In theory, electronic prescribing of controlled substances should be in wide use these days, as there’s never been more pressure of doctors to be very aware of and document carefully such prescriptions. However, a new blog item from ONC notes that this is not exactly how things stand.
In their recent item, doctors Andrew Gettinger and Thomas Mason note that there are a number of good reasons to use EPCS technology, including that it can support direct integration of opioid prescription information into EHRs and that it can streamline clinician workflow.
However, as Gettinger and Mason note, research from the National Electronic Health Record Survey found that as of 2017, only 32% of physicians used EPCS. The level of EPCS use varied significantly among different specialists, practice sizes and practice ownership structures.
For example, the research found that pain management specialists made an average of almost 1,400 Medicare Part D opioid prescription claims in 2016, with 20% of them transmitting the scripts via EPCS technology. Meanwhile, family practitioners made less than 250 opioid claims on average in 2016, with just 15% doing so electronically.
Also, 59% of physicians in groups of 100 or more physicians used EPCS in 2017, compared with 23% of physicians in a solo practice. What’s more, physicians in groups owned by health plans, HMOs, hospitals or other healthcare entities use EPCS at higher rates than those in private practice.
Technology usage patterns also seem to have an impact on EPCS use. For one thing, doctors using an ONC-certified EHR prescribe electronically at higher rates than those using uncertified EHRs, and half of physicians who are able to send, receive, find and integrate health information e-prescribe, compared with 29% of those who can’t perform in all four interoperability domains.
In considering these statistics, it’s worth noting that these numbers are likely to shift meaningfully over the next couple of years. In October 2018, Congress passed the Substance Use-Disorder Prevent that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, which requires that all Medicare Part D providers electronically prescribe controlled substances by 2021.
In the meantime, given the wide variations in EPCS use, it will be important to keep an eye on spontaneous adoption rates among physicians in different settings and specialties.
As with most other technologies, EPCS is most likely to generate maximum benefits if it’s near-universally used. At that point, physicians and practices begin to see the real benefits of scaling up their participation and taking ownership of the processes involved, which ultimately leads to a sustainable system. However, the statistics highlighted by Gettinger and Mason suggest that the process could use a helping hand.