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6 Must-do’s to Prepare for I-Stop



Many New York physicians may feel they dodged a bullet on March 13, 2015, when Governor Cuomo signed bill S2486, delaying the mandatory ePrescribing component of the I-STOP bill for one year. New York practitioners have until March 27, 2016, to comply with the law, and other states will soon follow.

To reiterate from the New York State Bureau of Narcotics Enforcement website, “Although this amendment extends the effective date of mandated electronic prescribing, ePrescribing of both controlled and non-controlled substances is currently permissible in New York. Practitioners must continue their efforts to become compliant with the requirement, including working with their software vendors to implement the additional security requirements needed for ePrescribing of controlled substances, and registering their certified software applications with the Bureau of Narcotic Enforcement.”1

As a provider, this means you should still work toward implementing controlled substance ePrescribing in the coming weeks. The main reason behind the delay is that many clinical IT vendors were not equipped to meet the deadline, despite having three years to prepare.

Even though many healthcare organizations, physician advocacy groups and practitioners asked for the delay, virtually no one is suggesting that universal ePrescribing should not be enacted, when ready, in New York and beyond. ePrescribing is critically important for both providers and patients, we’ll take a closer look at how ePrescribing can improve practice workflows, protect against drug misuse, and ultimately, help improve patient outcomes.

Fight Prescription Drug Abuse
Nationwide, drug overdose is the leading cause of death from injury, according to the Centers for Disease Control and Prevention (CDC)2, with most of those drug overdose deaths (53%) being caused by prescription drugs. An alarming 6.2 million adults in the U.S. use prescription drugs non-medically. Forty-six patients die each day from an overdose of prescription painkillers, and another 6,748 end up in emergency departments for the misuse or abuse of drugs. In 2013, a shocking 22,767 drug overdose deaths were related to pharmaceuticals. This is why the CDC has termed drug abuse as an epidemic, causing more deaths than traffic accidents.

In New York State, drug overdose deaths have risen 56% since 1999, according to the CDC, and New York physicians are the first line of defense in preventing drug-seeking patients from misusing prescription medications.

6 Advantages to ePrescribing

1. Improved Patient Safety
The most significant advance that ePrescribing gives providers is in the improvement to the safety and quality of patient care. Access to patient medication history during the prescribing process gives providers better information about home medications and meds prescribed by other physicians. Combining medication history with automated clinical decision support, such as formulary compliance, dose checking, drug-to-drug, drug-to-allergy, drug-to-condition and duplicate therapy alerts, helps remind providers when there might be an increased risk of over-prescribing, or prescribing medications and combinations that may cause adverse drug events. Accessing patient medication history at the point of care also helps providers more easily identify potential doctor shoppers, particularly with controlled substances, thus helping to stem prescription misuse. Doctor shopping in New York will decrease significantly after March.

2. Better Prescribing Workflow
Workflow efficiency is another key benefit to implementing ePrescribing for all meds. A study conducted by Medical Group Management Association shows that ePrescribing helps practices achieve an average annual savings of $15,769, per full-time physician, per year3. Such savings are realized in the form of lower administrative burdens, including reduced time for providers and staff, in clarifying and/or otherwise re-communicating with pharmacies and health plans regarding patient prescriptions. In addition, there is no longer a need to fax or write prescriptions on paper, enhancing workflow.

3. Meeting Meaningful Use Requirements
Another benefit to using ePrescribing for both legend drugs and controlled substances lies in meeting Meaningful Use requirements, in light of the schedule change by the DEA last year for hydrocodone combination products (HCP) from Schedule III to Schedule II. The impact of this change has been that with no call-ins or refills permitted, providers have been required to create a greater number of new prescriptions for products like Vicodin, which as a result, increased the total number of prescriptions issued. Since Meaningful Use stage 2 requires that more than 50-percent of all prescriptions must be transmitted electronically, an increase in paper prescriptions may push some physicians out of Meaningful Use compliance.

4. Patient Convenience
The advantages of ePrescribing for patients are also quite significant. In addition to the patient safety benefits outlined previously, patients save time and experience fewer hurdles while at the pharmacy. Medications are ready when the patient arrives at the pharmacy, as the formulary compliance check is already completed by the physician, and any prior authorization activities are also completed in advance. This convenience translates into better medication adherence and there is virtually no delay in patient access to their initial prescription. Some studies have demonstrated a 20% improvement with patients picking up their medications from the pharmacy as medications are ready when the patient arrives at the pharmacy as the formulary compliance check is already completed by the physician and any prior authorization activities completed in advance.

5. Pharmacy Readiness
New York providers, hospitals, pharmacies and extended care facilities are moving quickly to meet the March 7, 2016deadline. In New York State alone, there are more than 4,200 EPCS-enabled pharmacies. 97% of New York pharmacies are ready for ePrescribing, while 94% are EPCS-ready. Nationally, more than 80%, or 54,000, of all pharmacies are certified for EPCS.4

6. Security
Lastly, electronic prescribing is simply more secure than paper prescriptions. Paper prescriptions are subject to transcription errors and are targets for theft and tampering, making it relatively easy for drug-seeking patients to alter prescriptions by increasing dosage, number prescribed, or number of medication refills. In three years, up to 1.4 million prescription pads were stolen from New York hospitals.5 Special paper for prescriptions issued by New York and a few other states has helped reduce some of this fraud and diversion, but after a decade of experience, New York regulators felt that more was needed.

ePrescriptions are also delivered directly to the pharmacy, without exposing the physician’s DEA number to the patient. The consequences of DEA number theft include physician identity theft, temporary inability to prescribe controlled substances, and a damaged reputation, to name just a few.

Get Ready to ePrescribe
The benefits of universal ePrescribing are numerous, which is why physicians should consider implementation of ePrescribing for both legend drugs and controlled substances now, regardless of the recently extended I-STOP deadline. The value to practitioners and patients is clear. It is important that practices deploy an ePrescribing solution sooner rather than later to avoid other pitfalls, particularly involving office staff as they transition away from paper.

AdvancedMD is Ready
As leaders in the healthcare technology community, AdvancedMD is in the process of implementing EPCS for our independent practices located in New York and beyond. We know the benefits to you and your patients, such as reducing drug abuse, fraud, diversion, improving patient safety and streamlining workflow, will definitely be worth the effort.

Learn more about ePrescribing with AdvancedEPCS. Schedule a free demo of AdvancedMD today.


1. New York Bureau of Narcotics Enforcement,, December 2015.
2. Centers for Disease Control and Prevention,, 2013.
3. Medical Group Management Association,, 2014.
4. Soble-Lernor, Michelle, Helping Physicians Take Full Advantage of EPCS, DrFirst, September 21, 2015.
5. New York ePrescribing Mandate, Fighting Prescription Drug Abuse with Technology, DrFirst, September 21, 2015.
Article courtesy of Dr. Peter Kaufman, DrFirst, May 27, 2015.

Topic: EMR/EHR, Meaningful Use

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