The Insider Threat: The Assistants

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As we continue our Insider Threat series, we look to the role of the assistants within a dental practice. Specifically, the office assistant and the dental assistant. Though their responsibilities may vary from one practice to another, as well as from each other, assistants are often tasked with a myriad of similar duties, including having access to a dentist’s prescription pad or prescription software. The dental assistant, in particular, serves as a direct extension to the dentist and typically writes or calls in prescriptions on the dentist’s behalf.

Though the perceived trusting relationship between a dentist and their assistant(s) may alleviate the daily mundane tasks for the dentist, how much trust is too much? Should a dentist’s prescription pad or prescription software really be that accessible to anyone within the office? Let’s take a deeper dive and review three cases of prescription fraud committed by an office or dental assistant.

First up, in a West Michigan dental office, an office assistant decided to stay after hours and throw a party for some friends. Not only were multiple items stolen, but her friends utilized the dentist’s DEA number to call in and obtain unauthorized prescriptions from multiple pharmacies. Of the items stolen were the dentist’s prescription pad and signature stamp, of which, both were laying around in plain sight and available for anyone to take.

Another office assistant in Bethlehem, PA, whom had free access to a dentist’s prescription pad, admitted to taking two prescription slips, filling them out in the dentist’s name and authorizing 10 Percocet tablets on each for a family member. Not only were the unauthorized prescriptions filled, but the quantity dispensed was altered from 10 to 20 pills, which is easy to do given that they were paper prescriptions.

Lastly, a dental assistant in Alaska was found guilty of prescription fraud for phoning in numerous prescriptions for Vicodin on behalf of the dentist for a non-patient. In her capacity working in the dental office, she was allowed to call in prescriptions for patients, but took complete advantage of that authority. The pharmacist found the situation to be suspicious and contacted the dentist, whom confirmed that he had never authorized such prescriptions.

While the saying “any publicity is good publicity” may work in certain situations, bad press for a local dentist can be extremely detrimental. All three articles pertaining to the stories above include the dentist’s name and practice location, therefore there is no real way to hide from such unfortunate circumstances and stories like these have the potential to deter both current and prospective patients from a dental practice.

Luckily with e-Prescribing, there is no more need for paper prescriptions, therefore no more altered dispense quantities and no more stolen prescription pads. Furthermore, prescriptions will no longer need to be phoned in since it’s a simple click to send a prescription on its way to the pharmacy with no intermediary. A significant decline will also occur relative to the rate of fraud, resale and abuse of controlled substances because e-Prescribing secures all information exchanges from diversion.

 Click here to learn more about e-Prescribing and start saving time and money today!

This is not to say that assistants cannot aid a dentist with their patient’s prescriptions, quite the opposite in fact. When utilizing DoseSpot and with a dentist’s permission, office and dental assistants can receive their own e-Prescribing account and create prescriptions on behalf of the dentist. However, the dentist must utilize their own unique security passcodes to authorize and send the prescriptions along to the pharmacy, which is especially important when prescribing controlled substances.

To complete our Insider Threat series, we will be discussing how it’s not only office staff, but also fellow dentists, who can be a potential risk for prescription fraud within a dental practice. Look out for our next installment coming to you on Thursday, August 25^th!

Sources: Juneau Empire; Wood TV; WFMZ

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

The Insider Threat: The Office Manager

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To kick off our Insider Threat series, we shine light on dental practice Office Managers and the trusting relationship they share with dentists. After all, the office manager is meant to be the dentists’ point person who relieves them of administrative and financial duties within the office. Therefore, when it comes to the clinical management of patients, how much control should office managers have? Should office managers have access to the dentist’s prescription pad or prescription software?

Let’s take a look at Nicole Allenton, a now ex dental practice office manager in Washington state whom is serving one year in county jail for forging numerous prescriptions. Utilizing the office’s practice management software, Allenton took advantage of her position of trust and authority to print and fill 15 unauthorized pain medication prescriptions for herself and family members. None of whom were the dentist’s patients and sadly, this wasn’t her first time committing prescription fraud. She previously worked as a dental hygienist in another dental office and pulled off another non-sophisticated scheme to receive pain medication prescriptions simply by phoning the pharmacy “on behalf” of the dentist.

How could this possibly happen, you ask? Regardless of the trust factor, or lack thereof, the computer software in which the dental office deployed was not equipped to handle e-Prescribing. Although prescriptions were entered into the computer system, they could not be transmitted electronically to the pharmacy – they had to be printed, thus giving Allenton a perfect opportunity to take advantage of her superior’s handy DEA number and signature.

 Click here to learn more about e-Prescribing and start saving time and money today!

With written, printed or phoned in prescriptions, there are no checks and balances in place. Since e-Prescribing requires two-factors of authentication for controlled substances, Allenton wouldn’t have been able to forge any prescriptions since a dentist must enter two unique passcodes, including a 6 digit passcode that changes every 30 seconds. Furthermore, e-Prescribing provides a fully electronic audit trail which gives dentists complete insight into all of their prescription activity.

The aftermath pertaining to this case is substantial and it’s safe to say that the price to pay for not controlling prescription access is no laughing matter. Not only did Allenton end up behind bars, but as a result of her actions the two offices in which she was employed experienced severe financial repercussions and one office had to close its doors altogether.

Unfortunately, there are many instances in which a dental office employee has committed prescription fraud. As we will uncover in our next two cases, the office manager isn’t the only potential Insider Threat. Stay tuned for our next case, The Assistants, coming to you on Tuesday, August 23rd!

Sources: Tri-City Herald; News Talk

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

“Protecting the pill:” Johns Hopkins students develop tamper-proof, biometric pill bottle

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Over the past few years, prescription drug abuse has been a heated topic here in the U.S. among healthcare professionals and policymakers alike. Engineering students within Johns Hopkins University’s Whiting School of Engineering are taking strides to address continuously alarming drug abuse statistics with the creation of a novel, tamper-proof pill bottle.

As cited in HIStalk Connect’s article, the engineering students were called upon by the Johns Hopkins Bloomberg School of Public Health to undertake this special project. With more than 16,000 annual deaths attributed to prescription drug-related overdoses, the goal of Hopkins’ project was to develop a robust pill bottle that would help control the nation’s relatively unsecured supply of prescription narcotics. According to assistant professor at the Bloomberg School of Public Health, Kavi Bhalla, the overseeing team wanted “this personal pill ‘safe’ to have tamper resistance, personal identification capabilities and a locking mechanism that allows only a pharmacist to load the device with pills.”

The four engineering undergrads assigned to take on this project answered accordingly–by developing a 2.75 pound, nine-inch-tall, steel-constructed pill bottle that can withstand any hammer or drill activity. Additionally, fingerprint scanners are used to regulate dispensing and ensure that pills are only released to the patient a medication is prescribed to–at proper time intervals and in correct doses. After gaining positive feedback from both Bloomberg clinicians and pharmacists at the on-campus Rite Aid, Hopkins engineering students uncovered an important and overlooked design value: the ability to record medication adherence rates. If connected to a monitoring system, the tamper-proof pill bottle (again, equipped with fingerprint reading capabilities) could eventually be useful to payers and health systems working to reduce funds wasted on poor medication adherence.

For healthcare software companies looking to incorporate the ability to electronically prescribe controlled substances (EPCS), DoseSpot could be your solution of choice in just a few hours, days or weeks! Through our third party EPCS audit with Drummond Group Inc., a global software test and certification body that is approved by the Drug Enforcement Administration to audit EPCS software applications, DoseSpot is now able to deliver audited and trusted EPCS software applications to customers. For more information on DoseSpot’s EPCS software, please download our Integration Tool Kit here!

SOURCE: HIStalk

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.

DoseSpot Completes Electronic Prescribing of Controlled Substances Certification with Drummond Group

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Needham Heights, MA (PRWEB) October 15, 2014 - DoseSpot, an industry leader in e-Prescribing integration platforms for medical, dental and telehealth software, today announced that its software application has completed the required third-party Electronic Prescribing of Controlled Substances (EPCS) audit with Drummond Group Inc., a global software test and certification body that was approved by the Drug Enforcement Administration (DEA) to audit EPCS software applications.

DoseSpot selectively pursued EPCS Certification with Drummond Group, one of the first DEA approved certification bodies. “After undergoing Drummond Group’s extensive audit process and phased approach to understanding the EPCS requirements, DoseSpot may now deliver audited and trusted EPCS software to their customers,” said Aaron Gomez, Drummond Group’s Director of EPCS Auditing.

The audited EPCS software also incorporates industry leading two-factor authentication and identity proofing technologies to meet the requirements of the DEA Interim Final Rule for EPCS. “We strive to provide an easy-to-use e-Prescribing interface and our team has successfully incorporated the EPCS functionality without disrupting our existing user experience,” said Greg Waldstreicher, President, DoseSpot.

DoseSpot prescribers will now have the ability to e-Prescribe controlled substances in 49 states. “In less than six months, New York will be the first state to mandate e-Prescribing, including EPCS,” added Greg Waldstreicher. “We are committed to offering the best e-Prescribing integration experience for our current and future software customers and have made the process for enabling EPCS incredibly easy.”

For more information on DoseSpot’s EPCS software, please visit http://www.DoseSpot.com or contact Lindsay Walsh, Lindsay(at)dosespot(dot)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 has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. To request a demo of DoseSpot’s e-Prescribing integration platforms, please visit http://www.DoseSpot.com/.

About Drummond Group Inc. 
Drummond Group Inc. is a global software test and certification lab and third-party auditor that serves a wide range of vertical industries. In healthcare, Drummond Group tests and certifies Controlled Substance Ordering Systems (CSOS), Electronic Prescription of Controlled Substances (EPCS) software and processes, and Electronic Health Records (EHRs) – designating the trusted test lab as the only third-party certifier/auditor of all three initiatives designed to move the industry toward a digital future. Founded in 1999, and accredited for the Office of the National Coordinator HIT Certification Program as an Authorized Certification Body (ACB) and an Authorized Test Lab (ATL), Drummond Group continues to build upon its deep experience and expertise necessary to deliver reliable and cost-effective services. For more information, please visit http://www.drummondgroup.com or email DGI(at)drummondgroup(dot)com.

Read the full press release here: http://www.prweb.com/releases/2014/10/prweb12249755.htm

ePrescribe Controlled Substances in 2010?

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After a long anticipated wait, the DEA is revising its regulations to provide prescribers the ability to electronically prescribe controlled substances.

On June 27, 2008, DEA published a Notice of Proposed Rulemaking (NPRM) to revise the regulation to allow creation, signature, transmission and processing of controlled substances electronically. The DEA gave consideration to over 200 comments while drafting the IFR.

The DEA’s obligation as noted in the rule, is to ensure that the regulations minimize, to the greatest extent possible, the potential for diversion of a controlled substance resulting from non-registrants gaining access to electronic prescribing applications and systems.  The concern of insufficient Security has been the main barrier to allowing the ePrescription of controlled substances.  The authentication methods used in online or desktop applications is generally username and password.  Passwords are easily guessed or broken by using various password guessing programs.

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E-Prescribing 101

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

• E-prescribing 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 physician’s instructions.
• Electronic prescribing software eliminates the time and effort of trying to understand the prescriber’s handwriting, as well as the chance of an error in that translation.
• E-prescribing significantly reduces the chance that the prescriber’s intentions are misinterpreted.
• E-prescribing is often used in conjuction with clinical decision support to ensure that any drug to drug interactions or drug to diagnosis issues are found and reported to the physician before the prescription order is completed.

Electronic prescribing is considered one of the most important areas of Healthcare IT, which is why Medicare created payment incentives for physicians who use a qualified e-prescribing system. In 2009, the incentives are an increase of 2% in revenue for each patient when e-prescribing is used. Due to the 2009 HITECH Act, electronic prescribing is required as part of any EMR (EHR) which qualifies for Medicare reimbursement in 2011.