A number of New York State professional societies are asking the Department of Health for a one year delay to an e-Prescribing mandate that would require all prescribers to transmit prescriptions electronically, even for non-controlled substances. In a letter to Acting Department of Health Commissioner Howard Zucker, MD, JD, the medical groups argue that many providers, including nursing homes and long-term care providers, are not ready to comply with the rule since they lack EHR technology or cannot meet the workflow requirements necessary to embrace e-Prescribing full time.
“While we recognize the important efficiencies and patient safety enhancements which can be achieved through electronic prescribing, it is quite concerning that many EHR vendors, including several with significant market share in New York State, are not yet certified for electronic prescribing of controlled substances (EPCS) and will not be certified in most cases until sometime in the first quarter of 2015,” the letter says. “This is quite concerning for all prescribers, particularly large group and institutional prescribers whose systems must be tested and re-tested to remove operational flaws before the installation and implementation of software updates.”
The rule goes into effect on March 27, which does not allow providers enough time to adopt e-Prescribing technology and implement EHRs, the letter says. While the concept was first introduced in 2012 as part of a larger effort to stop prescription drug abuse, Senator David J. Valesky (D-Oneida), who is co-sponsoring legislation to implement the delay, says that certified e-Prescribing products have not been made available to providers quickly enough to move the needle on adoption.
“Unfortunately, the federal Drug Enforcement Agency moved slowly in certifying vendors who are authorized to transmit electronic prescriptions for controlled substances,” the legislation says. “As a result, many doctors and other prescribers around the state, many of whom have electronic records and e-Prescribing capability have contracts with vendors who have not yet received the necessary federal certification.”
The professional societies endorse the delay of the mandate, but would also accept a postponement of enforcement of the penalties associated with non-compliance. The letter suggests that providers who write fewer than 25 prescriptions per year be exempted from the requirement, as the cost of implementing health IT to enable e-Prescribing would be prohibitive to these low-risk entities. The coalition would also like to see financial support for nursing homes and assisted living facilities, which are not eligible for the EHR Incentive Programs, to help them adopt EHRs and meet the state’s expectations.
“Lastly, we encourage your consideration of a public education campaign which will educate the public as to the changes which will be encountered as they seek care from providers in all healthcare settings,” the letter concludes. “For some patients, the elimination of paper prescriptions may be somewhat concerning if not confusing and disempowering. It would be helpful for the state to begin to make patients aware of the positive reasons for the change while at the same time addressing concerns they may have about accessing needed medications from the pharmacy of their choice.”
Some of the eighteen organizations signing the letter include the New York Chapter of the American College of Physicians, the New York State Dental Association, the New York State Academy of Family Physicians, and the Nurse Practitioner Association New York State.