Skip to main content

Four big takeaways from the I-STOP delays in New York State

The state of New York’s Internet System for Tracking Over-Prescription program (I-STOP) is designed to transition prescribers and pharmacies into eRx software to reduce prescription drug abuse. The program mandates for prescribers to query a patient database and submit prescriptions of controlled substances electronically, which is said to improve accountability that had in the past been regularly challenged by forgery of hand-written prescriptions or errors in interpreting handwriting. I-STOP was originally scheduled to go into effect in December of 2014, was then delayed to March 2015, and after another re-evaluation of the existing industry circumstances as well as feedback from care organizations, the deployment of the program was delayed one more full year to March 27, 2016.

I-STOP isn’t applicable on a national level, but a lot of good lessons can be learned from New York’s early experiences and frustrations with e-prescribing software—particularly for prescribers and pharmacies anticipating similar legislation in the near future. The following are four important takeaways from the I-STOP deployment delay:

1. Transitioning to eRx software takes time

Unfortunately, compliance isn’t simply a matter of buying the right eRx software solution and switching it on. Becoming compliant with any form of regulation such as I-STOP is a regimented process that calls for the reorganization of several clinical and administrative workflows. Bear in mind that any existing contractual obligations with non-compliant vendors might still need to run their course before implementing DEA-certified software, and that validation cannot be performed by someone within the organization. Failure to understand the scope of the compliance process led to complications for many practices and pharmacies in New York.

2. Even the best eRx software doesn’t make you bulletproof

Regulatory compliance isn’t simply a one-time effort, even with a strong software solution in place. New regulations call for new protocols, which require proper staff training and quality control measures. Upholding new regulations is an on-going effort. Software may play a large part in the standardizing and automating of organizational workflows, but it cannot account for the human element involved. The necessary time and resources must be invested to ensure excellent staff use as well.

3. The industry game of “chicken” adversely affects care

Despite the state legislature setting a clear deadline for compliance, agencies in New York initially demonstrated hesitance to adopt a certified software solution. From a business standpoint, prescribers saw no value in investing into eRx software before pharmacies were equipped to handle submissions. Pharmacies were equally reluctant to buy into a certified eRx software system knowing it would be sitting idly until prescribers set themselves up.

Though the vast majority of pharmacies ended up making the original deadline (considerably fewer prescribers did, due to unforeseen delays with the DEA software certification process), it’s important to think about how this experience might affect patient care if similar transitions occur in other states. Are patients going to have continuous access to prescription drugs, for example, or will implementation problems somehow disrupt the process of care?

4. Early awareness is important

If your state rolls out a new round of regulation, how soon will you know about it? Do you have a compliance manager on staff who keeps abreast with regulatory requirements? How is that information disseminated throughout your state? The initial effort to pass I-STOP in the state of New York demonstrated the importance of early awareness. The already significant challenge of having to manage a sensitive timeline is further complicated by getting a late start, and was most likely an underlying cause in the majority of prescribers missing the original I-STOP deadline.

The delay of the I-STOP program is an important gut check for the healthcare industry. If the program proves to be a success, there is a chance that other states may begin to consider applying similar legislation. The challenges in New York will have provided a learning opportunity for other states that may have to upgrade to program-compliant eRx software in the near future.

Organizations that want to avoid some of the missteps described above will want to consider an EHR with integrated eRx software. Valant partners with Dr. First to provide certified solutions, and our implementation team guides customers through each step to ensure a smooth transition into eRx and EPCS capabilities. To request a product demonstration, click the button below.