In a letter sent last week(2 page PDF) to the acting administrator of the DEA's Office of Diversion Control, the AAFP insisted that the agency "promptly change the current rules for electronic prescribing of controlled substances so that the electronic prescriptions can be sent more easily to the pharmacy directly in a safe and secure manner."
The Academy further called on the DEA to "lead an effort to promote electronic prescribing of controlled substances (EPCS) on a national level so that states are not forced to impose onerous and patchwork requirements for prescribing controlled substances, as well."
In the letter, AAFP Board Chair Reid Blackwelder, M.D., of Kingsport, Tenn., points out that despite the release of an interim final rule in 2010(www.federalregister.gov) that called for "safe and legal EPCS," implementation remains out of reach because of the agency's onerous stipulations regarding software compliance among both prescribers and pharmacies, as well as its requirement for a complex, two-factor authentication protocol.
The result, according to Blackwelder: "Only 2.2 percent of medical providers in the country are enabled for EPCS, despite 72 percent of total providers electronically prescribing other medications. Meanwhile, fewer than half of pharmacies are enabled for EPCS, even though 95 percent of all pharmacies are equipped to receive electronic prescriptions of other medications."
Although the AAFP applauds the DEA's efforts to decrease diversion of controlled substances, Blackwelder says in the letter, the fact remains that the Substance Abuse and Mental Health Services Administration has recorded no change in the rate of medication diversion since the ruling went into effect in June 2010.
"More should be done to facilitate EPCS, since research shows that paper prescriptions for controlled substances increase the amount of diversion," the letter states. Not only is widespread adoption of EPCS in keeping with advances in technology, it also precludes any attempt by patients to alter prescriptions.
Moreover, Blackwelder adds, "Paper prescriptions can be dangerous for patients who carry the paper prescription, which can be stolen. On the other hand, e-prescribing makes pain medication more accessible to the patients who genuinely need it in a more timely fashion."
For those reasons, "The AAFP continues to advocate for secure electronic prescribing and electronic signatures of controlled substances in any setting," the letter concludes.
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