title: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Schneider Institutes for Health Policy, Brandeis University, Waltham, Massachusetts 02454, USA. cthomas@brandeis.edu
authors.forename: Cindy Parks
authors.initials: CP
authors.lastname: Thomas
authors.forename: Meelee
authors.initials: M
authors.lastname: Kim
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kelleher
authors.forename: Ruslan V
authors.initials: RV
authors.lastname: Nikitin
authors.forename: Peter W
authors.initials: PW
authors.lastname: Kreiner
authors.forename: Ann
authors.initials: A
authors.lastname: McDonald
authors.forename: Grant M
authors.initials: GM
authors.lastname: Carrow
mesh_terms: D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D061891:Controlled Substances; D055695:Electronic Prescribing; D006801:Humans; D008404:Massachusetts; D010595:Pharmacists
chemical_list: D061891:Controlled Substances
keywords: controlled medications; electronic prescribing; opioids
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