Committed to improving the health of children for over 70 years, Nemours Children’s Health System is one of the nation’s largest integrated health systems. Nemours selected HID Global to deploy strong authentication solutions enabling Electronic Prescriptions for Controlled Substances (EPCS) to enhance their processes and patient experience.
Complications in existing system
The Nemours Children’s Health System existing paper-based prescribing solution was extremely inconvenient for physicians, and created a negative patient experience by increasing pharmacy wait times. The manual system prevented physicians from being able to issue a prescription to patients during Telemedicine sessions – an otherwise efficient and real-time means for care delivery.
It also was burdened by the ongoing cost of expensive paper and secure record storage, and how difficult and time-consuming it was to use it when conducting investigations, as needed.
The system was particularly challenging for children whose family had to come long distances to pick up prescriptions, whether for a follow-up exam that would require another long trip, or for medication that they would ultimately be picking up back at home. For many Nemours patients, refills are needed as frequently as every 30 to 90 days.
Nemours solution requirements
Complicating matters, doctors are not always located at one of the several clinic sites where prescriptions are printed, adding to the amount of time that patients often had to wait. The hospital wanted to replace this paper-based prescription system with a convenient, Drug Enforcement Agency (DEA)-compliant and government certified solution for EPCS, so that physicians could send prescriptions at any time, from any place, and families could make a single trip to their local pharmacy. In addition, the solution had to be:
- Able to integrate with Nemours’ Epic Electronic Health Records (EHR) system
- Simple to use, providing options for the prescribing physicians who often travel and work at different locations or conduct telemedicine sessions
- Cost effective and easy to support from an IT perspective
Improving productivity and patient experience
By implementing a new EPCS solution, Nemours planned to increase overall productivity while improving the patient experience. The new solution would eliminate the need to obtain a paper-based prescription and reducing pharmacy wait times.
"Our mission is to be the guardians of children’s health and joy, and the guardians of their health information"
Its implementation would require instituting policies, procedures and new workflows into their prescribing framework, as part of a DEA-compliant system with two-factor authentication that would ensure physicians no longer had to find, sign and mail prescriptions. Instead, they could take care of everything electronically from inside the exam room, as part of an easy-to-use system that improved the prescribing experience for doctors and patients alike.
“Our mission is to be the guardians of children’s health and joy, which also extends to being the guardians of their health information,” said David Jollow, Chief Information Security Officer with Nemours Children’s Health System. “To fulfill our mission, we needed an e-prescribing solution that would enable us to provide the exact care our patients need, when and where they need it, and that minimised impact on home and work life while providing all necessary protections for personal data.”
HID Global credentials
Nemours selected an integrated, DEA-compliant and government-certified solution from HID Global that empowers them to attach a digital certificate of identity authentication to a FIPS 140.2 certified credential, using IdenTrust as the Certificate Authority for each authorised prescriber.
The HID Global credentials also include one-time password (OTP) functionality that allows EPCS authentication using an OTP, without the need of a desktop reader. With HID integration to Epic EHR, either the digital certificate or the OTP (with PIN) can be accepted within the EPCS module for two-factor authentication. This provides the convenience for the prescribing physician to choose the authentication mode that best fit his or her workflow in a given scenario. The integrated solution includes:
- ActivID® Credential Management System (CMS), ActivID Authentication Server
- OMNIKEY® readers/encoders and FIPS 140.2 contact credentials with an OTP generator and display window
- FARGO® printers and Asure ID® software to print customise credentials
- HID Professional Services for project management, installation, workflow analysis, training and support
Adoption of EPCS process
"We are seeing extremely rapid adoption rates for our new e-prescribing system, and overwhelmingly positive feedback since its roll-out"
The hospital has reported significant improvements in physicians’ prescribing experience now that they can quickly and simply authenticate to a system for writing on-line narcotic prescriptions, in full regulatory compliance. Dozens of doctors are using the new EPCS process, which also makes it possible to digitally monitor and track prescriptions to eliminate paper and storage costs. They can prescribe from any location, whether at work or home, and easily send prescriptions in the evenings, after hours and on weekends.
The patient experience is also better. They spend less time waiting at the pharmacy for new prescriptions and refills now that they can be sent ahead for fulfillment, prior to their arrival. In most cases, prescriptions can be filled in the same day – a savings of at least two to three days as compared to the earlier paper-based prescribing model. Meanwhile, both physicians and their patients have the confidence that prescriptions are going directly to the pharmacy without the previous risk of theft or loss when they were mailed.
“We are seeing extremely rapid adoption rates for our new e-prescribing system, and overwhelmingly positive feedback since its roll-out,” said Dr. David West, medical director for Nemours Health Informatics and the physician champion for the EPCS project. “Based on this high level of success so early in its deployment, we are now also exploring how to leverage the HID Global EPCS architecture for other valuable capabilities, such as authenticating to VPNs and enabling remote access using credentials, key fobs, mobile smartphones, and other smart devices and one-time password tokens.”