EPCS and Two Factor Authentication… Finally!


By Dawn Christodoulou, XLDent President

Before diving into an update on EPCS and two factor authentication, it’s probably prudent to review some basics about e-Prescribing in general.

What exactly is e-Prescribing?
e-Prescribing stands for electronic prescribing. With e-Prescribing, dentists can route prescriptions electronically to a patient’s preferred pharmacy, in addition to reviewing his/her medication history and insurance information.

What are the advantages of e-Prescribing?
e-Prescribing saves time, increases efficiency, and improves safety and security. Dentists that e-Prescribe should be able to instantaneously route prescriptions, check for dangerous drug-drug and drug-allergy interactions, and access dental-specific medication information with the click of a button. I say should because not all e-Prescribing solutions are created equal, and those features listed are the aggregate XLDent clients can count on when utilizing its integrated e-Prescribing service through DoseSpot. DoseSpot is a Surescripts™ certified e Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management, and telehealth software.

What does “dental-specific” e-Prescribing mean?
DoseSpot has an exclusive partnership with Lexicomp to provide dentalspecific medication information within the e-Prescribing workflow. Lexicomp is an industry-leading provider of drug information and clinical content for the healthcare industry. This means dentists can access crucial medication information such as a medication’s effect on dental use and dental treatment, dental usual dosages, and more.

What does EPCS stand for?
EPCS is the acronym for Electronic Prescriptions for Controlled Substances. Electronic prescribing was legalized for Schedule II through V controlled substances at the national level in 2010 by the Drug Enforcement Agency. As with any electronic standard, adoption and availability are typically the factors that govern implementation. Adoption of EPCS is largely controlled at the state level by the state pharmacy boards. It has taken time for legislation to be updated. EPCS has now been adopted by 49 states. Limited availability was due to the lack of DEA-approved EPCS certification bodies and the complexity of integrating two factor authentication into e-Prescribing systems. Under the interim final rule, the DEA allows the use of two of the following: something you know (a knowledge factor), something you have (a hard token), and something you are (biometric information). Two factor authentication protects the dentist from misuse of his/her credentials from both internal and external threats; authentication based solely on knowledge factors is easily guessed or hacked and used without the doctor’s knowledge. A practitioner must undergo identity proofing before he/she is approved to electronically prescribe controlled substances.

Some states mandated e-Prescribing long before EPCS systems became readily available. Former Minnesota Governor Tim Pawlenty, for example, signed into law in 2008 a bill that required electronic prescriptions and created quality reporting rules for physicians. Pharmacists, physicians, and others who prescribe or dispense medication in Minnesota were required to use electronic systems by 2011. While many dentists acknowledged the mandate, many were slow to implement because they felt EPCS was the missing link that justified such a big change in their workflow. Based on our observation, those that adopted early quickly realized the invaluable benefits a comprehensive product/service offering like XLDent/DoseSpot afforded them. The value is not in the actual sending of the electronic prescription (until recently, controlled substances still needed to be processed on paper), but rather the access to a patient’s medication history and the integrated interactions checking. Many XLDent doctors comment that they are more readily able to identify “drug seekers” and feel much more “in-the-know” when treating medically compromised patients.

Recently, two major legislative actions have had a serious impact on dental prescription writing. The first legislative action was the reclassification of hydrocodone combination products from Schedule III controlled substances to Schedule II controlled substances. Prescriptions for hydrocodone combination products, such as Vicodin, may no longer be called in or faxed to a pharmacy—dentists must issue e-Prescriptions or handwritten prescriptions on expensive, tamper-proof paper. The second legislative action was the passage of the I-STOP mandate in New York State. As of March 27, 2015, all prescriptions in the State of New York must be sent electronically and pharmacists can only fill prescriptions that have been submitted electronically via e Prescribing. The only exception is in the case of an emergency.

With the recent reclassification of hydrocodone combination products and passage of New York State’s I-STOP mandate, it’s important for dental providers to adopt an e-Prescribing solution capable of safely and securely sending all prescriptions electronically. It’s only a matter of time before more states will pass similar legislation.

More on XLDent, e-Prescribing and two factor authentication
XLDent was the first Dental Practice Management System to integrate e-Prescribing capabilities and is now the first PMS certified to send Electronic Prescriptions for Controlled Substances (EPCS). This major industry achievement now equips XLDent dentists with the ability to securely e-Prescribe controlled substances in 49 states. As explained in the associated article, EPCS requires an additional layer of security known as two factor authentication to protect the integrity of each controlled-substance prescription. The first factor is a PIN number that each dentist will set and the second factor is a cutting-edge mobile application that generates a sixdigit security code every 30 seconds. Using these two factors, dentists can quickly send a controlled substance prescription. XLDent continues to be at the forefront of dental e Prescribing and remains committed to moving this technology forward in dentistry.

ePrescription service works with all Dental Practice Management systems. XLDent™ is not required. Please inquire about the non-integrated option at http://www.xldent.com/esolutions/electronic-prescribing.

Click here to see the original article.

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