Revere Health Physicians Using Technology to Curb Opioid Abuse

PROVO, UT – May 9, 2017 – Opioid abuse is a problem throughout the U.S., but especially in Utah, which consistently ranks among the top 10 in the nation for prescription overdose deaths. Jeffrey Johnson, MD, an internal medicine physician at Revere Health, is one of the first physicians in Utah to start using Electronic Prescriptions for Controlled Substances (EPCS), a technology that can help reduce abuse.

EPCS is a program that legalizes and secures electronic prescriptions for controlled substances, including schedule II drugs like oxycodone or fentanyl. Electronic prescriptions have been available for over a decade, but schedule II drugs require an intricate process of checking and crosschecking—now possible with EPCS—that the original e-prescribing technology wasn’t equipped to handle.

It is beneficial in the same ways that electronically prescribing any medication is beneficial—electronic prescriptions are legible, whereas handwritten prescriptions can be misinterpreted by a pharmacist or altered by a patient. Additionally, electronic prescriptions can be checked for drug-to-drug interactions and other clinical alerts.

The number of opioid deaths in Utah has been climbing steadily—the state saw almost a 400% increase from 2000 to 2015—and today unintentional overdose deaths related to opioid abuse surpass the number of unintentional deaths due to firearms, falls and motor vehicle crashes. Policies and programs such as Utah’s Controlled Substance Database, mandatory physician education and the statewide “Stop the Opidemic” campaign all aim to combat prescription drug abuse, and EPCS, introduced to Utah in 2014, provides an additional solution to the growing problem.

“This is an advantage for those that frequently prescribe controlled substances,” said Johnson. “Through EPCS, these types of prescriptions are easier to handle and more secure for patients, and prescription drug abuse is less likely.”

Controlled substance abuse increases both human and financial cost throughout the state. In 2016, the Utah Legislature issued a concurrent resolution classifying Utah’s drug overdose death rate as a public health emergency. Nine lives are lost each week in Utah due to prescription drug abuse, and the cost of care for opioid abusers is eight times higher than that of non-abusers. EPCS helps decrease both death rates and healthcare costs through preventive measures against prescription fraud.

“Electronic prescriptions can significantly reduce the risk of fraud and misuse,” said Revere Health Pharmacy Director Chris Roller. “The prescriber is required to go through an authentication process, the prescriptions are nontransferable and the pharmacy that receives the prescription is the only one able to fill it. There is security in knowing a prescription can’t be stolen or altered and that there are no clerical errors.”

Prescription fraud occurs in many forms, whether through stolen prescription pads, doctor shopping, prescriptions made for fictitious patients or by illegitimate doctors, or alterations of a legitimate prescription.

“With the right equipment, anyone can copy and forge a written prescription,” said Johnson. “EPCS bypasses that problem completely with several levels of provider authentication.”

In order to prescribe controlled substances electronically, the provider’s identity must be verified through federally approved credentialing or certification organizations. EPCS also requires an additional level of authentication for each prescriber using two of three authenticators:

1. Something you know: information such as a secure password or PIN.
2. Something you have: a one-time password device or hard token
3. Something you are: certain biometrics, such as fingerprints, approved by the Drug Enforcement Administration (DEA).

Johnson, along with administrators and members of Revere Health’s IT team, are working with physicians in other departments at Revere Health to expand the use of EPCS throughout the clinic.

“We believe that EPCS is critical in helping reduce Utah’s rates of prescription drug abuse,” said Johnson. “Our goal is to help physicians at Revere Health who frequently prescribe controlled substances understand and have access to this tool.”