Readers Write: Understanding the Importance of Prioritizing e-Prescribing

Understanding the Importance of Prioritizing e-Prescribing
By Louis Hyman

As the industry awaits confirmation of a compliance deadline delay for the New York State e-prescribing mandate—which will require electronic prescribing of controlled and non-controlled substances—it’s important that providers don’t delay their preparation efforts, as this process can be time- and resource-consuming.

Under provisions of the New York State e-prescribing mandate and subsequent regulations (such as amendments to Title 10 NYCRR Part 80 Rules and Regulations), all prescriptions in the state must be transmitted electronically by authorized prescribers unless an exception exists. However, as many providers are struggling to meet compliance by the original March 27, 2015 deadline due to a myriad of challenges beyond their control, the New York legislature is working to pass a law to delay implementation of the mandate to March 27, 2016.

No matter the timing of the deadline, this mandate serves to be a game-changer for how providers share prescription information, and they should be aware that other states are closely watching New York’s rollout, with several already considering following suit.

The scope is intensified because the law covers both controlled and non-controlled medications and applies to all providers in New York State, including long-term and post-acute care organizations (LTPACs) and senior living facilities. Providers must start transitioning to the new requirement now to avoid significant penalties including fines, imprisonment, and/or professional license suspension or revocation.

As such, providers must make e-prescribing a priority in the midst of other major industry initiatives such as ICD-10 and Meaningful Use. However, e-prescribing easily can be incorporated into these efforts if organizations are already leveraging technology and staff training in their preparation.

To comply with the new mandate, healthcare organizations first must fully comprehend its scope. They need to look at its impact on provider, practice, and facility workflows, as well as how it ultimately affects patient or resident care. The following four best practices can help healthcare organizations engage providers and create a smoother transition:

1. Generate physician awareness of the implications. Regardless of the care venue, it’s important to meet with physicians to raise their level of awareness and engage them in understanding the law’s full scope. Providers need to be clear on what is expected from them within the new e-prescribing workflows, just as they adapted workflows for EHR implementations to meet Meaningful Use requirements. Building physician awareness is even more critical among those organizations that have not yet implemented an EHR and may therefore require standalone computerized order entry or electronic prescribing technology. These providers may not be accustomed to any form of e-prescribing.
2. Evaluate the workflows of all clinicians involved in the traditional prescribing process. This step is especially important in regard to the complex workflows in hospitals, skilled nursing facilities, and other senior living care settings. Because the law applies to both controlled and non-controlled medications and does not allow physicians to delegate the final steps within the prescribing process, four basic workflows need to be reviewed to understand how they will be impacted by e-prescribing. These workflows include: orders generated in-house for controlled medications, orders generated in-house for non-controlled medications, orders generated upon discharge for controlled medications, and orders generated upon discharge for non-controlled medications. Additionally, providers should examine specific workflows for nurses, physicians, and other clinicians. For instance, because telephone orders will no longer be accepted, healthcare organizations need to plan for physician availability during off hours and periods of high admission and discharge volumes.
3. Engage caregivers in decisions. Because caregivers are key stakeholders, they should be included in the workflow evaluation to gain accurate insight into the overall impact of e-prescribing. It’s important for organizations to involve these individuals in any technology selection as well to ensure the appropriate tools are in place to support necessary workflows. As part of the selection process, engage caregivers in active testing of how their workflows are accommodated on a day-to-day basis. Beyond supporting workflows, healthcare organizations also should confirm the selected technology performs on a variety of platforms used by caregivers – such as tablets, smartphones, laptops, and PCs, as the physician may not always be on site.
4. Train and practice e-prescribing. With workflows and technology in place, it’s now time to employ a robust training program to support efficiency and compliance by all caregivers. Providers should begin actively practicing e-prescribing as soon as possible to identify and resolve any issues prior to the compliance date.

Even with the possible New York State e-prescribing mandate deadline delay to March 27, 2016, New York providers need to make e-prescribing a priority. By focusing now on an e-prescribing strategy, healthcare organizations and providers across all care settings – including LTPACs and senior living providers – can realize the benefits to medication management and patient/resident safety while also maintaining compliance.

Louis Hyman is chief technology officer for SigmaCare.