UCSF is implementing electronic prescribing of controlled substances (EPCS) for attending physicians, prescribing nurse practitioners, and CIDP pharmacists in the Apex electronic health record. We had a successful pilot in Symptom Management Service practice in February, followed by three additional practices in March. We will begin the roll-out to other practices in the second half of April.
The Drug Enforcement Agency requires each provider to complete several steps before they can begin to electronically prescribe controlled substances.
- Prescribers will receive an email from UCSF IT Security with instructions to enroll in Duo 2-Factor Authentication for EPCS. This is necessary even if prescribers have already enrolled in Duo for VPN or other services; the DEA requires this second, separate process.
- Prescribers need to be identity-proofed in person; again a DEA requirement. This will be done by Practice Administrators and/or Division or Departmental Administrators, who complete a simple form and fax it to the Medical Staff Services Office. From then, in approximately one week the prescriber will get an Apex InBasket message that they are ready to e-prescribe controlled substances.
Once this process begins in late April, the only timeline for individual prescribers to begin using EPCS is the above process of 2-FA enrollment and identity proofing. For an individual practice it does not have to be done all at once, but can happen over time as prescribers are physically in clinic or otherwise available to be identity-proofed.
Training materials that explain how to e-prescribe controlled substances will be distributed to prescribers via the practices. It is very straightforward, and only a slight adjustment relative to our existing workflow.
What about senior residents and fellows, and prescriptions at discharge? There remain technical hurdles to overcome before residents in the third year and above, and ACGME Fellows, can electronically prescribe controlled substances. We are confident these will be overcome, but we do not want to delay making EPCS available to attendings and AHPs while that work continues.