Early experience with electronic prescribing of controlled substances in a community setting

Abstract

Background: In 2010, the US Drug Enforcement Administration issued regulations allowing electronic prescribing of controlled substances (EPCS), a practice previously prohibited. Objective: To carry out a survey of the experience of prescribers in the nation's first study of EPCS implementation. Materials and methods: Prescribers were surveyed in a community setting before and after implementation of EPCS, to assess adoption, attitudes, and challenges. Results: Of the 102 prescribers enabled to use EPCS and who responded to surveys before and after implementation, 70 had sent at least one controlled substance prescription electronically. Most users reported that EPCS was significantly less burdensome than expected. Over half reported that EPCS was easy to use and improved work flow, accuracy of prescriptions (69.5%), monitoring of medications (59.3%), and coordination with pharmacists, though high prior expectations for improved efficiency were not met. EPCS users reported a significant decrease in the perceived frequency of medication errors and drug diversion, compared with controls. Barriers to use of EPCS included limited pharmacy participation and instances of unreliability of the technology. Discussion: Interest in adoption of EPCS is considerable among providers, pharmacies, and vendors. The results suggest that while most EPCS security features may be more acceptable to providers than expected, barriers such as the limited participation by pharmacies may also partly explain slow adoption rates for EPCS nationally. Conclusions: EPCS was a better experience for many providers than they had expected, but related improvements in practice efficiency and quality of care will depend upon implementation strategies.