Novant Health Inc. is launching an e-prescription service to make it easier for patients, providers and pharmacists to comply with tighter federal regulations on obtaining controlled substances.
Those regulations, introduced in October, made the path longer for getting a prescription filled for hydrocodone combination products. The rule change moved hydrocodone to the more restrictive Schedule II category from the Schedule III category.
Patients needing those potent painkilling drugs have had to go to a physician's office to pick up a signed prescription slip for a 90-day supply and take it to the pharmacy, rather than having it faxed or emailed to the pharmacy.
Another change is that a return doctor visit is required to get the next 90-day supply.
The goal of the U.S. Drug Enforcement Administration is reducing the potential misuse of hydrocodone drugs, particularly for recreation purposes, since the drugs can be addictive for some people. The agency also is encouraging physicians to prescribe a less-potent drug when it is an acceptable option.
Novant debuted the service at physician clinics in the Lake Norman area. The rollout will go to Charlotte clinics in September and October, Winston-Salem in late October and November and the rest of the Triad by year's end, spokeswoman Graziella Steele said Tuesday.
Novant is using Imprivata’s authentication system called MyID, which includes a fingerprint reader, to allow providers to prescribe controlled substance medications to pharmacies quickly and securely, as well as potentially reduce errors in database entries. The e-prescriptions are processed by Surescripts.
“The system combines the technology of our Epic electronic medical record system, Imprivata and Surescripts to provide a seamless and safe approach for prescribing, transmitting and processing of prescriptions,” said Dave Garrett, senior vice president and chief information officer at Novant.
Medical studies show that patients with e-prescriptions follow drug treatment plans more, and that e-prescribing saves on health-care costs because of improved patient outcomes and reduced medical visits.
Centers for Disease Control and Prevention data for 2011 showed more Americans died between ages 25 and 64 from a drug overdose than motor-vehicle accidents, with 55 percent of the overdose fatalities coming from pharmaceutical drugs.
"Hydrocodone is generally not an ideal agent for chronic pain, but it is often used by patients to have on hand when unexpected pain flares,” said Adam Orsborn, pharmacy director at Wake Forest Baptist Medical Center.
"Many patients who receive hydrocodone need it for a short-term issue, and do not need a refill."
Wake Forest Baptist has said it plans to offer a similar e-prescription service.
According to Forbes magazine, since 2007 more U.S. prescriptions were written for hydrocodone plus acetaminophen than any other drug. There were 135 million prescriptions written in 2012 alone. The prescribed drug with the next-highest total in 2012 was thyroid hormone at just more than 100 million.
Teens and young adults, in particular, are using and abusing such painkillers as hydrocodone with the brand names of Vicodin, Oxycontin and Valium, law-enforcement officers said.
Project Lazarus, which began as a pilot program in Wilkes County in 2008, is a statewide initiative aimed at reducing prescription-drug overdose deaths.
The program is known for providing anti-overdose kits to at-risk patients who are starting methadone treatment to try to kick opioid addictions. The kits include the drug naloxone (known as Narcan), which reverses opiate overdose by blocking the brain's opioid receptors.
There are 14 Triad and Northwest North Carolina participating pharmacies, including six in Winston-Salem.
The program also has helped coordinate statewide medication "take-back" events conducted by law enforcement, educational and public-safety groups. Some pharmacies have created drop boxes for safely disposing of expired or unneeded prescription drugs.
By Richard Craver
August 25, 2015
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