As electronic prescribing mandates sweep the nation, it’s clear that paper prescriptions are on the way out, even as some states include exemptions for hospice. The first of 2020 saw five more states implement e- prescribing laws for controlled substances. By this time next year, at least 16 more states will follow suit.
As of today, 27 states (accounting for three quarters of the U.S. population) have passed laws mandating e-prescribing for controlled medications. Five of the laws go further, requiring e-prescribing for nearly all prescriptions.
Even without a mandate, the growing ease of e-prescribing and its substantial benefits for patients and providers offer more than enough reason to finally get rid of that fax machine. These include:
- Speed: E-prescribing systems prompt the prescriber to choose the drug, select from available dosages and quickly add common instructions, leading to faster prescribing and dispensing
- Accuracy: With fewer opportunities for error for both prescriber and pharmacist, e-Prescribing can reduce drug errors as well as highlighting potential allergies or interactions.
- Security: E-prescribing virtually eliminates the risk of tampering or altering prescriptions.
- Reporting: E-prescribing provides additional reporting tools as well as data points such as time from request to prescription.
Enclara continues to develop technology and resources to assist clients in the adoption of e-prescribing protocols. Over 60% of Enclara Pharmacia nurses are now using our E3 MobileTM app that ties together e-prescribing, patient medication records and formulary guidance to save time and improve care. A new desktop version, E3 ConnectTM, is coming to our client portal soon, enabling more flexibility and better coordination between nurses and managers. With available EMR integration, the benefits are even greater.
A Look at the Spread of E-Prescribing Mandates
It’s important for hospice executives to understand the urgency of the shift to e-prescribing. A decade ago, the DEA did not even permit e-prescribing for controlled substances. Prior to this year, just five states had mandates:
- Minnesota (2011, all prescriptions, not currently enforced)
- New York (2016, all prescriptions)
- Maine (2017, all controlled substances)
- Connecticut (2018, all controlled substances)
- Pennsylvania (2019, all controlled substances, hospice exemption)
Five more states implemented mandates on the first of the 2020 (Virginia’s law takes effect in July):
- Arizona (Schedule II, hospice exemption)
- Iowa (All prescriptions)
- North Carolina (Schedule II-III)
- Oklahoma (All controlled substances)
- Rhode Island (All prescriptions)
- Virginia (July 2020, any controlled substance containing an opiate, hospice exemption)
In 2021, however, at least 15 more states will implement mandates:
- Arkansas (All controlled substances)
- Colorado (All controlled substances, hospice exemption)
- Delaware (All prescriptions)
- Florida (All prescriptions, hospice exemption)
- Indiana (All controlled substances)
- Kansas (Any controlled substances containing an opiate)
- Kentucky (All controlled substances, hospice exemption)
- Massachusetts (All controlled substances)
- Missouri (All controlled substances)
- Nevada (All controlled substances)
- South Carolina (All controlled substances)
- Tennessee (Schedule II)
- Texas (All controlled substances)
- Washington (All controlled substances, hospice exemption)
- Wyoming (All controlled substances)
Additionally, the federal government will require e-prescribing for all controlled substances covered under Medicare Part D by 2021. While that rule does not affect hospices, things could change if the Medicare Advantage hospice carveout is successful.
As requirements to electronically prescribe controlled substances becomes standard, it’s likely more states will consider joining the five whose mandates cover all medications.
If you’re a current client looking to implement or expand e-prescribing, contact your account manager. We encourage our clients to consult their counsel to determine how e-prescribing may affect their practice. Not a member of the Enclara family? Contact us to learn how Enclara can design a solution just for you.