“The way we currently write paper prescriptions is tantamount to leaving blank checks all over town.”
$2,500 a year. However, a free e-pre- scribing application is available through the National ePrescribing Patient Safety Initiative. For more information on the free program, visit
www.nationalerx .com.
Next, Dr. Schade says his software
vendor, DrFirst, had to verify his iden- tity. Physicians’ e-prescribing vendors typically use a third-party authentica- tion service that requires physicians to provide detailed personal information, including credit reports, to confirm the physicians are who they say they are. Only the third-party authentication ser- vice has access to the physician’s private information; the software vendor does not.
me any support. I’m not sure if it’s lack of knowledge on the part of law enforce- ment, lack of funding, or lack of inter- est,” she said. “It’s been expensive, it’s been very time-consuming, and it’s been frustrating.” Dr. White says because people are using her information to cash in faulty prescriptions all over the state, the case involves multiple police jurisdictions, and, she says, the local departments do not collaborate well. In addition, the perpetrators are hard to pin down, she says. The fake patient could claim he or she didn’t know it wasn’t Dr. White who provided the pre- scription, or the perpetrator could use a fake identity at the pharmacy, she says. “These investigations are painstakingly
slow,” she said. “And the criminals are always getting smarter.” Dr. White personally called about 20 pharmacies in the Houston area to warn them against filling a prescription with her name on it that doesn’t match her actual phone number and office address. “Through speaking with pharmacists and various sources in law enforcement, I’ve found that at least 25 to 30 physi- cians in the Houston area have had the same thing happen to them. I suspect there are many more who don’t even know that it’s happened to them because they never dreamed they might be vul- nerable,” she said.
Physicians who suspect prescription 56 TEXAS MEDICINE July 2014
fraud should notify DPS by calling (512) 424-7293 or emailing RSD_CES_Crimi
nal@dps.texas.gov. Dr. White says if you have the cre- dentials to write a prescription for a con- trolled substance, you must safeguard those credentials. “Generally, the pharmacists try to do the right thing,” she said. “But identity theft is so easy, and I’ve seen this prob- lem becoming bigger every week.”
An invasive procedure DEA legalized EPCS nationally in 2010. The process for a doctor to become cer- tified for EPCS is arduous and intrusive, says C.M. Schade, MD, who specializes in pain medicine in Mesquite. Dr. Schade is a member of the Texas Medical Asso- ciation Interspecialty Society Committee. As a leader in pain medicine, Dr. Schade says he is participating in EPCS to help guide fellow physicians through the process. “At this point, it [the pro- cess] doesn’t work very well.” First, Dr. Schade says, he had to pur- chase e-prescribing software from an EPCS-certified vendor. Purchasing and installing the software and completing training on how to use it took about a month. According to the U.S. Department of Health and Human Services Health Resources and Services Administration, the stand-alone cost of an e-prescribing application can cost a physician up to
“They know everything about your identity,” Dr. Schade said. “They have more information than the credit bureau has. It’s scary.” It took Dr. Schade about a week to
complete the authentication process, which included answering detailed ques- tions about his credit history. “It’s not something you can do in a
day,” he said. “It’s fairly rigorous.” Once DrFirst verified his identity, Dr. Schade had to create two identifiers to use whenever he prescribes a controlled substance electronically. An identifier can be a password, a fingerprint, a reti- nal scan, or a token. Dr. Schade uses a hard token and a password. A hard token is a pocket-sized elec-
tronic device. When physicians want to verify their identity, they can push a button on the token that will generate a number the physician must enter into an electronic prescription form within a short time frame, usually 30 seconds to a minute. A soft token works similarly but takes the form of an app physicians can down- load onto their smartphones. After the vendor sent him a hard to-
ken, Dr. Schade says he wanted to give the process a trial run. He called 20 pharmacies near his office to see which ones could fill an electronic prescription for a controlled substance. He says half of the pharmacists flat-out refused his EPCS request.
Of the pharmacies with EPCS-certi- fied software systems, only 25 percent
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