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.

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.

Massachusetts’ Prescription Monitoring Program Takes a New Turn

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For the first 6 months of 2016 in Massachusetts, there have been almost 500 confirmed cases of unintentional opioid overdose deaths and an estimated 500 additional cases have not yet been confirmed.

The majority of overdoses found in MA are due to substances such as fentanyl and heroin, but rates of cocaine and benzodiazepines present in opioid deaths have been steady since 2014. Although the rates of heroin and prescription drugs present in opioid deaths have been decreasing due to many efforts that have been implemented across the nation, the rate of fentanyl has been on the rise. This is in large part due to the fact that many opioid addictions start at the hands of a prescriber with a prescription and when the pill bottle runs dry, patients are left seeking other options that produce the same euphoric effect.

With the rapid increase of deaths and devastation by way of the current opioid epidemic plaguing the state, Massachusetts has recently implemented further requirements concerning practitioner’s prescribing protocols. Specifically, with the state’s Prescription Monitoring Program, or PMP.

The PMP serves as a database for all prescription drugs that are dispensed across the state, including those that are highly sought after for non-medical use and represent the highest potential for abuse, better known as Schedule II-V drugs such as narcotics, sedatives, and stimulants.

When properly used, the PMP aids in the identification and prevention of drug misuse, diversion, and potential doctor shopping by providing a patient’s medication history of the past 12 months. It is meant to be utilized as a key clinical decision-making tool that allows providers to receive a big picture view of the patient they are treating in real time.

As a solution to this widespread epidemic, Massachusetts has introduced new legislation and requirements when utilizing the MassPAT (Massachusetts Prescription Awareness Tool).

Effective October 15, 2016, practitioners must abide by the following:

1. A registered individual practitioner must utilize the prescription monitoring program each time the practitioner issues a prescription to a patient EACH time for a narcotic drug in Schedule II or III.
2. A registered individual practitioner must utilize the prescription monitoring program prior to prescribing to a patient for the first time:
   1. A benzodiazepine; OR
   2. Any controlled substance in Scheduled IV or V which the department has designated in guidance as a drug that is commonly abused and may lead to dependence. At this time, there are no drugs that have received this designation.

Prior to the aforementioned requirements, legislation ruled that practitioners, among other factors, need only check the state PMP when prescribing a controlled substance to a patient for the first time, while it is now required for a practitioner to check the system EVERY time when prescribing Schedule II or III drugs.

An example of just how serious Massachusetts is about this crisis, and also believed to be the first agreement of its kind, CVS recently paid almost $800k to the state because pharmacists were not checking prescriptions or the database thoroughly. In exchange, CVS agreed to provide its pharmacists access to the PMP website, train its pharmacists to register for and use the PMP as appropriate, and has further agreed to implement policies that would require pharmacists to consult the PMP before dispensing certain opioids in MA.

Massachusetts and CVS, among many other organizations, recognize the importance of the state’s PMP as a tool to detect and prevent the abuse and misuse of controlled substances. The PMP is not meant to be another government-controlled, green monster hanging on a practitioner’s back at all times; it is meant to serve as a safety extension for practitioners, but most importantly for their patients.

PMP’s can also be most effective when linked with an e-Prescribing solution. Working together, e-Prescribing eliminates the need for paper prescriptions, thus reducing the risk of altered dispense quantities, stolen prescriptions or prescription pads, and the reselling of such prescriptions before they’re filled as a means of lessening the red flags if a patient is doctor shopping.

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.

DoseSpot Forecast: 3 Segments Positioned for Telehealth Growth

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It’s no surprise that technology should be considered a key player as we shift to value-based care. With smartphones, tablets and computers, health information is readily available for patients with a simple click of a button. Why should a consultation with a healthcare professional be any different?

Telehealth greatly increases the scope of the healthcare industry and is bound to open huge opportunities in increasing the quality of healthcare. The ultimate goal here, is to prevent hospital readmissions through better management of individuals with chronic conditions, while also reducing associated costs. By enabling remote patient monitoring and remote access to clinicians, market growth is inevitable as awareness and implementation of standards for reimbursement and adoptions of these care models expands.

While several reports claim that “technology gets in the way of the patient experience,” patients are in fact the ones demanding such access to care. This increase in patient demand for telehealth services has prompted many companies and healthcare organizations to think outside of the box and reevaluate the patient-centric model, while questioning what that care model really means to a patient.

Well, it’s simple. Patients want a customized, cost-effective and convenient healthcare experience to which telehealth can provide.

A recent report states that the global telehealth market was valued at $14.3 Billion in 2014 and is estimated to reach $36.3 Billion by 2020, growing at a CAGR of 14.30% from 2014 to 2020.

With these numbers in tow, we predict the most growth in three different segments:

Behavioral Health and Addiction

As mentioned in a previous post, telehealth has the ability to bridge the gaps in care of behavioral health patients and providers. Not only does it provide a convenient, more comfortable and less expensive medical consultation, but it broadens accessibility to patients whom may not have many options when seeking a behavioral health provider, especially in rural areas. Unfortunately, the lack of psychiatrists and addiction specialists across the nation, as well as the stigma often involved, are contributing to the mental health and addiction issues and creating barriers to appropriate care.

Patients will see their primary care physician and may not receive the exact treatment plan that they need; after all, primary care physicians do not specialize in behavioral health or addiction and often, these illnesses require a lot of time and patience to which the physician may not be able to accommodate. Telehealth will be able to connect patients in need with specialists regardless of their location who know how to treat these specific health issues.

This effective care model will not only lessen the hit on the nation’s bottom line as more and more individuals grapple with suicide, addiction, and other mental health issues, but also revolutionize the way people view the stigma involved and encourage patients to seek help as they are able to receive treatment from the comfort of their own home.

Geriatric Care

Geriatric patients stand to benefit tremendously as a digital health consumer. As mobility can be especially difficult for these patients, the ability to see a physician remotely removes one of the largest barriers to care. Furthermore, transporting patients of this age may potentially do more harm than good.

With telemedicine, providers can more quickly spot at-risk patients and provide interventions to avoid an otherwise unnecessary hospital admission. Similarly, nursing homes can partner with health systems to provide bedside care for their residents at a fraction of the price of an onsite physician.

These infrastructure synergies provide connectivity with electronic health records (EHRs) and create clear communication among hospitals, senior care facilities, referring physicians and patient families. They also provide the link to population based management databases and other health care analytic functions to measure value.

Surgery

Many surgical departments find telehealth to be a more convenient and cost-effective way for pre- and post- operative instructions for procedures of all magnitudes including wisdom teeth extraction, colonoscopies, stent placement and more.

With in-person visits and paper instructions, patients may misinterpret or even forget important information relative to their surgery. This includes what medications to stop taking and how to physically prepare for surgery, while providing a clear, direct line of answers for any questions a patient may have. With instructions digitally delivered prior to surgery, telehealth reduces patient no shows and saves valuable scheduled operating room time.

For post-op patients, providers can check the patient visually, ensuring that patients are following their treatment plans and making adjustments as needed. Through this continuous connection, providers are empowered to deliver the guidance that many patients need as they go through the healing process. These virtual check-ins ensure the patient is on the road to recovery, thus reducing readmission rates all without the patient ever having to leave their home.

Furthermore, telehealth can improve treatment and medication compliance, specifically with controlled substances, i.e. pain medication. Opioid addiction often begins at the hands of a prescriber and with the nation currently facing an opioid epidemic, marrying technology and follow-up appointments when prescribing these types of medications serves as the optimal solution for the safety of all involved.

Technology should no longer be viewed as a barrier to care, but rather embraced in order to improve the healthcare industry, including the improvement of interoperability as well as patient outcomes. Telehealth not only meets the ever increasing demands of patients, but it also assists in preventative care by creating greater access to such care, thus reducing down-the-road costs and burdensome associated with chronic disease. With many chronic diseases being completely preventable, the prevent vs. treat mantra should be sound in every healthcare professional’s mind, while realizing that telehealth is a seamless way of delivering healthcare for all involved.

There may currently be barriers in place regarding reimbursement from payers, but that’s sure to change as more and more payers jump on board for this new delivery model. After all, who’s to say telehealth won’t become the norm and be known as simply….health?

Sources: American Well; OpenPR; mHealth Intelligence; Healthcare IT News

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.

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.

Dental Associates Realizes Clinical Efficiencies and Increased Patient Satisfaction with DoseSpot’s e-Prescribing of Controlled Substances Solution

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Dental Associates, a leading family group dental practice managing 14 dental clinics and over 100 dentists in Wisconsin, has realized clinical efficiencies and increased patient satisfaction since their launch of DoseSpot’s e-Prescribing of Controlled Substances (EPCS) solution in March of 2015.

Prior to the launch of DoseSpot’s e-Prescribing of Controlled Substances solutions, Dental Associates had deployed e-Prescribing software, but their dentists could only transmit non-controlled prescriptions electronically. As such, dentists wasted time electronically prescribing antibiotics and subsequently printing controlled substance prescriptions. DoseSpot now marries the two and gives Dental Associates’ dentists the ability to streamline care, spend more time with patients and discontinue the use of costly prescription printers and the associated tamper proof prescription paper.

Click here to learn how your company can simplify clinical workflows with e-Prescribing!

“We understand that healthcare technology is shifting and remaining innovative is in Dental Associates’ best interest. Our dentists find DoseSpot to be top-notch and they’re now able to spend more time with their patients rather than running back and forth between the patient’s chair and the prescription printer,” commented Donald Whamond, Chief Technology Officer, Dental Associates. “Printing prescriptions was not only wasting time and money, but also taking valuable time away from the provider-patient relationship.”

Dental Associates chose DoseSpot as its e-Prescribing partner due to DoseSpot’s unique boutique-style approach to customer service, the ease of e-Prescribing controlled and non-controlled prescriptions, and to enhance the overall security measures surrounding the prescription writing process within Dental Associates’ clinics.

“DoseSpot has made writing prescriptions easier and less time consuming. With the development of my prescription favorites list, it is easy for my staff and I to build a prescription and even change it if need be. Once the prescription is built, it is simple to select and send the prescription to the pharmacy. Life is good with DoseSpot!” said Dr. John Zweig, Chief Dental Officer, Dental Associates.

Register today for our free webinar addressing dentistry and the opioid epidemic on 9/22!

Dental Associates also wanted to stay ahead of the IT curve which in turn has allowed the company to better recruit and attract new dentists.

“Dental Associates prides itself on the patient-centric care model, therefore our patients’ well-being is of utmost priority and DoseSpot simply aligns with our company values,” Whamond added. “We can call any DoseSpot team member at any time and know they will answer right away. That includes Greg Waldstreicher, CEO, DoseSpot.”

“Like Dental Associates, DoseSpot is committed to offering innovative solutions to the dental market and we put our partners first in everything we do,” said Greg Waldstreicher. “To have the opportunity to deliver a comprehensive, personalized, and integrated platform for Dental Associates is a homerun for both parties.”

Simplify clinical workflows and improve patient outcomes with DoseSpot e-Prescribing integration for both controlled and non-controlled prescriptions. Schedule your free demo today at www.DoseSpot.com or contact Shauna Leighton, Shauna@DoseSpot.com.

About Dental Associates

Founded in 1973, Dental Associates is Wisconsin’s largest family-owned dental group practice with multiple clinics throughout the state and nearly 800 staff members. Dental Associates provides complete family dental services, both general and specialty dentistry, under one roof, from pediatric dentistry to specialized dental services for older adults with a focus on excellent care that is affordable, accessible and personalized. For additional information please visit www.DentalAssociates.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.

Steering the Path to Change: Dentistry’s Role in Addressing the Opioid Epidemic

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In recognition of Pain Awareness Month, DoseSpot will be hosting a live webinar to discuss:

• Our nation’s current opioid epidemic by the numbers
• Dentists’ roles regarding prescribing habits and how they can help steer the path to change
• The face of addiction: understanding how prescription opioids from a dentist can fuel a painful, and often fatal, battle for patients
• The path ahead including state mandates, PDMPs, e-Prescribing, and other helpful tools to properly educate and promote safe prescribing habits within dental practices

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.

Register now to reserve your spot! We hope you can join us.

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.