Friday, March 25, 2016

Statement from Joseph Maldonado, MD, President, Medical Society of the State of New York

“New York’s physicians have been on the front lines of responding to the opioid addiction crisis.
We are proud that, as a result of our efforts and the efforts of other prescribers to check the prescription monitoring database before we write a prescription for a controlled substance, inappropriate prescriptions due to “doctor shopping” are down by 90% in New York. And data shows that prescriptions for the most powerful opioid medications have been declining in New York and are far below most other states in the country. However, we need to do more.
New York physicians have been steadily working to implement e-prescribing technologies into their practices.  Part of the challenge has been that, until recently, many of the systems physicians and hospitals use had not been certified as required by the federal government.   This glitch has caused significant hassles for physicians and hospitals seeking to incorporate these technologies into their electronic medical record systems to enhance, rather than interfere with patient care. Moreover, there are numerous patient situations where e-prescribing is not yet practical for all medications and all healthcare settings; this week, the State Health Commissioner released a letter identifying 12 situations where e-prescribing will not be required.
There are many physicians across New York State who, by the nature of their patient care setting, write very few prescriptions.  Mandating these physicians to adopt costly and cumbersome technologies that, so far, have proven to be extremely challenging may cause many long time physicians to give up patient care altogether.  As a result, MSSNY is seeking legislation so that these physicians (those who write 25 or less prescriptions per year) can continue to issue paper prescriptions.  Many of these physicians have applied for and received a waiver from New York State.  We seek to eliminate the need for these physicians to apply year after year.
The other change we request is to lessen the paperwork burden for those instances when a physician has to issue a paper prescription when technological issues arise that prevent a patient from getting an e-prescription.  The current law requires extensive documentation from the physician to the NYS DOH, including articulating the specific section of law they invoke asking for the exceptions.  This requirement is unnecessarily burdensome to prescribers, and will take unnecessary time away from delivering care.   MSSNY is asking that prescribers be permitted to document the issuance of a paper prescription in the patient’s record.
New York physicians very much want to make sure that powerful opioid medications are only being used by those who truly need them.  As we all work together to implement New York’s I-STOP law, which includes the e-prescribing mandate that goes into effect March 27, we are, in no way, undermining the goals of ISTOP. The requirement to check the database is still in force even for low prescribers.
However, let’s make sure that there is flexibility so that patients’ care won’t be unnecessarily delayed by an over-complicated system that deters continuity of medical protocols.”