How Providence's remote prescribing capabilities have increased security, streamlined clinical workflows


Renton, Wash.-based Providence began its electronic prescriptions for controlled substances (EPCS) implementation project in 2018 to make e-prescribing more secure and easier to use for clinicians.

During an Oct. 14 webinar hosted by Becker's Hospital Review and sponsored by Imprivata, industry experts discussed Providence's EPCS approach and the authentication modalities it has deployed to accommodate clinical workflows.

The speakers were:

  • Scott Smitherman, MD, associate vice president and chief medical information officer for ambulatory at Providence
  • Sean Kelly, MD, chief medical officer at Imprivata

Five takeaways:

1. Motivating factors behind Providence's EPCS implementation. The health system chose to partner with Imprivata for its EPCS rollout in 2018 primarily to meet compliance with state and federal requirements. While the federal EPCS mandate was delayed until late 2021 due to the COVID-19 pandemic, they require providers to electronically prescribe controlled substances in order to get reimbursement for Medicare through CMS, Dr. Kelly said. 

2. Providence's EPCS rollout plan. Since starting its EPCS implementation in 2018, Providence has deployed it across 51 hospitals and in more than 750 clinics in Washington, Oregon, Alaska, Montana and California. Having a comprehensive plan in place and the support of clinicians has been integral to the process, Dr. Smitherman said.

"You absolutely need to have clinicians help drive [the implementation]," he said. "Once you get EPCS integrated into your EMR and it works as smoothly as ours does, it's just an easier path. We don't have a lot of trouble getting people to use EPCS once they get signed up because patients like it and then the physicians ultimately don't want to chase down paper scripts."

3. Imprivata expands identity proofing. Imprivata works with Providence and other health systems to help them delegate the task of identity proofing providers, which ensures the person who signs a prescription is eligible to do so. With Imprivata's platform, administrative employees can enroll providers in EPCS via laptop to simplify the process and establish a secure chain of trust from a usability standpoint, Dr. Kelly said.

4. EPCS for easiest, lowest cost and high volume workflows. While Providence has deployed various multifactor authentication modalities for EPCS workflows, Dr. Smitherman said passwords as the first factor are the easiest and cheapest to implement and that the health system uses finger print scanners in high volume areas such as the emergency department where physicians don't always have their phones.

5. EPCS for fastest workflows and remote prescribing. Hands-free authentication is the quickest EPCS method for physicians; it is powered via Bluetooth that searches for the presence of a physician's phone nearby and then authenticates their identity and account without them needing to take any action on their phone. Dr. Smitherman said he also encourages all Providence physicians to sign up for Providence's push token app on their phones, which allows them to remotely log into the Epic EHR and refill prescriptions by typing in their password and using the push token on their phone to log in. 

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