POCP Blog

By Connie Sinclair, Director, Regulatory Resource Center

Lawmakers are reacting to America’s opioid epidemic by creating new mandates that will affect electronic health records (EHRs). Compliance will create many challenges for EHR vendors, who must keep up or risk declining market share or even product survival. Here are five ways the opioid epidemic affects EHRs.

1. Mandatory EPCS. Many states are now requiring electronic prescribing for controlled substances (EPCS) to fight the opioid epidemic. Maine has now joined New York in mandating EPCS for opiates. Several other states have passed similar legislation, which becomes effective over the next couple of years.  Mandatory EPCS at the federal level also is likely, with new draft legislation (H.R. 3528) that would require EPCS for all prescriptions covered by Medicare Part D. Consequently, EHR vendors must ensure their products are compliant with all new federal and state requirements for EPCS, which could be a challenge due to variability in requirements.
2. Mandatory PDMP use. States are beginning to mandate the use of Prescription Drug Monitoring Programs (PDMPs), which are statewide databases of controlled substance prescriptions. So far, more than 30 states have some form of required access; however, details vary greatly, creating challenges for EHR implementation. States also are getting much more specific about the “who, what, when and how” of PDMP access. For example, access might be based upon the prescriber type, diagnosis, or days’ supply to be prescribed. Vendors may be forced to incorporate these requirements into their ePrescribing modules, which will, again, be difficult as a result of significant differences among the states. EHR vendors are likely to be pressured to enable efficient and timely access to PDMPs to facilitate prescriber compliance.
3. EHR Integration. Prescribers typically use a separate login to access PDMP information, which is outside their EHR workflow. In fact, many states still have statutes barring the integration of PDMP data with EHRs and local medication profiles. That is changing as states enact new legislation to remove those barriers.  EHR vendors must keep current with such rapidly changing developments and ensure their products are compliant. They also must stay current with guidance and legislation pending in state legislatures.
4. Interoperability. Despite progress that has been made, work remains to make PDMPs and EHRs interoperable. For example, a recent study found that fewer than half of states are actively exchanging PDMP information with other states and such authorized users as hospitals. A high-level federal commission recommended that PDMPs become completely interoperable in less than 12 months. This means that pressure will be put on EHRs and PDMPs to step up interoperability.
5. Limits on Controlled Substance Prescriptions. Controlled substance prescribing limits are quickly being enacted to provide only the minimum medication needed to address patient pain. Again, there is no consistency in implementing these requirements. Prescribers will need new forms of decision support to meet these and state board requirements.

Keeping up with developments. Keep current with federal and state legislation aimed at fighting the opioid abuse epidemic through Point-of-Care Partners’ ePrescribing State Law Review  and our recently launched ePrescribing State Law On-Demand.  Contact me at connie.sinclair@pocp.com to learn more.

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