Class II Controlled Substance Prescription Management Enhancements

We are struggling because our automated phone messaging directs patients to contact their pharmacy to have refill requests sent electronically. Class II (C2) substances cannot be refilled per federal law so the pharmacy system will not allow refill requests to be sent, therefore directing the patient to contact the clinic. This is frustrating to the patient. We would like to suggest some enhancements to the system to improve the C2 Rx management process:

• Have an indicator next to selected drug when completing a prescription to indicate it is a C2 and carry this to the prescription list. (Immediate request)

• Create a C2 Alert on the Home Screen so that when it gets close to the 30 day stop date the provider is aware and can write a new Rx so the patient does not have to call the office. We know we can run the Prescription History report daily and sort by C2 DEA class but this is not as convenient as having an automated alert.

• We know we can set up scripts with future start dates and send them but we are fearful of what this does to medication reconciliation as the patient comes in to other sites (such as ED) during the 90 day period and these scripts might be dc as duplicate. What if on the initial Rx, there is the ability to mark that close to the end of the 1st Rx, the system sets up a 2nd rx as a pending prescription that we would see in the Unprocessed Prescription Q to review and process and so on with the 3rd script (3 max). Our other concern with setting up and sending all 3 at the same time with the second/third future dated is if the Rx gets changed or cancelled and management of this.

• Console - Home Meds - we would like to be able to have a filter to see controlled substances sorted by class.

• Controlled Substance Checklist - add this in to Rx Entry - each site likely has a checklist of items they require before writing a CS meds - date contract signed, date of last drug screen, date of last visit, etc - it would be nice if we could create this checklist and document at the point of the Rx. Not in each Rx but within Prescription Entry module and triggered for review/entry by the DEA class of the script being written.

We recognize the need to meet the Federal and State regulations around EPCS while at the same time trying to bring to the attention of the provider that the 30 day script is coming due for review and a new script may need to be written or other intervention without a phone call to interrupt the clinic flow. We appreciate starting discussion about this issue.