As an epidemic of opiate abuse in Massachusetts rages on, stopping the flow of drugs has proved to be a stubborn problem.
Unlike common medications, which are usually prescribed electronically, almost all prescriptions for controlled substances such as codeine and oxycodone are issued on old-fashioned paper. That gives addicts access to a physician’s signature and prescribing number, making it surprisingly easy to write a fake prescription.
Now, a Lexington health care IT security company, Imprivata Inc., says it has a solution: an electronic prescription system for controlled substances that securely transmits sensitive information directly from doctors to pharmacies. The software, called Confirm ID, is set for release Monday after a trial run last year at 10 health systems.
“If you can move controlled substance prescriptions to being only electronic, over time we can have better visibility and control and deal with this fraud,” said Omar Hussain, the company’s chief executive. “It’s a solvable problem.”
The Imprivata software is intended to make it easier for doctors and health care systems to meet federal standards for prescribing controlled substances through an electronic system. Most doctors have stuck to paper for these drugs because the Drug Enforcement Agency requires a series of checks for electronic prescriptions of controlled substances, including additional authentication using either a thumbprint or electronic token. Most of the software systems used by doctors and health care providers do not have that level of security.
The Confirm ID system requires doctors to scan their fingerprint or use a one-time password. The launch of the product is timely: A New York law requiring nearly all prescriptions to be transmitted electronically goes into effect this spring, and the federal government is promising to help states improve prescription-monitoring programs.
Imprivata’s product integrates with many existing medical software systems that health care providers already use — a key feature that saves physicians from having to spend time learning a new system or reentering information in a separate program.
“A lot of times when a new electronic health system is introduced, doctors and nurses hate it because they take a huge productivity hit,” Hussain said. “We had to make it easy enough that they don’t prefer the paper system.”
Imprivata says Confirm ID will keep physicians’ signatures and their DEA registration numbers, which can be used to forge painkiller prescriptions, out of public view. The software also will allow health care administrators to track opiate prescriptions and intervene with doctors who prescribe too many painkillers.
The company says making it easier to prescribe controlled substances will help curb the practice of over-prescription; doctors sometimes give patients more pills than they need just to avoid writing a second prescription. Those leftover pills are another source of opiates for addicts.
“Right now, doctors try to prevent renewals by giving patients more pills at the initial visit,” said Michael Lee, director of clinical informatics at Atrius Health, a large medical group in Massachusetts that participated in the trial.
“I had a patient who got 360 oxycontins after surgery, and he had 300 leftover,” Lee said. “The volume of pills being prescribed is insane.”
Lee said Confirm ID is working well at Atrius after a few initial bumps. Setting up the system was time-consuming because each doctor’s credentials had to be verified and linked to his or her account to ensure security.
Moreover, some pharmacies initially balked at receiving electronic prescriptions for controlled substances, Lee said, because they were so used to paper.
Imprivata’s CEO says the system aims to be easy for doctors to use.
Not everyone agrees an electronic prescribing system will reduce opiate abuse.
E-prescriptions of controlled substances “can reduce some diversion but won’t prevent addiction,” said Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, who noted that because the software does not track or store patient information, it will not flag those patients who are “doctor-shopping” to get more painkillers.
“Pills obtained through forged prescriptions or stolen prescription pads typically make their way to people who are already addicted,” he said. “To really bring the epidemic under control, you need to prevent new cases and treat people who have it.”
Controlled substances account for about 10 percent of all prescriptions, according to a study published in the American Journal of Managed Care , but most are still prescribed by pen and paper. Analysts said that low use rate gives Imprivata plenty of room to grow, especially since other software companies have mostly avoided this business because of the federal regulations and variations in state rules.
“The health care software companies could do it themselves, but given the privacy and regulatory risks of not doing it right, you’re better off just outsourcing it to the experts,” said Sean Wieland, a research analyst at Piper Jaffray & Co. who follows the company. “And Imprivata has some pricing power here because it’s not a ‘nice-to-have,’ it’s a ‘must-have.’ ”Dan Adams can be reached at firstname.lastname@example.org. Follow him on Twitter @DanielAdams86.