Time is often not on our sides and we find ourselves with less hours in the day to catch up on the news and to learn new things. Video and auditory content is a great alternative to reading and can be convenient and insightful to get informed about things that interest you. TED (Technology, Entertainment, Design) Talks have been increasing in popularity as well as volume over the years. Here are 5 of our favorite TED Talks from over the years that highlight a wide range of Health IT topics. Enjoy!
Wearables, Beyond the FitBit
What if doctors could monitor patients at home with the same degree of accuracy they’d get during a stay at the hospital? Bioelectronics innovator Todd Coleman shares his quest to develop wearable, flexible electronic health monitoring patches that promise to revolutionize healthcare and make medicine less invasive. More here.
An Oldie, but a Goodie: Innovation in Health IT
Daniel Kraft offers a fast-paced look at the next few years of innovations in medicine, powered by new tools, tests and apps that bring diagnostic information right to the patient’s bedside. More here.
Progression of Collecting Health Data: From Paper to the Cloud
Collecting global health data is an imperfect science: Workers tramp through villages to knock on doors and ask questions, write the answers on paper forms, then input the data — and from this messy, gappy information, countries and NGOs need to make huge decisions. Data geek Joel Selanikio talks through the sea change in collecting health data in the past decade — starting with the PalmPilot and Hotmail, and now moving into the cloud. More here.
Get Curious, Start Innovating
Science is a learning process that involves experimentation, failure and revision — and the science of medicine is no exception. Cancer researcher Kevin B. Jones faces the deep unknowns about surgery and medical care with a simple answer: honesty. In a thoughtful talk about the nature of knowledge, Jones shows how science is at its best when scientists humbly admit what they do not yet understand. More here.
Nanotechnology and the Future of Disease Detection
What if every home had an early-warning cancer detection system? Researcher Joshua Smith is developing a nanobiotechnology “cancer alarm” that scans for traces of disease in the form of special biomarkers called exosomes. In this forward-thinking talk, he shares his dream for how we might revolutionize cancer detection and, ultimately, save lives. More here.
About 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. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
On February 23-24, 2017, I had the privilege of visiting the Windy City to attend the 152nd Chicago Dental Society (CDS) Midwinter Meeting. With the show theme of “leadership”, the bustling event attracted more than 28,000 attendees and the agenda was full of influential speakers, enticing exhibits, insightful lectures, and networking opportunities.
Opening Day
The conference kicked off with a bang on Thursday to a packed exhibit hall featuring more than 6,000 exhibitors comprised of 500+ booths. The opening session that evening was led by John F. McDonough, President and CEO of the Chicago Blackhawks. Through his speech he discussed leadership and its direct correlation to success. Something that really resonated with me was when he said, “In sports it’s hard to win, really hard to win. So much more goes in to it than just talent.” In retrospect, I think this thought applies to much more than sports, but also in industry. It takes a lot more than just talent, or a great product, or great service to be a leader in your industry, be that in dental practice management solutions, running a dental practice, or in e-Prescribing.
Awards
A number of prestigious awards were presented throughout the weekend to individuals who best portray the key values of not only the Chicago Dental Society, but also the dental industry as a whole. The winners were as follows:
Dr. K. William ‘Buddy’ Mopper was presented the Gordon J. Christensen Lecturer Recognition Award as an acknowledgement of his contributions to the dental profession in the area of conservation dentistry which places a value on conserving teeth opposed to extraction and implants.
Dr. Thomas Sullivan, past President of the Illinois State Dental Society and former Vice President of the American Dental Association (ADA), was awarded the George H. Cushing Award for his contribution to public awareness and importance of oral health.
Dr. Flava Lamberghini was awarded the CDS Foundation Vision Award in recognition of philanthropy by providing preventive dental care to students in more than 60 Chicago public schools.
An award was also provided to third-year dental student, John Tran, who wrote an interesting essay titled, “Thinking about Another Sweet Gulp? Think Againâ€, that reviewed the risk that sugar and sweetened drinks have on your teeth. You can read the full essay here.
Continuing Education
Continuing education drew large crowds with over 200 courses offered on a wide variety of topics ranging from clinical topics like 3D imaging, prosthodontics, implants and CPR, to business development topics such as communication and technology. Again, an overall theme of leadership could be seen throughout many of the courses with topics covering Practical Leadership, Strategic Leadership, Visionary Leadership, Business Decision-Making and Leadership, and of course the Leadership 101 course.
Networking and Special Events
A number of networking events were held as a means to gather individuals from similar locations and experience. Some well attended events included the New Dentist Reception held for dentists who have practiced for ten or fewer years and a special breakfast reception for the Wisconsin residents. There was also a special buffet luncheon provided for dental students and dentists alike to learn about the Chicago Dental Society’s Mentor Program and there was even a Country Night which offered the musical tunes of a country cover band. In staying with the yearly theme of ‘leadership’, fashion leaders were highlighted at the Fashion Show and Luncheon. The show wrapped up on Saturday with the ever-special President’s Dinner Dance which featured the Chicago Dental Society President Phillip Fijal and the music of the High Society Orchestra.
Reflection
Overall, I found the Chicago Midwinter Meeting to be impressive and inspiring. Throughout my time on the exhibit room floor, I was able to witness dentists old and new, dental students, hygienists, office staff, and even supportive family members taking in all the show had to offer. New skills were learned, new equipment was tested, and new business relationships were made. I look forward to seeing how this show will continue to grow at the 153rd Midwinter Meeting next year which will focus on “A Dental Triad: Pride, Passion, and Professionalism.â€
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
It’s no secret that e-Prescribing has its benefits. Many professionals agree that eRx greatly improves patient safety and reduces overall health care costs by lowering potential medication errors. Additionally, the ability to electronically prescribe controlled substances (also known as EPCS) greatly reduces fraud while preventing patients from being able to “doctor shopâ€, or receive multiple prescriptions for the same drug via different prescribers.
According to Paul Uhrig, Chief Legal Officer for Surescripts, between 3-9% of all opioid abusers use or have used forged prescriptions. With e-Prescribing, the ability to forge prescriptions is completely taken off the table. On top of that, with the addition of Prescription Drug Monitoring Programs (PDMPs) now implemented in all 50 states, prescribers are able to see all pertinent data that has been pulled from the patient’s electronic health record (EHR). This inevitably helps them make more knowledgeable and appropriate choices when prescribing scheduled medications.
With so many known benefits of e-Prescribing, and also because of the nationwide opioid epidemic, many states are getting on board the mandate train, which requires that by law, all prescribers must submit prescriptions electronically. There are currently 3 states which have this e-Prescribing mandate: New York, Maine, and Minnesota and many more that already have legislation in the works for an e-Prescribing mandate.
Taking the First Step: Minnesota Mandate
Minnesota was the first state to create an e-Prescribing mandate, which was intended to push all prescribers to establish and maintain an electronic prescription program that complied with state standards (listed here), effective January 1, 2011. According to the Minnesota Department of Health (MDH), Minnesota measures the status of e-Prescribing in three ways: total transactions, enabled pharmacies, and prescriber utilization. They’ve provided the following chart to demonstrate the increase in e-Prescribing transactions since 2008:
We can see that there was a pretty steep jump in 2011, which is when the mandate went into effect. However, the climb from 2011-2013 was slow yet steady.
Reinforcement of the Mandate, or Lack Thereof
The Minnesota Department of Health reiterates that there is currently no enforcement mechanism for not complying with the state’s e-Prescribing mandate. MDH does stress the benefits of e-Prescribing to providers as well as threaten with the possible implications of non-compliance from a patient/healthcare perspective. When the mandate was first released, it was implied that there would most likely be future establishment of enforcement methods. However, as of today, there is still no means of forcing providers to comply with the mandate.
Because there are no negative repercussions to providers who do not comply, there are many that choose to still utilize paper prescriptions, especially when it comes to sending controlled substances. According to Surescripts, only 3.5% of doctors in Minnesota were using EPCS in 2016. Additionally, the Minnesota Department of Health showed that drug overdose deaths increased 11%, reporting 516 deaths in 2014 to 572 deaths in 2015. These statistics could very well be unrelated to each other, but it still goes to show that that there is work to be done in Minnesota in regards to the opioid epidemic and electronic prescribing.
Some Considerations
Even though there is proof that it has its benefits, the challenges that come with implementing e-Prescribing can’t be ignored. Understandably, and rightfully so, prescribers have long expressed that their main focus is on their patients and they generally don’t enjoy being dictated by the government if it means being intrusive in helping their patients. This is especially true when it involves new systems that require onboarding and training time, but it can also be an even bigger challenge for prescribers to find the funds to support the implementation of an e-Prescribing system.
With these two large considerations in mind, it’s important that future states not only allow healthcare software companies and associated practices ample time to get their e-Prescribing systems up and running, but also offer some form of incentive or enforcement mechanism to keep prescribers in compliance. However, it’s even more important to remind prescribers that the perceived difficulty during the transition time in the beginning is minimal in comparison to how many benefits will transpire in the future. It’s all about taking that first step.
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
Patient engagement: the latest development in the healthcare industry, or is it?
You see, patient engagement has always existed. A little well-known term in the business world, “consumer engagementâ€, pioneered the strategies years ago that are utilized to engage customers, create better experiences, and enhance brand relationships to retain customers and increase revenue.
To be quite frank, these strategies have no “wow†factor. Engage with your customers to create brand loyalty and increase sales? Groundbreaking. Engage with your patients to improve health outcomes and lower associated costs? I see a trend coming on here.
While the healthcare industry has long understood the importance of having a patient engaged in their own health, it’s been said that the industry is typically five years behind with technological advancements. Perhaps it’s the resistance to change, the varying patient populations relative to age, or the perceived obstacles with seamless integrations for all pertinent parties, specifically EHRs.
However, one thing is certain: patient engagement technology is a viable solution that patients need, and deserve, to stay accountable and to stay connected in order to better manage their health.
The Benefits of Patient Engagement Technology
Now that patients are becoming more trusting of technology thanks to the Internet and social media, they have easier access to healthcare information at their fingertips. How many times have you googled your symptoms or visited WebMD rather than consulted with a doctor? Don’t be shy, we’ve all done it.
The downfall to these methods, however, is the potential danger involved if patients are self-diagnosing themselves without proper medical intervention. So, why not pair the two together?
The goal of patient engagement technology is to create a better relationship between providers and their patients. It’s also said that patients whom engage as decision-makers in their care tend to be healthier and have better outcomes, especially those dealing with chronic diseases.
Other benefits of using technology for patient engagement include:
The Challenges of Patient Engagement Technology
Though the benefits make sense, there are many challenges these latest tools are faced with. Not only is it new technology, but patient engagement will also require a cultural shift relative to changing behaviors and different communication preferences. Let’s not forget the operational and implementation challenges either.
Before an organization can determine what technology to use, it has to understand its users. Creating these personas will help healthcare technology organizations design better engagement tools with patients in mind, especially for older patients who might be less tech-savvy. It’s no easy feat getting providers and their patients to learn how to use these tools, as getting them up and running is most often viewed as a burden. That’s why there needs to be better integration with clinical workflows and simple-to-use products so providers aren’t wasting time on these technologies.
Furthermore, there needs to be more innovation in patient engagement tools. A glucose meter, an arm band, or a simple appointment reminder just isn’t going to cut it in today’s day and age. Give us substance, give us value, and give us healthier patients.
Other challenges of providers using technology for patient engagement include:
3 Patient Engagement Technology Companies to Watch
With so many patient engagement technologies being introduced to the market, here are 3 innovative companies making waves:
Klara takes collaboration to the next level. It’s not just a messaging application nor just an appointment reminder. Its platform engages all medical professionals for patients in order to be more efficient, more productive, and to work better as a team. They even tell you why “patient portals suckâ€. For more information please visit www.klara.com.
Medelinked encourages patients to manage their health by connecting with the healthcare community around them. It’s a secure mobile and online health platform that allows patients to build their health profile to discover, connect, and share their health and wellness information with their trusted healthcare providers. It not only connects individual patients, but families as well. For more information please visit www.medelinked.com.
AbleTo enables patients, payers, and providers to work together with their impressive behavior health care coordination platform that’s available nationwide to identify, engage, assess, and treat patients dealing with stress, anxiety, and depression. They pride themselves in reducing co-morbid behavioral health issues to improve patient outcomes, decrease the cost of care and help people reclaim their health and happiness. For more information please visit www.ableto.com.
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
The significant role of oral health and its contribution to an individual’s well-being has come under scrutiny as of late. In 2014, it was estimated that more than 181 million Americans would not visit a dentist because of several barriers to care, or a self-diagnosis of “my mouth is healthy – I do not need to visit the dentist.†Other reasons noted by individuals not seeing their dentist on a consistent basis were: cost or no insurance, limited dental access in their area or lack of transportation, or they simply did not have the time.
With this data in tow, a more efficient and readily available business model has become increasingly popular within dentistry: Dental Support Organizations.
What is a DSO?
According to the Association of Dental Support Organizations (ADSO), Dental Support Organizations (DSOs) contract with dental practices to provide critical business management and support, including non-clinical operations, and range from small to large size organizations serving dental practices throughout the country.
The business models of DSOs do differ and while the neighborhood family dentist typically treats the general patient population, dental practices supported by DSOs often focus on specific populations. For example, some DSOs are entirely focused on meeting the needs of pediatric patients, while others are focused on more rural populations. This is not to say that DSOs do not serve the general population, as many still do.
The Patient Experience
The true patient benefit of a DSO model lies in the integrated technologies and streamlined processes. DSOs offer patients many time saving benefits including:
Online appointment booking systems
Online bill pay
Flat rate appointments
Flexibility to visit dentists between multiple offices
DSOs are at the forefront of technology, both from a clinical and administrative standpoint. They pride themselves on remaining innovative, not only to better treat their patients, but to also have a competitive advantage and to attract and maintain new dentists. From billing software to detailed patient charting to specific treatment mechanisms, technology is embedded in nearly every workflow.
While many DSOs have thrown out their dentists’ paper prescription pads and have adopted electronic prescribing (e-Prescribing) software, there is still plenty of room to grow. e-Prescribing software provides dentists with the ability to send non-controlled and controlled prescriptions electronically directly to the patient’s pharmacy which adds convenience to the patient’s experience.
In addition to the prescription writing feature, e-Prescribing includes high value functionality for the dentist, patient and management teams such as:
Insight into a patient’s current medication regimen.
Ability to check for drug-to-drug and drug-to-allergy interactions at the point of care to help improve treatment decisions.
Reporting capabilities that share what is prescribed and in what quantities to assess for in regards to compliance. This is especially crucial with the current opioid epidemic and having the ability to track prescriptions for controlled substances.
Documentation for both the dentist and the patient including dental specific dosing information, as well as medication monographs.
What’s Ahead for DSOs
DSOs are continuing to shake up the dental industry. New DSOs continue to emerge, while existing ones are frequently acquiring new dental practices, therefore expanding and continuing to growing throughout the country. As previously discussed, cost and limited access to care were the most popular barriers, but DSOs offer streamlined solutions for both barriers as they are committed to the improvement of oral health in the United States through the accessibility of high-quality dental care. It is only a matter of time before more and more dentists hop on board.
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
With Super Bowl LI right around the corner, and as a lifelong NFL fan, I started to think about how crucial an integrated team is and how it can be applicable in so many occurrences. The latest buzz of health care interoperability, and the need for a connected health care system, further proves this point.
Let me explain.
NFL teams need proper strength and conditioning programs to improve agility and overall athletic ability for elite sport performance. Likewise, each position on a football team has a specific job, and they must work in sync to defend their opponent, gain yards, and score touchdowns to come out on top. Behind the scenes, their playbook is constantly being strategized, with plays being practiced over and over, while also throwing vital wrenches into the mix to keep the other teams guessing.
The same can be said for health care technology. Think of health IT as a football team. You have:
Key Decision Makers – the Coaches
Development and Implementation Teams – the Defensive and Offensive Lines
Providers – the Quarterbacks
Patients – the Fans
While the coaches are leading the pack and deciding what is best for their respective teams, they must collaborate with other members. Key decision makers might be at the top of the funnel, but they need to work with other departments, providers, and patients to bring new technology into health care delivery as efficiently as possible.
The defensive and offensive lines (development and implementation teams) also need to work together and follow suit with what the quarterback thinks is best for a particular play, i.e. what is best for the providers at point of care. The football (data) is passed back and forth, with the end goal of moving the ball down the field and scoring touchdowns, thereby creating loyal fans (patients) that continue to support and cheer for their team.
The ultimate “Super Bowl†win, in health IT’s case, is enhancing the patient experience and increasing patient satisfaction, while keeping all pertinent individuals connected.
Here are three things good ‘ol pigskin can teach us about health care interoperability:
1. Technology is Crutch for Game Time Success
Technology powers the league to monitor games and evaluate its officials, drives the instant replay system that helps officials in getting calls right, and enables communications that coaches, players and officials use during games.
All of this technology is particularly demanding on game day, when it must operate smoothly for a time-sensitive, live event that is unpredictable and sometimes played in bad weather. Making it all work requires attention to detail and the technical knowledge to troubleshoot on the fly and make the game seem like a well-oiled machine.
We know how important technology’s role in health care is, that’s a given. Latest developments like telehealth and remote monitoring programs are becoming increasingly popular, especially within rural areas. The demand for such technology has been in place for years, yet adoption and appropriate reimbursement models still move at a snail’s pace. Even so, the electronic efficiency put in place will allow providers to do what they do best and spend more time with their patients, while also improving the value of treatment relative to patient outcomes.
2. Make Smarter Game Time Decisions
Technology also helps players and teams communicate and gives coaches the tools needed to create game plans and to adjust them at any moment. It speeds up the pace of games, ensures that they run fairly and smoothly, while also improving the fans’ experience watching the game from home and at the game itself.
If a coach sees that certain plays aren’t working against a particular opponent, they adjust at time of play. They embrace innovation as a strategy, which is exactly what health care organizations and providers need to do. In order to make smarter treatment decisions, providers need the appropriate data and technological ability within a well-connected network for the well-being of their patients.
3. There Is No “I†in Team
I know this saying is extremely old, and perhaps a bit cheesy. However, it still serves a great point. Do you think the greatest teams in NFL history could have gotten to the Super Bowl as a one-man team? Besides the logistics of how the game of football is actually played, there isn’t one player completely responsible for the game’s entirety. Sure, there may be an MVP, but it’s the synergy of the team working together to achieve the same goal that makes them a winner.
With health IT, it works in the same manner. There cannot be responsibility placed on one sole party and there cannot be a disconnect between key players. At the snap, a quarterback typically doesn’t change the play that was already discussed unless there are certain circumstances involved. An off tackle won’t suddenly become an up the middle play last minute. No one would be prepared and the ball would most likely be fumbled.
Ideally, there needs to be a shift in how health data is exchanged between providers and other data users, including how it is accessed by patients. This is why the goal of seamless communication across providers exists, regardless of which EHR or Practice Management vendors they work with. While many are already in place, utilizing more powerful application programming interfaces (APIs) would allow for various systems to talk to each other and exchange data to create a better connected network.
So, what does this all mean?
A football team may not always be in perfect unison – there may be picks and fumbles along the way – but those that make it to the Super Bowl have proven their ability time and time again throughout the season because of their collective effort. This is ultimately what health IT is striving for with their interoperability goals. Still, this isn’t something you want to throw a “Hail Mary†for and hope for the best. Continue to place patients at the center of health care interoperability and there will be a Lombardi Trophy for everyone involved in due time.
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
As we discussed in our previous post, e-Prescribing is the electronic transmission of a prescription from the prescriber’s device to the patient’s pharmacy of choice, therefore replacing the traditional paper prescription.
How does e-Prescribing work for end users?
While e-Prescribing software comes in many shapes and sizes, e-Prescribing integration is directly integrated into healthcare software such as an Electronic Health Record / Electronic Medical Record, telehealth application, or dental practice management solution. By way of integrating e-Prescribing into a healthcare software, the e-Prescribing platform becomes an integral component of a healthcare software’s product offering.
e-Prescribing integration seamlessly allows a prescriber to log into their existing healthcare software, select a patient, then search for, enter and send an e-Prescription for the patient in a few short steps. The process saves the prescriber time while improving patient outcomes.
What are the benefits of a custom, white labeled solution?
When an e-Prescribing solution is “white labeledâ€, this means the e-Prescribing user interface mirrors the look and feel of the healthcare software in which the e-Prescribing solution has been embedded. Colors, fonts, font sizes, layout – you name it – can all be completely customized to provide a seamless experience for end users.
Furthermore, mobile optimization has become a major trend as more healthcare software solutions are operating in the cloud and prescribers are accessing applications from multiple devices and multiple locations. This is why it’s important that the e-Prescribing functionality performs well in different environments, but most importantly, on smaller screens.
Responsive design is critical in ensuring that any e-Prescribing solution is accessible on every device. It’s the best one size fits all solution as this type of design allows the webpage to expand and contract in order to perfectly fit within any screen in both the traditional office and mobile settings. Ultimately, responsive design cuts down on development time as the e-Prescribing user interface does not need to be adjusted manually for each type of device (i.e. mobile, tablet, laptop, or desktop).
What does it take to cross the finish line and go live?
To go live with e-Prescribing and be able to send prescriptions electronically, all healthcare software companies must go through a Surescriptsâ„¢ e-Prescribing integration review. Surescripts operates the largest health information network that connects the diverse and expansive community of care partners nationwide, including pharmacies, providers, benefit managers, and health information exchanges.
As part of this e-Prescribing integration review, healthcare software companies will have to successfully execute various test scenarios during a web meeting with Surescripts. Test scenarios will be provided for the following services:
NewRx: Route new prescriptions to the patient’s pharmacy of choice
Refills: Receive prescription renewal requests and submit responses between doctor and pharmacy
Medication History: View aggregated medication history data from pharmacies and pharmacy benefit managers (PBMs) upon receipt of patient consent.
Prescription Benefit: Surescripts’ Prescription Benefit service puts eligibility, benefits and formulary information at a prescriber’s fingertips at the time of prescribing. This enables prescribers to select medications that are on formulary and are covered by the patient’s drug benefit.
Electronic Prescribing of Controlled Substances (EPCS): Product has achieved Surescripts EPCS certification and has provided third-party audit documentation as required by the DEA.
Upon completion, healthcare software companies will be listed on the Surescripts website.
Healthcare software companies also looking for the ability to Electronically Prescribe Controlled Substances (EPCS) will need to go through a similar testing process with an approved e-Prescribing of Controlled Substances auditor such as the Drummond Group Inc., one of the first DEA approved certification bodies for EPCS.
Learn about DoseSpot’s e-Prescribing integration process by downloading our latest Integration Tool Kit.
Don’t miss the other parts of our e-Prescribing 101 series:
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
Navigating the waters of e-Prescribing can seem like a very daunting task considering the various state and federal regulations. To assist you in understanding, let’s review the information relative to e-Prescribing of Controlled Substances (EPCS) in all 50 states and how your state is measuring up.
Until recently, one-half of all U.S. States prohibited e-Prescribing of controlled substances. The thought was that paper prescriptions were safer and more secure. On September 15, 2015, however, Vermont became the last state to allow electronic prescribing of controlled substances, or Schedule II-V medications, making this process legal in all 50 U.S. states.
“We certainly believe that because of the enhanced security associated with e-Prescribing of controlled substances, the opportunity for abuse, misuse, and fraudulent activity is going to be dramatically reduced,” said Ken Whittemore, BSPharm, MBA, Senior Vice President of Professional and Regulatory Affairs at Surescriptsâ„¢, a nationwide health information network.
So, why the discrepancy? Are pharmacies not accepting electronic prescriptions? Are prescribers not able, or willing, to send these prescriptions electronically? Is this process too difficult? Why is this process used in some states so heavily, but so infrequently in others?
Pharmacies are ready!
In 2010, the DEA published a final ruling giving not only practitioners the option to write controlled substances electronically, but also for pharmacies to receive, dispense, and archive electronic prescriptions.
“It became incumbent upon a number of stakeholder groups in the pharmacy industry to tackle the issue and bring states into alignment with the DEA’s rule,” Ken Whittemore, BSPharm, MBA told Pharmacy Today.
Many pharmacy stakeholder groups, including APhA, the National Alliance of State Pharmacy Associations (NASPA), the National Association of Chain Drug Stores, and Surescripts, worked together over a 5-year period to rework some state laws, a process that can take a long time. Between 2010 and 2015, the pharmacy end of the spectrum worked hard on adoption and enablement, while prescriber enablement trailed. Using data from Surescripts, a study published in the January 2015 American Journal of Managed Care found that pharmacies with technology in place to accept e-Prescriptions for controlled substances increased from 13% in 2012 to 30% in 2013. By contrast, only 1% of all prescribers were capable of e-Prescribing controlled substances in 2013.
However, between 2012 and 2013, the number of e-Prescriptions for controlled substances grew dramatically from 1,535 to 52,423. Talk about a rapid jump!
According to the 2015Â Surescripts National Progress Report, an average of 81% of pharmacies were enabled for EPCS in 2015. States including Hawaii and Mississippi were at the bottom of this list with less than 70% of pharmacies enabled, while states in the Northeast such as Massachusetts, New York, New Hampshire, and Rhode Island led this list with over 90% of pharmacies enabled for EPCS.
As of December 1, 2016, these numbers have only risen, with both Hawaii and Mississippi now having over 75% of pharmacies enabled. New York and Maine lead the race on that front with 96.8% and 95.2% of pharmacies enabled currently. This is in large part due to the state mandates put into place in 2016 and 2017, respectfully.
How about the prescribers?
With so many pharmacies enabled for EPCS, and legislature allowing this process in all 50 states, it may be surprising to know that an average of 3.39% of prescribers were enabled to e-Prescribe controlled substances according to the 2015 Surescripts National Progress Report.
Lengthy and time-consuming software auditing and prescriber identity proofing processes are likely factors that have stalled prescriber adoption of EPCS, but for pharmacists, the initial setup is much easier. In addition, there have not been enough incentive for prescribers to adopt EPCS.
e-Prescribing was a requirement under the federal Meaningful Use Electronic Health Record (EHR) program, which incentivizes the use of EHRs through financial payments. However, e-Prescribing of controlled substances was specifically exempted from Meaningful Use Stages 1, 2, and 3. For these reasons, it isn’t surprising that in 2015 the state with the highest number of prescribers enabled was New York, as that was one of the only states with an e-Prescribing state mandate in effect at that time.
In 2015, New York had 26.6% of their prescribers enabled for EPCS, with Nebraska not far behind at 15%. Fast forward to December 1, 2016 and prescriber enablement has grown tremendously in some states, but remain dismally low in others. New York now has 71.5% of prescribers enabled, with no other state having even one-third of their prescribers enabled for EPCS. In fact, the average percentage for EPCS enabled prescribers remains even as of December 1, 2016, at only 8.4% despite all of the benefits of EPCS.
Why are these numbers so varied?
Electronic prescribing of controlled substances (EPCS) reduces fraud and keeps patients from getting multiple prescriptions for the same drug, so why are some states seeing major buy-in while other states are lagging? Much of this is impacted by states that have legislation in place to either require or reinforce the use of e-Prescribing, as outlined below.
Minnesota
Minnesota was the first state to implement an e-Prescribing mandate in 2008 in order to improve quality outcomes and efficiency in health care. The state mandate required prescribers, pharmacists, pharmacies, and pharmacy benefit managers (PBMs) to be up and running with e-Prescribing by January 1, 2011, however, only 13% of prescribers are actually enabled for EPCS as of late. Could this be because legislation doesn’t enforce its own law or penalize prescribers for not adhering to this legislature? Marty LaVenture, director of the Minnesota Office of Health IT and e-Health, seems to agree and notes, “policy levers could be used to encourage full adoption and use of e-Prescribing capabilities.”
New York
As you may already know, New York was the first state to require e-Prescribing of all prescriptions, both controlled and non-controlled, and the first to implement penalties for failing to adhere to this ruling. Penalties include, but are not limited to, loss of license, civil penalties, and/or criminal charges. With the highest rate of prescriber EPCS enablement, it’s evident that New York prescribers are taking this quite seriously.
Maine
Maine is the next state to implement an e-Prescribing regulation as of July 1, 2017 where all opioids prescriptions must be sent electronically. With only 0.6% of prescribers enabled for EPCS in the state according to the Surescripts report, and up to 2.9% as of the beginning of December 2016, it’s clear that Maine has a long way to go for all prescribers to be ready to follow this regulation.
In Summary
Although it’s legal in all 50 states, and there are many reasons EPCS is safer than on paper or another method, there is still a great discrepancy between EPCS enabled pharmacies and EPCS enabled prescribers due in part to the strict requirements put in place on the prescribers. While the statistics referenced here show that provider adoption of EPCS is still low in comparison to the pharmacy adoption we have seen, it’s important to remember that the e-Prescribing of non-controlled substances also took years to reach the level we now see today. It seems the only tried and true way for these numbers to rise quickly and meet the numbers we currently see for pharmacy enablement is to implement regulations and penalties for not adhering to this requirement as outlined in the above state mandates. All eyes are now on Maine to see how their journey goes.
Check out the maps below to see how your state measures up!
DoseSpot is a Surescripts certified e-Prescribing platform specifically designed to integrate with electronic health record, electronic dental record, practice management, and telehealth software. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing to more than 150 health care software companies since 2009. For more information, please visit www.DoseSpot.com.
On Monday, November 7, 2016, Health 2.0 Boston held a panel discussion with three of 2016’s 75 Most Powerful Women in Healthcare IT named by HealthData Management and the DoseSpot team was fortunate to be in attendance. The three influential women brought up many interesting points and offered inspiring words of wisdom to the crowd, the majority of which were females. Although the event was structured with prepared questions for the panelists, these power women provided answers that were honest, open and personal, thus creating a comfortable and therapeutic-like atmosphere. This event navigated the different paths that were taken by each of the female leaders and highlighted the trials and tribulations that they encountered while on the rise to success in a primarily male-driven industry.
The Panel
Helen Figge, PharmD, MBA, FHIMSS – SVP, Global Strategic Development, LumiraDx, Inc.
Sue Schade, MBA, LCHIME, FCHIME, FHIMSS – Principal, StarBridge Advisors
Cara Babachicos – Corporate Director/CIO, Community Hospitals at Partners Healthcare
Here are DoseSpot’s key take-away points from the panel discussion:
Culture
All three Health IT leaders agreed that when it comes to the topic of company culture, it is not only important to be a part of a workplace where women are valued, but also to be part of a workplace where women have the ability to flourish and be the competent employee they worked and studied so hard for. Cara Babachicos, specifically, mentioned that internal happiness and success are the most important components of one’s career and the company someone works for should be promoting those components. It is one thing to be qualified for a position, yet another to be the right fit. Consistently evaluating if you are the right fit for a specific position or company is crucial in your path to success.
Mentorship
Are mentors a necessity to rise to the top? All three women agreed that it is not necessarily a career killer if one does not have a mentor. However, being able to navigate and find someone whom you can model after is going to immensely help on your career journey.
Helen Figge mentioned that even if you don’t have a mentor per se, you can still find a particular skill(s) in someone that you can model yourself after and learn from, as long as you don’t set boundaries for yourself of who you could one day become.
Another interesting point made was that a mentor doesn’t necessarily have to be a person you WANT to be; it can be a person who makes you realize who you DON’T want to be. Lessons can be learned from all types of people, of all different backgrounds, personalities and roles.
Rising Above
Each one of the ladies on the panel highlighted the largest obstacle they were required to overcome in order to become who they are today. Helen, who addressed a disability she has experienced her whole life, had to adjust and overcome many challenges to work harder in school and in her career. She courageously saw past her physical obstacle to see the trajectory of what she wanted to be in the long run. Her advice? Like yourself. No matter what.
Cara’s biggest obstacle was having patience. As with building anything great or influential, it takes time. Her advice was to be more patient with yourself and your life, both personally and professionally. Eventually, all of the pieces will come together.
Lastly, one of Sue’s greatest obstacles was dealing with bullying behavior from colleagues, primarily men back in the 80’s when a woman with authority in IT was a rarity. She made it clear to always be willing to speak up for yourself and make sure your superior is aware of what is going on in the workplace, even if stepping up is the hardest thing to do. As a leader of hundreds of employees, she further pointed out that she may not know everything that’s going on in her department. An employee may act differently in front of leadership than they do in front of their peers.
Words of Wisdom
The three power women of health IT left us with a few final points to think about when climbing the career ladder of success:
Speak Up! – Stand up for yourself and for what you deserve, even if it may feel uncomfortable.
Know Your Stuff – Constantly challenge yourself and learn new things. Be an overachiever. Success comes to those who work for it!
Don’t Question Yourself – Even if you feel nervous or anxious, strive to be authentic and confident in everything you do.
Trust Your Gut – If you have to question something, always do what’s right for the organization. Your company will thank you for it.
And finally, at the end of it all: Always do what’s right foryou.
About Health 2.0
The Boston Chapter of Health 2.0 is a part of the national Health 2.0 organization, which is the premiere showcase and catalyst for the advancement of new health technologies. Through a global series of conferences, developer competitions, and leading market intelligence, Health 2.0 drives the innovation and collaboration necessary to transform health and health care. For more information, please visit: www.bostonhealth20.com.
About 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. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
Unfortunately, the opioid epidemic that is currently grappling the United States isn’t exactly news. Headlines appear on a daily basis in regards to this addiction, the overdoses and fatalities, as well as the healthcare community’s contribution to this crisis, both the good and the bad.
We’ve seen Congress, the Surgeon General, and many other organizations make extreme efforts to combat this crisis, yet despite the widespread media attention, many healthcare professionals still don’t realize how dangerous the drugs can be or how addictive they are.
DoseSpot recently conducted a live webinar in an effort to educate and discuss the critical role that dentists in particular play in mitigating the current opioid epidemic that is upon us and during that time, the following crucial points were made:
The blame game needs to stop
Blaming others only diverts the necessary action of collectively coming together as a nation, regardless of one’s associated industry. Healthcare, Law Enforcement, Politics – there needs to be a strong, unified foundation for which we can assemble and fight this battle together.
Break the habit: prescribing patterns of pain medication
Dentists serve a unique role in overcoming this epidemic due to the nature of their work and the procedures they perform, specifically wisdom teeth extraction. It’s a fair statement that the majority do not enter the healthcare industry with ill intent of harming their patients, yet it’s also fair to say that lack of proper education and prior pharmaceutical marketing tactics have fueled poor prescribing patterns. In order to change one’s behavior, programmed thoughts and approaches must be reevaluated.
Opioid addiction does not discriminate
This addiction can affect anyone regardless of one’s socioeconomic status or in some cases, a person’s relationship to their dentist. What DoseSpot coins as “The Insider Threat,” we reveal how certain folks pose a potential risk relative to obtaining controlled substances, both knowingly and secretively. Stories of addiction that are shared during our recent webinar further prove that opioids do not discriminate.
Solutions are available
The truth of the matter is, there is not one single solution that can work independently. It needs to be a collective effort and innovation is critical to success. There needs to be multifaceted solutions to tackle this complex problem ranging from increasing specialty training and education to proper treatment technology, data, and analytics.
Dr. John Zweig, Chief Dental Officer, Dental Associates
Donald Whamond, Chief Technology Officer, Dental Associates
Jason Wolan, Director of EHR Implementation, Great Expressions Dental Centers
Daniel Smelter, Director of Business Analysis, Benevis, Inc.
About 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. DoseSpot is certified to e-Prescribe controlled substances and has provided simple, affordable and integratable e-Prescribing solutions to healthcare IT companies since 2009. For more information, please visit www.DoseSpot.com.
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