How a Nevada health system keeps patients, providers safe with remote prescribing

Electronic prescribing for controlled substances eliminates paper prescriptions, and thereby reduces the need for in-person visits, allowing patients and providers to follow social distancing policies amid the pandemic.

Imprivata's platform allows for remote implementation of EPCS, while remaining compliant with federal regulations and maintaining patient safety. 

In a June 23 webinar presented by Becker's Healthcare and sponsored by Imprivata, leaders from Reno, Nev.-based Renown Health and Imprivata discussed how organizations can meet Drug Enforcement Administration requirements while moving to all electronic prescriptions, a potentially difficult process amid the pandemic. The discussion centered around the key policy, process, and technology decisions that Renown Health, a system consisting of three hospitals and more than 70 clinics, did to successfully enable EPCS.

The speakers were: 

  • Patrick Woodard, MHA, MD, vice president and chief medical informatics officer for Renown Health  
  • Dan Borgasano, vice president of product marketing for Imprivata 

Below are five key points about EPCS: 

1. EPCS are beneficial for both patients and providers, Dr. Woodward said. Beginning in January 2021, the federal SUPPORT for Patients and Communities Act requires electronic prescribing for controlled substances when serving Medicare Part D patients. That's about half of Renown's patients, according to Dr. Woodward. Nevada will require electronic prescriptions for all controlled substances starting in 2021, with several other states implementing similar mandates. Complete use of EPCS can also improve provider prescribing workflows. Having a manual process for controlled substances and electronic prescribing for non-controlled substances was inefficient, as well as inconvenient for patients. Some pharmacies and payers are even refusing paper prescriptions. 

2. Currently 29 states have EPCS regulatory mandates, Mr. Borgasano said. The DEA requires all providers to complete identity proofing before they can be enabled for EPCS. DEA clarified that remote institutional identity proofing is allowed, so long as organizations meet additional requirements. Imprivata Solution has nomination, identity proofing, credential enrollment, two-factor authentication and logical access control. Renown used about 85 percent Imprivata Professional Services, along with internal resources, to enroll 250 providers in the first two days. Enrollment went significantly faster than a lot of people are used to, Dr. Woodward said, which has helped drive results.

3. Imprivata offers Zoom sessions to help complete remote identity proofing for EPCS. During the scheduled session, providers show their government-issued photo ID to the enrollment supervisor, who will then give the provider control of the session. The provider will enter their password to attest to the identity proofing, along with their Imprivata ID mobile token information that the enrollment supervisor authenticates. Dr. Woodward said blocking time in providers' calendars for the remote enrollment session can help, though the total process takes about 5 to 10 minutes, depending on the provider's comfort level with the technology. A similar workflow can be used for internal processes, and providers can contact practice managers for 'on-the-fly' enrollments if needed. 

4. Renown chose Imprivata Confirm ID because the solution met the organization's needs for the entire EPCS process. While Renown could have completed some parts of the process on its own, the organization wanted to focus on patient care. "The hardest component of this is not the technological one," Dr. Woodward said. "When COVID-19 hit, we needed to quickly adjust our plan and accelerate our timeline to enable remote identity proofing and provider enrollment." 

The move to a virtual work environment helped get more providers on board with EPCS. Just three weeks after EPCS went live, 47.5 percent of prescriptions for controlled substances were electronic. To date, 50 percent of Renown providers are enrolled. Patients have also benefited, with the ability to avoid in-person pickups of paper prescriptions.

6. Imprivata Confirm ID is a compliant, convenient and complete EPCS solution, Mr. Borgasano said. Imprivata has significant experience with EPCS regulatory mandates, and the solution offers end-to-end recordkeeping and reporting. The solution is beneficial for not only providers, but patients as well, and can now be implemented remotely. 

Click here for more information about Imprivata.  

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