In the latest Part B News we discuss how to deal with a stolen prescription pad in your practice. Years before he became vice president and chief medical informatics officer at Hartford HealthCare, Spencer Erman, M.D., was a family practitioner when he had a pad stolen; he tells us how he handled it, and what he learned.
Before we went electronic on our EHR, I was making very reasonable efforts to protect my prescription pads. I kept them in my lab coat pocket or locked in a desk drawer. But someone, somehow must have found one of my spare pads in a cabinet or something – and took it and tried to pass off a fake prescription.
That was ten years ago, when I was working in a busy family practice in Avon, Connecticut. Luckily, I had been in the area for a number of years and all the pharmacists knew me. They called right away because it was known that whenever I wrote prescriptions for controlled substances I would always make it out for an odd number of pills. So, the pharmacist knew this particular script was probably fraudulent when they saw my license and DEA number on a script for an even 30 pills, instead of 31. They called me and we got the DEA and police involved right away. And that was it, luckily.
Reflecting back, I think I was being as safe as I could have been at the time. I’ve seen many providers try different approaches to prevent prescription pad theft and fraud. Some write their prescriptions in a certain color ink or use pads that can’t be photocopied. Others, including me, have tried using special fonts that can only be read with a magnifier that only pharmacists have.
The problem is all of these approaches still depend in part on pharmacists’ knowledge of each prescriber’s habits.
We made the switch to EPCS [E-Prescribing of Controlled Substances] because it was mandated in the state of Connecticut, but we were heading down that path anyway because of the opioid crisis. Our leadership and providers understood it was necessary to do our part to help combat opioid and substance abuse. But making the switch has proved to have many advantages beyond fraud protection. For example, EPCS is helping doctors limit the amount of medication they prescribe. In the past we might give patients 7-10 days’ worth of pills to avoid the hassle of having them physically come back for another paper prescription. Now we can give just 2-3 days’ worth and send a new prescription electronically to people who legitimately need more medicine. It is convenient for patients and limits the number of pills out on the streets or sitting unused in medicine cabinets.