PowerPoint Presentation

AAFP State Legislative Conference:Electronic Prescribing for Controlled Substances (EPCS) Update

Ken Whittemore, Jr., R.Ph., MBAVP, Professional & Regulatory Affairs

October 28, 2016

2 Copyright 2016 by Surescripts, LLC. All rights reserved.Unrivaled in scale1.41 Billion electronic prescription transactions annually

Access to over 240 Million covered lives

Over 700,000 health transactions and 160,000 e-prescriptions routed every hour

Protected and secureElectronic Healthcare Network Accreditation Commission (EHNAC) Accreditation and Federal Information Processing Standards (FIPS) encryption provides pharmacies with data security and protection

99.96% network reliability

Connected to care deliveryPHYSICIANS: 7 out of 10 office-based physicians use our network every day

EHRs: Integrated with over 700 certified EHR applications

PATIENTS: 3 Million patients get their prescriptions routed over our network each day

Over the past 15 years, we have built a health information network that is

We provide secure, reliable communication exchangeacross a vast national network of partners

3 Copyright 2016 by Surescripts, LLC. All rights reserved.

Prescriber CommunicationsPharmacy Communications

EPCS Regulatory HighlightsBackgroundAfter 12 years of deliberation, the DEA issued an interim final rule (IFR) allowing EPCS on 03/31/2010, effective 06/01/2010Allowed prescribers the option of signing and transmitting prescriptions electronicallyPermitted pharmacies to receive, dispense and archive controlled substance prescriptions totally electronically

Governing rulesThe DEAs EPCS IFR did not preempt state rules, so the most restrictive rules governEarly EPCS rule challenges:Most of the original 19 states that permitted EPCS in 2010 allowed all schedules IIV, but some only allowed schedules IIIVSome drugs were scheduled in the states but not by the DEA (e.g., carisoprodol, tramadol, pseudoephedrine)Prior to all states aligning their rules with the DEAS EPCS IFR, in order for EPCSs to cross state lines, they had to be permitted in both locales

4 Copyright 2016 by Surescripts, LLC. All rights reserved.

2008: DEA first proposes rule to allow e-prescribing of controlled substances (EPCS)EPCS not permitted anywhere.5 Copyright 2016 by Surescripts, LLC. All rights reserved.

2010: DEA regulation allows e-prescribing of controlled substancesState rules also had to permit the technology before its use. By the end of 2010, EPCS was legal in 19 states. 6 Copyright 2016 by Surescripts, LLC. All rights reserved.

2015: EPCS permitted in all 50 states and DCIn August, Vermont became the 50th state to adopt rules to allow EPCS for all schedules of controlled substances. 7 Copyright 2016 by Surescripts, LLC. All rights reserved.

Surescripts Network Enables Pharmacy and Prescriber Software Applications for EPCS

Provides standards for EPCS implementationCertifies software applications for secure EPCS transactions Connects pharmacy and prescriber software through a trusted national health information network

Prior to certification, pharmacy system and physician EHR software companies must take additional security and technology steps to comply with the Drug Enforcement Administration's Interim Final Rule (IFR) and state board of pharmacy regulations.

Local Provider ActionsID Proofing SetupTwo-Factor Authentication SetupSet Access ControlsTraining

Local Pharmacy ActionsSet Access ControlsTrainingVendor Updates SoftwareEPCS CertificationVerified AuditRollout update to local pharmacy

Pharmacy IT VendorVendor Updates SoftwareEPCS CertificationSelect Identify ProofingVerified AuditRollout update to local practice

Ready to receive EPCS

Ready to send EPCS

EHR

Provider EHR VendorKey Actions for EPCS systems connect to Surescripts network to enable EPCS

PMS

To realize the benefits of EPCS, we need transactions. At a high level, there are 3 major steps.

Step 1, at the corporate level, the provider EHR and Pharmacy IT vendors update their software, get a verified audit and certify connectivity to a secure network like Surescripts.

Step 2, at the practice and pharmacy level, EPCS is enabled in local systems and rolled out to end users

Step 3, prescribers can send electronic prescriptions for controlled substances to pharmacies

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Utilization of EPCS is growing rapidly as more prescribers and technology vendors get certified10 Copyright 2016 by Surescripts, LLC. All rights reserved.64 pharmacies and pharmacy vendors are certified100+ prescriber vendors are certified

12.8 Million EPCS transactions were sent across the Surescripts network in 2015. Over 30.8 Million have already been sent through September 2016.

Status of EPCS Adoption September 2016111 Copyright 2016 by Surescripts, LLC. All rights reserved.Nationally 63% of all prescribers sent an e-prescription in the last 30 daysNationally 13% of all prescribers are enabled2 to send EPCS71% EPCS adoption in New YorkPrescriber Adoption

Pharmacy Adoption

Nationally 96% of all pharmacies received an e-prescription in the last 30 daysNationally 88% of all pharmacies received an EPCS in the last 30 days97% EPCS adoption in New YorkPlease note that adoption stats for all states are available on the More Details page of getEPCS.com.Enabled means a prescriber has software that is capable of sending EPCS, but practice level setup may not be complete.

New York I-STOP has been an unprecedented driver of provider adoptionI-STOP has been a tremendous success that can potentially spill over to the rest of the nation.

I-STOP drove the EPCS certification of over 100 EHRs and countingNew York ranks first in the nation for1:Active e-prescribers with 88% (national average is 63%) EPCS enabled prescribers with 71% (North Dakota is 2nd with 27%)E-Prescribing volume representing 10% of US totalEPCS volume representing 41% of US total

12 Copyright 2016 by Surescripts, LLC. All rights reserved.Surescripts network data, September 2016

Thank You

Ken.Whittemore@surescripts.com(703) 921-2114Copyright 2016 by Surescripts, LLC. All rights reserved.