E-prescribing Tackles the Opioid Epidemic

Using two-factor authentication when e-prescribing for controlled substances saves physicians hours and helps stem prescription drug abuse.

As the U.S. Senate begins reconciling its bill to stem the opioid epidemic with the House, one health system in Massachusetts is already using e-prescribing technology, newly enabled to include controlled substances, to help reduce opioid abuse.

An executive at Massachusetts-based Cambridge Health Alliance says the system, in place for a year, has already saved its more than 700 physicians hundreds of hours and has made patients' lives immeasurably easier.

Using two-factor physician authentication technology from Imprivata, a year ago CHA bid farewell to the lion's share of use of secured, controlled paper printing for writing prescriptions for controlled substances.

In its place is a system that requires physicians to enter a user name and password, then, using Imprivata's e-prescribing app for controlled substances (EPCS) on their smartphones, a sequence of numbers, which refreshes every 30 seconds.

This protocol meets the strict authentication and audit requirements that the Drug Enforcement Administration insisted upon before permitting EPCS in the U.S.

Before rolling out EPCS, Cambridge Health Alliance physicians found themselves having to drive across town to another clinic to sign prescriptions, printed on a secured printer, for maintenance doses of controlled substances.

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Now signing these scrips is as simple as approaching any Cambridge Health Alliance physician's workstation, says Art Ream, chief information security officer at CHA.

Twice the Productivity

His team is working on equipping each workstation with a Bluetooth adapter, which can recognize each physician's mobile device also running Bluetooth, even in a busy room with multiple physicians using the EPCS system simultaneously.

"It's increased twofold our providers' productivity from that perspective," Ream says.

"It's kept the overhead out of here, as far as keeping track of the paper, and the controlled prescription paper. Conservatively, it's 400-plus hours of time in the past year returned to those providers, to spend time with their patients versus chasing pieces of paper."

EPCS also benefits the Cambridge patient population.

"We're a huge indigent care behavioral health population hospital system," Ream says.

The patient who probably doesn't have benefits and who probably doesn't get time off because he is hourly, now doesn't need to leave work to get on public transportation, spend money, get to the doctor's office, pick up the piece of paper, get back on the bus and go back to the pharmacy.

"They're probably in pain now. [But] they have to give the piece of paper to the pharmacy.  [They have to] get that filled, sit there, hang around… get back on the bus and get home," he says.

"And now they can't put a jug of milk on their table for their kids. They just spent it trying to get across town to make sure that they're healthy and taken care of, so that they're not in pain so that they can take care of their kids. So I can fix all of that, and we did, with all of this."

Unfortunately, a state effort to require EPCS across all of Massachusetts recently failed in the legislature. Nevertheless, Massachusetts is ramping up a new online version of its statewide Prescription Drug Monitoring Program.

Even though physicians may have to toggle between screens in the course of their day to contain to make headway against overall opioid abuse, Ream sees it as progress.