Digital signatures are now required for providers who prescribe outpatient controlled substance medications. The VA's implementation of digital signatures for these medications also allows sites to limit, if needed, the outpatient controlled substance pharmacy schedules (pharmacy schedules 2-5) a prescriber has permission to prescribe. Of course, the site can also allow the provider to write for all schedules.
To digitally sign the controlled substances outpatient orders requires what is called two-factor authentication, which means that in addition to entering their electronic signature, the providers must use their smart card (Personal Identification Verification, or PIV cards, for example), card readers attached to workstations, Personal Identification Numbers (PIN), and digital certificates to digitally sign the orders.
When the provider attempts to digitally sign the order, CPRS checks for a valid DEA registration number, VA number, or Detoxification/Maintenance number for the prescriber and to see if the provider is authorized to write medications for the specified pharmacy schedule to which the selected medication belongs. It uses a digital certificate on the card to sign the order.
By digitally signing the controlled substance order, the prescriber acknowledges and accepts the following as mandated by the DEA:
By completing the two-factor authentication protocol at this time, you are legally signing the prescription(s) and authorizing the transmission of the above information to the pharmacy for dispersing. The two-factor authentication protocol may only be completed by the practitioner whose name and DEA registration number appear above.
How Does CPRS Show a Digital Signature?
CPRS displays order information in several places where users will be able to see that an outpatient controlled substance order was digitally signed.
Cover Sheet: If the order has been digitally signed, the detailed order display from right-clicking the order on the Cover Sheet where it now shows "Elec Signature:" will show "Dig Signature:".
Orders Tab and Meds Tab: If the order has been digitally signed, the detailed order display from right-clicking the order on the Orders tab or from selecting it and choosing Details from the View menu where it now shows "Elec Signature:" will show "Dig Signature:".
Reports Tab: On the Daily Order Summary and Order Summary by a Date Range reports, the signature type will be Digital. On the Chart Copy Summary report, the indicator shows that the order was digitally signed.
Digitally Signing Orders
VA employees have been given a smart card, such as a Personal Identification Verification (PIV) card, to improve security. Digitally signing orders for controlled substances is one area where providers will use their smart cards.
A Personal Identification Number (PIN) controls access to the smart card. When a user needs to digitally sign an order, the user must be at a workstation with a card reader and must insert the smart card and enter the card's current PIN.
To sign controlled substance orders, digitally sign the order by
· Proceeding with the normal electronic signature process.
· Selecting the controlled substance orders that you want to sign. You must select each order individually.
· Inserting your smart or PIV card into the card reader.
· When prompted, entering your PIN and clicking OK or pressing <Enter>.
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