prescription medications, that is regulated by a government based on the drug or chemical’s manufacture, possession, or use.

Why are certain drugs categorized as a controlled substance?

A drug is typically classified as “controlled” due to the potential detrimental effects on a person’s health and well-being. As a result, state and federal governments have seen fit to regulate such substances.

It’s for this reason that drugs, substances, and certain chemicals used to make drugs of this caliber are classified into five categories. The drug segregation is dependent upon the drug’s acceptable medical use and the drug’s abuse or dependency potential.

What are the medication schedules for controlled substances?

Schedule I

• Drugs with no currently accepted medical use and hold a high potential for abuse.
• Examples: Heroin, Marijuana (Cannabis), LSD, and Ecstasy

Schedule II

• Includes drugs that are accepted for medical use, but have a high potential for abuse, with use potentially leading to severe psychological or physical dependence.
• Examples: Vicodin, OxyContin, Adderall, and Ritalin

Schedule III

• Drugs with a moderate to low potential for physical and psychological dependence, with less abuse potential than Schedule I or Schedule II drugs.
• Examples: anabolic steroids, testosterone, and Tylenol with codeine

Schedule IV

• Drugs within this category have a low potential for abuse and dependence.
• Examples: benzodiazepines (Xanax, Valium, Ativan), Tramadol, and Ambien

Schedule V

• The lowest schedule for controlled substances, these drugs have lower potential for abuse and consist of preparations containing limited quantities of certain narcotics.
• Examples: Robitussin AC, Lyrica, and Motofen

What is EPCS?

EPCS stands for the Electronic Prescribing of Controlled Substances and is a technology that has been put into place to help address the rising issue of prescription drug abuse in the United States.

Understanding two-factor authentication

This two-step process is part of EPCS and ensures that only an authorized prescriber can electronically sign and send controlled substance prescriptions to a pharmacy, thus increasing patient safety. The process includes the entry of something you have, such as a token generated one-time code, and something you know, like a password. There are various options for two-factor authentication including: fob tokens, mobile phone applications, smart cards, USB thumb drives, and fingerprint scanners.

What is an opioid?

Opioids are substances that act on the body’s opioid receptors to produce euphoric effects, better known as a “high”, and are most often used medically to treat moderate to severe pain that may not respond well to other pain medications.

Why are opioids so addictive?

Opioid drugs work by binding opioid receptors in the brain, spinal cord, and other areas of the body to reduce the sending of pain messages to the brain, thus simultaneously reducing the physical feelings of said pain. They create artificial endorphins, the body’s natural painkillers, which tap into the “reward” sector of someone’s brain. However, with chronic use, opioids eventually trick the brain into stopping the production of these endorphins naturally. In doing so, the tolerance level increases and a patient is left with taking more medication to achieve the same effect.

They are most dangerous when taken in certain ways to increase the “high”, such as crushing pills and then snorting or injecting the powder, or combining the pills with alcohol or drugs, especially benzodiazepines. While some patients do take them for their intended purpose, they can still risk dangerous adverse reactions by not taking them exactly as prescribed, i.e. they take more at one time, or combine them with other medications not checked by their doctor.

Unfortunately, the fear of the intense withdrawal symptoms is often the biggest culprit when it comes to patients remaining addicted and ultimately leads them to continue taking the medication even if they no longer want to.

The correlation between prescription opioids and the opioid epidemic

In 2012 alone, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills. In comparison to ten, even five years ago, this number is dramatically increasing as time goes on and more and more opioid overdoses are being reported on a daily basis.

Physicians and dentists are collectively responsible for providing 81.6% of opioid prescriptions in the United States and because of this, they have a very unique role in mitigating the impact of this opioid epidemic. Opioid addiction often starts at the hands of healthcare professionals simply trying to do their job, prescribing pain medications to relieve their patients of painful woes, especially during post-operative recovery.

While many prescriptions are meant for initial, short-term treatment, some doctors and dentists authorize refills time and time again because they want to help patients whom claim that they are still in pain. However, when the pill bottle and refills run out, patients are left seeking alternatives to create that euphoric escape they’ve become so accustomed to. This could mean an endless search of several different doctors to prescribe more substances (also known as doctor shopping), purchasing pills on the black market, or worse, turning to heroin as a cheaper and more readily available alternative.

Furthermore, the associated stigma often deters patients from receiving proper rehabilitation treatment and even if they do seek treatment, the government currently limits the number of patients a single provider may treat with drugs such as buprenorphine or methadone, which are both proven to reduce cravings and save lives. This leads to many patients relapsing.

How does e-Prescribing help?

• e-Prescribing diminishes the possibilities of duplicate or lost prescriptions since the prescription is sent directly to the patient’s pharmacy.
• A patient will no longer have a paper prescription where the dispense quantity can be altered.
• Prescriber’s will have access to a patient’s medication history, therefore they can determine if a patient is doctor shopping or has a history of substance abuse.

Don’t miss the other parts of our e-Prescribing 101 series:

e-Prescribing 101, Part I: The Basics

e-Prescribing 101, Part III: End Users

Sources: DEA; DrugAbuse.gov; FDA

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

e-Prescribing 101, Part I: The Basics

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Another year has come and gone. Time to start fresh, gain new perspective, and bring it back to basics. e-Prescribing basics, that is.

During our reflection on 2016, the DoseSpot realized that there’s so much information out there regarding e-Prescribing and its different components; so many key opinion leaders and incredible resources to tap into to help educate the world about e-Prescribing. However, how could we make it easier? How can we assist those who just want to learn more about e-Prescribing in general without the endless Google searches?

That’s why we decided to create a three-part blog series covering all e-Prescribing basics; a one-stop-shop to answer all of your e-Prescribing questions and curiosities.

We can promise you this – this is one New Year’s resolution we won’t give up on.

Let’s get started.

What is e-Prescribing?

The term e-Prescribing has become a popular buzzword in the healthcare industry, but what exactly does it mean? To put it simply, electronic prescribing, known in short as e-Prescribing, is a method of prescription transaction that allows prescribers to write and send prescriptions to pharmacies electronically instead of writing, phoning-in, or faxing. It ultimately replaces the costly paper prescription pad and tamper-proof printing paper from a prescriber’s office for good.

e-Prescribing solutions have the following capabilities:

• NewRx: Route new prescriptions to the patient’s pharmacy of choice.
• Refills: Receive prescription renewal requests and submit responses between doctor and pharmacy.
• Medication History: View aggregated medication history data from pharmacies and pharmacy benefit managers (PBMs) upon receipt of patient consent.
• Prescription Benefit: Surescripts’ Prescription Benefit service puts eligibility, benefits and formulary information at a prescriber’s fingertips at the time of prescribing. This enables prescribers to select medications that are on formulary and are covered by the patient’s drug benefit.
• Electronic Prescribing of Controlled Substances (EPCS): Product has achieved Surescripts EPCS certification and has provided third-party audit documentation as required by the DEA.

What are the benefits?

e-Prescribing is not just the ability to send prescriptions electronically to pharmacies. It can also increase care quality in a number of ways:

• Eliminates the time and effort of trying to understand the prescriber’s handwriting, as well as the chance of an error in that translation.
• Makes sure that the prescriber is providing enough specific information for the pharmacist to fill the prescription, including the name of the drug, the dosage, its physical form, the route, and the prescriber’s instructions.
• Ensures that any drug-drug and drug-allergy interactions based on a patient’s medication history are found and reported to the prescriber before the prescription order is completed.
• Checks a patient’s pharmacy benefit and associated formulary at point of care to encourage the prescriber to choose the best medication option, both medically and financially.
• Increases patient medication pick-up adherence. Between 28% and 31% of all paper prescriptions either never make it to the pharmacy, or are not picked up once patients see how much it will cost.
• Drives down healthcare costs and improves patient satisfaction by getting medications to patients in a timely, convenient, and secure manner at the patient’s pharmacy of choice.
• Curbs prescription drug abuse and increases patient safety. No longer will a patient have access to a paper prescription, therefore no more altered dispense quantities, stolen prescription pads, or lost or duplicate prescriptions.
• Lowers costs associated with purchasing expensive paper prescription pads and the time and resources spent on redundant administrative tasks.
• Simplifies clinical workflows and allows prescribers to do what they do best and spend more time with their patients.

Who can e-Prescribe?

State or provincial legislation governs who can write a prescription, and under these rulings, any licensed physician, dentist, nurse practitioner, etc. allowed to write prescriptions by hand can also prescribe electronically.

Many electronic prescribing vendors also allow the use of proxy users, such as nurses, medical assistants, or office staff. While they cannot legally send a prescription to a pharmacy, they are able to access the e-Prescribing solution and fill in all required fields of the prescription for a prescriber to then approve and send.

What pharmacies allow e-Prescribing?

All 50 states and D.C. allow the e-Prescribing of both controlled and non-controlled substances and more than 90% of pharmacies can receive e-Prescriptions. Of course this includes the larger retail pharmacy chains such as CVS and Walgreens and mail-order pharmacies like Catamaran and Express Scripts.

Don’t miss the other parts of our e-Prescribing 101 series:

e-Prescribing 101, Part II: Controlled Substances

e-Prescribing 101, Part III: End Users

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

e-Prescribing of Controlled Substances – How Does Your State Measure Up?

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Navigating the waters of e-Prescribing can seem like a very daunting task considering the various state and federal regulations. To assist you in understanding, let’s review the information relative to e-Prescribing of Controlled Substances (EPCS) in all 50 states and how your state is measuring up.

Until recently, one-half of all U.S. States prohibited e-Prescribing of controlled substances. The thought was that paper prescriptions were safer and more secure. On September 15, 2015, however, Vermont became the last state to allow electronic prescribing of controlled substances, or Schedule II-V medications, making this process legal in all 50 U.S. states.

“We certainly believe that because of the enhanced security associated with e-Prescribing of controlled substances, the opportunity for abuse, misuse, and fraudulent activity is going to be dramatically reduced,” said Ken Whittemore, BSPharm, MBA, Senior Vice President of Professional and Regulatory Affairs at Surescriptsâ„¢, a nationwide health information network.

With this process now legal in all 50 states, and the safer option at that, it may be surprising to find that as of the most recent data available, only 7% of prescribers are sending controlled substances on the Surescripts network.

So, why the discrepancy? Are pharmacies not accepting electronic prescriptions? Are prescribers not able, or willing, to send these prescriptions electronically? Is this process too difficult? Why is this process used in some states so heavily, but so infrequently in others?

Pharmacies are ready!

In 2010, the DEA published a final ruling giving not only practitioners the option to write controlled substances electronically, but also for pharmacies to receive, dispense, and archive electronic prescriptions.

“It became incumbent upon a number of stakeholder groups in the pharmacy industry to tackle the issue and bring states into alignment with the DEA’s rule,” Ken Whittemore, BSPharm, MBA told Pharmacy Today.

Many pharmacy stakeholder groups, including APhA, the National Alliance of State Pharmacy Associations (NASPA), the National Association of Chain Drug Stores, and Surescripts, worked together over a 5-year period to rework some state laws, a process that can take a long time. Between 2010 and 2015, the pharmacy end of the spectrum worked hard on adoption and enablement, while prescriber enablement trailed. Using data from Surescripts, a study published in the January 2015 American Journal of Managed Care found that pharmacies with technology in place to accept e-Prescriptions for controlled substances increased from 13% in 2012 to 30% in 2013. By contrast, only 1% of all prescribers were capable of e-Prescribing controlled substances in 2013.

However, between 2012 and 2013, the number of e-Prescriptions for controlled substances grew dramatically from 1,535 to 52,423. Talk about a rapid jump!

According to the 2015 Surescripts National Progress Report, an average of 81% of pharmacies were enabled for EPCS in 2015. States including Hawaii and Mississippi were at the bottom of this list with less than 70% of pharmacies enabled, while states in the Northeast such as Massachusetts, New York, New Hampshire, and Rhode Island led this list with over 90% of pharmacies enabled for EPCS.

As of December 1, 2016, these numbers have only risen, with both Hawaii and Mississippi now having over 75% of pharmacies enabled. New York and Maine lead the race on that front with 96.8% and 95.2% of pharmacies enabled currently. This is in large part due to the state mandates put into place in 2016 and 2017, respectfully.

How about the prescribers?

With so many pharmacies enabled for EPCS, and legislature allowing this process in all 50 states, it may be surprising to know that an average of 3.39% of prescribers were enabled to e-Prescribe controlled substances according to the 2015 Surescripts National Progress Report.

Lengthy and time-consuming software auditing and prescriber identity proofing processes are likely factors that have stalled prescriber adoption of EPCS, but for pharmacists, the initial setup is much easier. In addition, there have not been enough incentive for prescribers to adopt EPCS.

e-Prescribing was a requirement under the federal Meaningful Use Electronic Health Record (EHR) program, which incentivizes the use of EHRs through financial payments. However, e-Prescribing of controlled substances was specifically exempted from Meaningful Use Stages 1, 2, and 3. For these reasons, it isn’t surprising that in 2015 the state with the highest number of prescribers enabled was New York, as that was one of the only states with an e-Prescribing state mandate in effect at that time.

In 2015, New York had 26.6% of their prescribers enabled for EPCS, with Nebraska not far behind at 15%. Fast forward to December 1, 2016 and prescriber enablement has grown tremendously in some states, but remain dismally low in others. New York now has 71.5% of prescribers enabled, with no other state having even one-third of their prescribers enabled for EPCS. In fact, the average percentage for EPCS enabled prescribers remains even as of December 1, 2016, at only 8.4% despite all of the benefits of EPCS.

Why are these numbers so varied?

Electronic prescribing of controlled substances (EPCS) reduces fraud and keeps patients from getting multiple prescriptions for the same drug, so why are some states seeing major buy-in while other states are lagging? Much of this is impacted by states that have legislation in place to either require or reinforce the use of e-Prescribing, as outlined below.

Minnesota

Minnesota was the first state to implement an e-Prescribing mandate in 2008 in order to improve quality outcomes and efficiency in health care. The state mandate required prescribers, pharmacists, pharmacies, and pharmacy benefit managers (PBMs) to be up and running with e-Prescribing by January 1, 2011, however, only 13% of prescribers are actually enabled for EPCS as of late. Could this be because legislation doesn’t enforce its own law or penalize prescribers for not adhering to this legislature? Marty LaVenture, director of the Minnesota Office of Health IT and e-Health, seems to agree and notes, “policy levers could be used to encourage full adoption and use of e-Prescribing capabilities.”

New York

As you may already know, New York was the first state to require e-Prescribing of all prescriptions, both controlled and non-controlled, and the first to implement penalties for failing to adhere to this ruling. Penalties include, but are not limited to, loss of license, civil penalties, and/or criminal charges. With the highest rate of prescriber EPCS enablement, it’s evident that New York prescribers are taking this quite seriously.

Maine

Maine is the next state to implement an e-Prescribing regulation as of July 1, 2017 where all opioids prescriptions must be sent electronically. With only 0.6% of prescribers enabled for EPCS in the state according to the Surescripts report, and up to 2.9% as of the beginning of December 2016, it’s clear that Maine has a long way to go for all prescribers to be ready to follow this regulation.

In Summary

Although it’s legal in all 50 states, and there are many reasons EPCS is safer than on paper or another method, there is still a great discrepancy between EPCS enabled pharmacies and EPCS enabled prescribers due in part to the strict requirements put in place on the prescribers. While the statistics referenced here show that provider adoption of EPCS is still low in comparison to the pharmacy adoption we have seen, it’s important to remember that the e-Prescribing of non-controlled substances also took years to reach the level we now see today. It seems the only tried and true way for these numbers to rise quickly and meet the numbers we currently see for pharmacy enablement is to implement regulations and penalties for not adhering to this requirement as outlined in the above state mandates. All eyes are now on Maine to see how their journey goes.

Check out the maps below to see how your state measures up!

Author: Lindsey W.

Sources: American Pharmacists Association; USA Today; Surescripts 2015 National Progress Report; Surescripts EPCS; Minnesota Department of Health; Maine Medical Association; e-Prescribing Blog; CMS

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management, and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing to more than 150 health care software companies since 2009. For more information, please visit www.DoseSpot.com.

Climbing the Ladder to Success: An Evening with the Power Women of Health IT

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On Monday, November 7, 2016, Health 2.0 Boston held a panel discussion with three of 2016’s 75 Most Powerful Women in Healthcare IT named by HealthData Management and the DoseSpot team was fortunate to be in attendance. The three influential women brought up many interesting points and offered inspiring words of wisdom to the crowd, the majority of which were females. Although the event was structured with prepared questions for the panelists, these power women provided answers that were honest, open and personal, thus creating a comfortable and therapeutic-like atmosphere. This event navigated the different paths that were taken by each of the female leaders and highlighted the trials and tribulations that they encountered while on the rise to success in a primarily male-driven industry.

The Panel

• Helen Figge, PharmD, MBA, FHIMSS – SVP, Global Strategic Development, LumiraDx, Inc.
• Sue Schade, MBA, LCHIME, FCHIME, FHIMSS – Principal, StarBridge Advisors
• Cara Babachicos – Corporate Director/CIO, Community Hospitals at Partners Healthcare

Here are DoseSpot’s key take-away points from the panel discussion:

Culture

All three Health IT leaders agreed that when it comes to the topic of company culture, it is not only important to be a part of a workplace where women are valued, but also to be part of a workplace where women have the ability to flourish and be the competent employee they worked and studied so hard for. Cara Babachicos, specifically, mentioned that internal happiness and success are the most important components of one’s career and the company someone works for should be promoting those components. It is one thing to be qualified for a position, yet another to be the right fit. Consistently evaluating if you are the right fit for a specific position or company is crucial in your path to success.

Mentorship

Are mentors a necessity to rise to the top? All three women agreed that it is not necessarily a career killer if one does not have a mentor. However, being able to navigate and find someone whom you can model after is going to immensely help on your career journey.

Helen Figge mentioned that even if you don’t have a mentor per se, you can still find a particular skill(s) in someone that you can model yourself after and learn from, as long as you don’t set boundaries for yourself of who you could one day become.

Another interesting point made was that a mentor doesn’t necessarily have to be a person you WANT to be; it can be a person who makes you realize who you DON’T want to be. Lessons can be learned from all types of people, of all different backgrounds, personalities and roles.

Rising Above

Each one of the ladies on the panel highlighted the largest obstacle they were required to overcome in order to become who they are today. Helen, who addressed a disability she has experienced her whole life, had to adjust and overcome many challenges to work harder in school and in her career. She courageously saw past her physical obstacle to see the trajectory of what she wanted to be in the long run. Her advice? Like yourself. No matter what.

Cara’s biggest obstacle was having patience. As with building anything great or influential, it takes time. Her advice was to be more patient with yourself and your life, both personally and professionally. Eventually, all of the pieces will come together.

Lastly, one of Sue’s greatest obstacles was dealing with bullying behavior from colleagues, primarily men back in the 80’s when a woman with authority in IT was a rarity. She made it clear to always be willing to speak up for yourself and make sure your superior is aware of what is going on in the workplace, even if stepping up is the hardest thing to do. As a leader of hundreds of employees, she further pointed out that she may not know everything that’s going on in her department. An employee may act differently in front of leadership than they do in front of their peers.

Words of Wisdom

The three power women of health IT left us with a few final points to think about when climbing the career ladder of success:

Speak Up! – Stand up for yourself and for what you deserve, even if it may feel uncomfortable.

Know Your Stuff – Constantly challenge yourself and learn new things. Be an overachiever. Success comes to those who work for it!

Don’t Question Yourself – Even if you feel nervous or anxious, strive to be authentic and confident in everything you do.

Trust Your Gut – If you have to question something, always do what’s right for the organization. Your company will thank you for it.

And finally, at the end of it all: Always do what’s right for you.

About Health 2.0

The Boston Chapter of Health 2.0 is a part of the national Health 2.0 organization, which is the premiere showcase and catalyst for the advancement of new health technologies. Through a global series of conferences, developer competitions, and leading market intelligence, Health 2.0 drives the innovation and collaboration necessary to transform health and health care. For more information, please visit: www.bostonhealth20.com.

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

Addressing Dentistry’s Role in the Opioid Epidemic

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Unfortunately, the opioid epidemic that is currently grappling the United States isn’t exactly news. Headlines appear on a daily basis in regards to this addiction, the overdoses and fatalities, as well as the healthcare community’s contribution to this crisis, both the good and the bad.

We’ve seen Congress, the Surgeon General, and many other organizations make extreme efforts to combat this crisis, yet despite the widespread media attention, many healthcare professionals still don’t realize how dangerous the drugs can be or how addictive they are.

DoseSpot recently conducted a live webinar in an effort to educate and discuss the critical role that dentists in particular play in mitigating the current opioid epidemic that is upon us and during that time, the following crucial points were made:

The blame game needs to stop

Blaming others only diverts the necessary action of collectively coming together as a nation, regardless of one’s associated industry. Healthcare, Law Enforcement, Politics – there needs to be a strong, unified foundation for which we can assemble and fight this battle together.

Break the habit: prescribing patterns of pain medication

Dentists serve a unique role in overcoming this epidemic due to the nature of their work and the procedures they perform, specifically wisdom teeth extraction. It’s a fair statement that the majority do not enter the healthcare industry with ill intent of harming their patients, yet it’s also fair to say that lack of proper education and prior pharmaceutical marketing tactics have fueled poor prescribing patterns. In order to change one’s behavior, programmed thoughts and approaches must be reevaluated.

Opioid addiction does not discriminate

This addiction can affect anyone regardless of one’s socioeconomic status or in some cases, a person’s relationship to their dentist. What DoseSpot coins as “The Insider Threat,” we reveal how certain folks pose a potential risk relative to obtaining controlled substances, both knowingly and secretively. Stories of addiction that are shared during our recent webinar further prove that opioids do not discriminate.

Solutions are available

The truth of the matter is, there is not one single solution that can work independently. It needs to be a collective effort and innovation is critical to success. There needs to be multifaceted solutions to tackle this complex problem ranging from increasing specialty training and education to proper treatment technology, data, and analytics.

To learn more on dentistry’s role in the opioid epidemic, watch the full webinar here.

Presenters:

Greg Waldstreicher, CEO, DoseSpot

Dr. John Zweig, Chief Dental Officer, Dental Associates

Donald Whamond, Chief Technology Officer, Dental Associates

Jason Wolan, Director of EHR Implementation, Great Expressions Dental Centers

Daniel Smelter, Director of Business Analysis, Benevis, Inc.

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

The Impact of Digital Health on the Ages

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How does digital health affect the circle of life?

Today, a patient’s well-being rests in the hands of multiple healthcare professionals, including primary care providers, specialists and surgeons – and sometimes in their own hands with the latest medical devices and technological advances.

In keeping up with this new delivery model, it’s important to understand how people of all ages, pediatric to geriatric, attribute to the nation’s overall population health, its effects on the healthcare system and the United States’ bottom line, while also understanding how technology can play a major role.

This free eBook addresses:

• The definition of digital health, the current landscape, as well as what’s to come
• How individuals of all ages affect the health care system and how digital health can help
• Three health care specialties positioned for digital health growth
• The role of technology as we shift to value based care
• Missing pieces of the digital health offering

Download your free copy here!

About DoseSpot

DoseSpot is a Surescriptsâ„¢ certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

3 States Laying Down the Law on Opioids

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On par with our last post, the widespread media attention and devastating losses associated with our nation’s current opioid epidemic has sparked certain state legislatures to regulate and improve providers’ prescribing habits for prescription painkillers.

With good intentions in tow, some rulings seem to lack readily available solutions that are proven to curb this crisis. However, they do realize that their recent proposals do not mark the end of this uphill battle, rather multifaceted solutions need to be in place to truly, and successfully, overcome this epidemic.

[Read: Overdose Awareness – The Time to Stand Together is Now]

Here are three states that have recently proposed rulings on how opioids should be prescribed:

Vermont

Coined as a “cutting-edge” approach to overcoming the opioid crisis, Governor Peter Schumlin announced proposed limits on the number of opioid medications that could be prescribed.

Like every other state, Vermont has seen an incredible increase in deaths related to opioid and heroin overdose in recent years and Governor Schumlin is no longer sitting on the sidelines.

Earlier this year, he approached both the FDA and pharmaceutical industry in his State of the State address claiming that OxyContin “lit the match that ignited America’s opiate and heroin addiction crisis,” and that the booming American opiate industry knows no shame, an outcry after the FDA approved OxyContin for children a few months ago.

The proposed ruling states that the severity and duration of pain will determine the specific limit for a prescription of opioids. For example, a minor procedure with moderate pain would be limited to 9-12 opioid pills and the amount would increase based on the procedure performed and the level of pain a patient claims. The ruling would also require providers to discuss risks, provide an education sheet to the patient and receive an informed consent for all first-time opioid prescriptions.

The Green Mountain State’s Governor believes that limiting the number of opioid pills prescribed would be an effective way to reduce addiction, yet some folks believe the ruling would only encourage patients to seek illicit drugs elsewhere if they cannot receive pain medication through their provider.

This does make sense considering many former and current heroin abusers have stated that their addiction started from a prescription and when the pill bottle ran out, they were left seeking these drugs on the streets, which have proven to be very, if not more, dangerous than the prescription.

However, the intent of the Governor’s ruling is to prevent addiction from ever happening in the first place. His ruling is specific to cases of acute pain, therefore changing the over-prescribing habits and learned behavior of utilizing opioids as first-line therapy; habits that ensued in large part due to incentives, the surge of pharmaceutical marketing tactics and claims that painkillers were not addictive.

[Read: How Costly Are Prescription Pain Meds?]

New Jersey

With the rate of drug overdose deaths on the rise by 137% since 2000, New Jersey is another state to recently propose new regulations on how and to whom opioids are prescribed.

New Jersey, much like many other states, believes that prevention is key when fighting this crisis and they couldn’t be more correct. Unfortunately, several barriers often occur when seeking appropriate treatment after a patient becomes addicted, (for example, providers are limited to certain amounts for which they can administer reversal drugs), and therefore why not PREVENT addiction, rather than simply TREAT addiction when at many times, it’s too late?

Senator Raymond Lesniak has introduced a bill that would put restrictions on health insurance coverage for opioid medications, while also requiring prescribers to first consider alternative pain-management treatments, follow federal prescribing guidelines and explain the risk of addiction with such substances to their patients before prescribing. Furthermore, providers will need to complete several steps before receiving approval of an opioid prescription. These steps include providing a patient’s medical history, conducting a physical exam and developing an appropriate medical plan for treating a patient’s pain.

While new rulings in place can certainly shift this epidemic, Angela Valente, the executive director of the Partnership for a Drug-Free New Jersey, said it best:

“Awareness and education is the key factor in preventing the abuse of opiates—everyone must have a role in reversing this epidemic, including lawmakers, parents, coaches, educators, and yes, even doctors and dentists.” – Angela Valente

Dr. Andrew Kolodny, executive director of Physicians Responsible for Opioid Prescribing, further backs Valente’s point while also motioning that the medical community has been prescribing too aggressively.

[Read: The Opioid Epidemic: Are Dentists the Black Sheep?]

Pennsylvania

Unfortunately, Pennsylvania experienced 3,500 deaths last year as a result from drug overdose, one of the highest overdose rates in the nation.

The state has had a Prescription Drug Monitoring Program for quite a few years now, however it wasn’t functional until August 2016, when their new program was officially rolled out. Pennsylvania requires providers to query the state’s prescription drug database the first time they prescribe a controlled substance to a patient or if they have reason to believe that the patient is doctor shopping.

Governor Tom Wolf addressed other initiatives underway including requiring providers to query the database EACH time they prescribe opioids, updating medical school curriculum and continuing education, changes to the process of pain care to lower inappropriate use of opioids, and improved screening, referral and treatment for addiction.

What’s bothersome in Pennsylvania, is the method in which these substances have to be prescribed. The Pennsylvania Controlled Substance Act requires narcotic prescriptions to be handwritten on paper prescription pads, yet every other substance can be electronically prescribed. This allows the risk of written prescriptions being lost, stolen, or sold. Luckily, Senator Richard Alloway intends to introduce this measure before the legislative session’s end.

It’s promising to see how the above states are utilizing their state’s Prescription Drug Monitoring Program, or PDMP. All three require their prescribers to query the affiliated state database, however the parameters in which, or how often, they check varies.

While said efforts are better than no effort at all and states are starting to fully understand the need for multifaceted solutions in order to overcome this epidemic, one key solution is missing. E-Prescribing.

[Read: The Link Between PDMP’s and e-Prescribing]

How does e-Prescribing help combat this epidemic?

• e-Prescribing diminishes the possibilities of duplicate or lost prescriptions since the prescription is sent directly to the patient’s pharmacy
• A patient will no longer have a paper prescription where the dispense quantity can be altered
• Prescribers will have access to a patient’s medication history, therefore they can determine if a patient is “doctor shopping” or has a history of substance abuse

To learn how to incorporate e-Prescribing as a solution to the opioid epidemic, schedule a meeting with DoseSpot today.

Sources: NY Times; Boston.com; ABC News; Press of Atlantic City; PennLive

About DoseSpot

DoseSpot is a Surescriptsâ„¢ certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

Docity Meets Increasing Patient Demands with Innovative Telehealth Platform and Integration of DoseSpot e-Prescribing Solution

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NEEDHAM HEIGHTS, MA – Docity, a veteran-owned, connected telehealth platform that enables real time HIPAA-compliant communications between healthcare providers and patients, has announced their strategic, patient-driven integration of DoseSpot’s e-Prescribing solution.

The key component of Docity’s business model is simple: to put patients first by listening to their needs and adapting a digital healthcare system based on those needs.

“Docity’s business is driven solely by the patient-centric model and DoseSpot understood that crucial factor from the very beginning,” said James Cowan, CEO, Docity. “As part of this model, Docity knew that incorporating e-Prescribing was a non-negotiable. E-Prescribing isn’t just a feature; it’s something you must have in today’s competing market.”

Prior to integrating DoseSpot, Docity was offering their connected health platform to several clinics with existing patients, but prescribing was done on the clinician’s own terms. Since the integration with DoseSpot’s e-Prescribing solution, Docity will now be able to offer a comprehensive digital platform to serve the needs of individual patients on a subscription basis.

“The integration process with DoseSpot was a breeze,” Cowan added. “Their team was very flexible and actively engaged, working around the clock to ensure that Docity met al Surescripts certification requirements in a timely manner. Furthermore, they were able to work directly with our developers and their project management tool kept everyone organized which made for a seamless process overall.”

Docity is not only meeting the increasing demands of patients and providers, but the DoseSpot integration has better leveraged relationships with key stakeholders, primarily from a compliance perspective.

“Since integrating with DoseSpot, Docity has seen significant buy-in from highly sought after individuals, providers and companies in the healthcare community who are more eager than ever to stand behind our vision,” said Cowan. “It’s a win-win for both parties.”

“Our partnership with Docity is rooted in understanding and listening to both the patients’ and providers’ demands. Patient-centricity is a current healthcare trend we are committed to upholding as the healthcare landscape continues to evolve,” said Greg Waldstreicher, CEO, DoseSpot. “As a telehealth company, Docity recognized that e-Prescribing is a key component of the value-based delivery model and should be interwoven at the forefront to create a seamless healthcare experience for all involved.”

To learn more about how Docity is meeting the demands of the healthcare community with comprehensive and innovative solutions, please visit www.DoseSpot.com or contact Shauna Leighton, Shauna@DoseSpot.com.

About Docity

Docity Health is a connect health startup headquartered in Chattanooga, TN. Their mission is to connect providers with patients and patients with their health through on demand access to healthcare. For additional information please visit www.Docity.com.

About DoseSpot

DoseSpot is a Surescriptsâ„¢ certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.

The Uber of Healthcare…No, Really.

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As the healthcare industry shifts to a value-based care delivery model, that is, the value equivalent to patient outcomes over cost, more and more initiatives are being introduced as a way to combat the ever-increasing wasted costs our healthcare system experiences. This includes efforts to reduce hospital readmissions, better manage pharmacy drug spend and medication adherence, and broaden access to care, especially for the elderly, disabled and low-income patients.

While many programs are in place to provide services for the above mentioned, one may not realize how transportation costs are attributing to the rising healthcare spend. One may also not view Uber as an innovative solution for reducing such costs, however the company, partnered with Circulation, has recently announced a HIPAA compliant pilot program with certain hospitals that will provide non-emergency medical transportation in urban areas within Massachusetts, Pennsylvania and Delaware.

Why does this matter?

In a given year, 3.6 Million Americans, including almost one million children, will miss doctor’s appointments due to a lack of transportation or one’s inability to drive, resulting in wasted spend for the healthcare system. More specifically, Medicaid spends $3 Billion per year on non-emergency medical transportation, with a third of those payments being deemed inappropriate.

How does it work?

Circulation is integrated with existing and on-demand secure healthcare information systems that schedules non-emergency medical rides that are affordable and tailored for patients’ specific needs such as wheelchair accessibility. Patients do not even need to utilize the Uber mobile app or own a smartphone. They can simply call to schedule their pick-up time and after dispatch confirms their eligibility and transport authorization, they will receive a text, call or email confirming the driver’s estimated pick-up time and description of the vehicle to which they are then safely driven to and from their destination.

Research thus far has proven to reduce wait times for transportation by almost 30 percent and cut costs by almost a third, while boasting patient satisfaction at 80 percent.

Uber and Circulation provide more than just a ride – they are creating a seamless experience for patients, providers and hospital staff all from one convenient interface and in real-time. The system not only allows the scheduling of transportation, but also notifies providers when a patient has arrived for their appointment.

With the current unmodernized healthcare transportation system in place, this program proves to be an innovative step in the right direction.

Sources: Business Wire; HealthcareIT News; Circulation; JAMA

Photo Credit: Google Play

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit http://www.DoseSpot.com.

3 Takeaways from Boston’s Opioid Summit and Hack-a-Thon

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Recently, DoseSpot was fortunate to attend Boston’s first ever opioid epidemic hack-a-thon to hear from key opinion leaders in an effort to pitch solutions on how to combat the country’s rising opioid epidemic. Sponsored by the GE Foundation and Massachusetts General Hospital (MGH), the event was comprised of like-minded individuals from all walks of life and specialties, many whom normally wouldn’t sit side by side in the same room until this specific event brought them together. Attendees were given the opportunity to innovate, think differently about this issue and further realize that a significant change is needed in order to tackle this fatal crisis currently grappling our nation.

After attending the summit, the message was clear: we can no longer sit back and believe that there is a one-stop solution. Collective efforts must be put in place and educating and incorporating all components of the healthcare system is imperative to its success.

Here are DoseSpot’s 3 takeaways from the summit:

Opioid addiction does not discriminate

Athletes, politicians, police officers, clinicians, mothers, fathers, siblings, children. Regardless of one’s socioeconomic status, opioid abuse and addiction can affect anyone. In MA alone, there are 4 deaths per day due to opioid overdose and in 2012 there were enough opioid prescriptions to give every American adult their own bottle of pills. However, beyond these statistics are the stories and these courageous stories rang loudly throughout the entire event.

Treat opioid addiction just like any other chronic illness

The stigma associated with addiction often deters people from receiving the treatment they need, and worse, sometimes that stigma is put in place by the very people meant to help them. As many of the speakers at the summit expressed, overcoming stigma should be of utmost priority and addiction should be treated in an effective, mainstream way just like any other condition. Addiction is not a choice; it is a disease.

There needs to be multifaceted solutions to tackle this complex problem

One panelist pointed out that the nation is not thinking big enough or differently enough. Clinicians and healthcare professionals may have blinders on when treating patients, but “one size does not fit all” should be the mantra that everyone utilizes when evaluating their treatment approach. A provider shouldn’t refer to themselves as a one treatment option provider, but utilize all best practices available. As Governor Baker asked, “Wouldn’t you be a better clinician if you expanded your knowledge through a variety of options and techniques?” This includes big data, analytics, e-Prescribing, Medication Assisted Therapy (MAT) and much, much more.

Sources: WBUR; Boston Globe; The Daily Free Press; Boston Business Journal

About DoseSpot

DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.