Use of e-prescribing for controlled substances is low, but rising

While the usage rate of electronic prescribing for controlled substances by clinicians is low, adoption of the technology is growing, according to the Office of the National Coordinator for Health IT.

A new ONC data brief, based on results from the 2017 National Electronic Health Records Survey, reveals that 32 percent of office-based physicians that prescribed controlled substances did so electronically.

“New data show that use of EPCS technology is on the rise, but varies across clinician characteristics,” write ONC’s Chief Clinical Officer Andrew Gettinger, MD, and Chief Medical Officer Thomas Mason, MD, in an October 3 blog post. “Understanding differences in clinicians’ use of EPCS technology is critical to identifying ways to address barriers to use such as costs and security requirements.”

In particular, the ONC data brief finds a relationship between the technology that physicians possess and whether doctors also prescribe controlled substances electronically. Specifically, one third of physicians with computerized systems for prescribing prescriptions indicated that they electronically prescribe controlled substances.

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“Most physicians (86 percent) have a computerized system to order prescriptions; which is comparable with the national rate of physicians with an EHR (86 percent),” states the data brief. “Approximately 90 percent of physicians with electronic prescription capabilities use certified EHRs. Moreover, approximately 36 percent of physicians with electronic systems to order prescriptions, also EPCS. This rate is similar to rates of EPCS among physicians with additional electronic capabilities of the computerized systems.”

When it came to interoperability, ONC noted that physicians with the ability to send, receive or integrate patient health information from outside a doctor’s organization were significantly more likely to EPCS.

“For physicians that engaged in all four interoperability domains, 50 percent of them electronically prescribed controlled substances, compared to 29 percent of physicians who were not engaged in all four domains, a significant difference,” according to the agency.

In addition, ONC discovered that doctor characteristics were also an important factor for EPCS, with larger physician practices having significantly higher rates of use.

“In 2017, 59 percent of physicians in practices of 100 or more physicians EPCS compared to only 23 percent of physicians in practices of three or fewer physicians,” the agency reports. “Similarly, more than 40 percent of physicians in practices owned by a hospital or insurance company EPCS compared to 25 percent of physicians in practices owned by physicians or community health centers.”

At the same time, ONC found no significant difference in rates of EPCS between physicians in rural and urban areas and no difference in rates of EPCS by physician specialty.

The agency noted that Congress in October 2018 passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, mandating that all Medicare Part D providers electronically prescribe controlled substances by 2021.

“The data presented in this brief can be used as a baseline to help inform the implementation and evaluation of the SUPPORT Act as well as other related policies,” concluded ONC.

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