CONTROLLED SUBSTANCES

EPCS: what to expect when you sign a controlled substance

Electronic prescribing of controlled substances in Epic Hyperspace adds a few screens after Sign Orders: a PDMP check, a DEA review, and a second signature on your phone. Four steps, start to finish.

Imprivata ID, on your phone →Required before your first controlled prescription. Download the app.

BEFORE YOU STARTEnroll Imprivata ID on your phone first. Without it, step 4 has nowhere to send the approval and the prescription will not sign. Prescribing from Haiku or Canto? Also enroll your face. Need help setting up? Use remote setup.

Need Imprivata set up? Get remote help

If Imprivata ID is not set up on your phone yet, or your Imprivata enrollment for EPCS is not finished, the enrollment team can finish it with you by phone and a remote connection to your Freeman computer. No trip in person.

Call 417-347-3227 (from a Freeman phone, dial 347-3227), 8 a.m. to 4 p.m., Monday to Friday.

Already have Imprivata ID set up and want EPCS from Haiku or Canto? Enroll your face yourself; no call needed.

Before you call: install Imprivata ID on your phone

Download Imprivata ID from the App Store or Google Play, then follow these screens.

Imprivata ID screen: Looks like you haven't enrolled Imprivata ID on this phone yet, with This is my first time circled

Tap This is my first time

Open Imprivata ID. When it asks whether you have used it before, tap This is my first time.

Imprivata ID Fast Access screen with Not now circled

Fast Access: tap Not now

Fast Access may come later; you can turn it on in the app's settings.

Imprivata ID Simplified E-Prescribing screen with Not now circled

Simplified E-Prescribing: tap Not now

This may come later too, and can be turned on in the app's settings.

Imprivata ID Automatic Signout screen with Not now circled

Automatic Signout: tap Not now

The same: it may come later, and can be turned on in the app's settings.

Imprivata ID screen showing a Serial Number (blurred) and a six-digit Token Code

Serial Number and Token Code: you are ready

When you see this screen, Imprivata ID is installed correctly and the team can register it with you. Now call.

A step not working? Delete Imprivata ID from your phone, install it again, and start from the top. This is a known issue if you used Imprivata on a different phone before but never registered it.

Then connect and call

Open Freeman Remote Support

On a Freeman computer, double-click Freeman Remote Support on the desktop: the orange headset icon. Super users and administrators may see a shield with two arrows instead.

No icon? Use the web page

Open a browser on the Freeman computer and go to support.freemanhealth.net.

Freeman Health System Remote Support web page at support.freemanhealth.net, with the Session Key box and Submit button outlined

Call and type the session key

Call 417-347-3227 and ask for Imprivata setup for EPCS. Type the Session Key they give you, then click Next (on the web page, Submit).

Freeman Remote Support Button window with the Session Key field and the Next button outlined

Let the team connect

An enrollment supervisor connects to your computer, watches your enrollment, and registers Imprivata ID with you. Keep your phone in hand.

Order, sign, and clear any warnings

Start the way you start any prescription. The controlled-substance screens only appear once you sign.

Place the order and check the pharmacy

Enter the controlled medication and confirm the patient's pharmacy is the right one (covered in basic training). Then press Sign Orders.

Epic order sidebar: outpatient ALPRAZolam order with the pharmacy shown and the Sign Orders button

Review the warnings

Read each warning and act on it. Remove or Discontinue a duplicate, or give an override reason and press Override and Accept to continue.

Medication Warnings dialog: a High duplicate therapy warning with Remove, Discontinue, override reasons, and Override and Accept

Check the PDMP

Before you go further, review the patient's PDMP.

Look for a recent prescription for the same or a similar medication from another prescriber, and for a total daily dose that puts the patient at excessive MMEs. If either is there, stop and reconsider the prescription before you sign it.

Screenshot coming. The PDMP view is not pictured yet; the step is the same.

Pick your DEA number, mark Reviewed, and Sign

The Review of Controlled Medications for E-Prescribing window is the DEA-required check of each order.

In DEA Number, pick the right registration: your Individual DEA # or the Missouri one.
Tick the Reviewed box beside each medication after you have checked the provider, patient, drug, sig, and dispense details.
Press Sign. Completing the two-factor step that follows is your legal signature and authorizes transmission to the pharmacy.

Review of Controlled Medications for E-Prescribing: DEA Number picker with Individual and Missouri options, Reviewed checkbox beside the medication, and the Sign button

Confirm your identity on your phone

Imprivata asks for two things: your Freeman password at the workstation, then one tap on your phone.

Type your Freeman password

The Confirm your identity bar appears. Enter your Freeman network password and press the arrow.

Imprivata Confirm your identity bar with the password field and arrow button

Epic waits for your phone

The bar shows a check on the password and "Approve on your" followed by the phone you enrolled. Pick up that phone.

Imprivata Confirm your identity bar: password accepted, now asking you to approve on your enrolled phone

Press Approve

An Imprivata ID notification arrives: "Approve this access request." Press Approve on the notification, or open the app and press Approve there. The prescription signs and transmits to the pharmacy.

Imprivata ID phone notification: Approve this access request, with Deny and Approve

Imprivata ID app dialog: Approve this access request, with Deny and Approve buttons

EPCS from Haiku and Canto

You can sign controlled substances from Haiku on your phone and Canto on your iPad too. Every controlled prescription needs two factors, every time, but the two are not the same:

In Hyperspace, at a computer: your Freeman password plus the Imprivata ID approval on your phone (step 4 above).
In Haiku and Canto: your face plus your Freeman password. Face recognition is only for signing controlled substances; you still log in to Haiku and Canto with Duo. Enroll your face once, at a Freeman computer, before your first controlled prescription from your phone or iPad.

Step by step instructions for signing in Haiku and Canto are coming to this page.

Enroll your face in Imprivata

The screens advance on their own; tap a step to hold it there.

You need two things first

Imprivata ID already registered and set up with Freeman on your phone. Step 9 of enrollment sends an approval to it; without it, enrollment cannot finish. Not set up yet? Use remote setup.
A Freeman Windows computer with a webcam, signed in with your own Freeman account.

Windows notification area with the hidden icons open and the Imprivata icon outlined, plus a larger view of the icon: a dark circle with a white i and a green check

Find the Imprivata icon

In the notification area at the bottom right of your screen, find the Imprivata icon. If it is not showing, click the up arrow to show hidden icons.

Imprivata menu with Enroll Authentication Methods outlined

Right-click it and choose Enroll Authentication Methods

Right-click the Imprivata icon, then choose Enroll Authentication Methods.

Imprivata Enroll and manage your authentication methods window with the network username and password fields outlined

Type your Freeman username and password, then press Enter. Leave the domain set to FREEMANHEALTH.

Imprivata enrolled methods list showing Imprivata ID and security questions, with Enroll your face outlined under Not enrolled yet

Click Enroll your face

Under Not enrolled yet, click Enroll your face.

Imprivata Manage your face page with the top Enroll face link outlined

Click Enroll face

Click the top Enroll face link, not the one under Legacy Mobile EPCS enrollment.

Look at your webcam

The Imprivata Authentication window opens and uses your webcam. Look straight at the camera while it captures your face.

Imprivata Authentication required page with the password field and arrow outlined

Type your Freeman password

Because you can sign controlled substances, Imprivata asks you to confirm it is you. Type your Freeman password and press the arrow.

Imprivata Authentication required page with the password accepted and Imprivata ID, Approve on your phone, outlined

Imprivata waits for your phone

The password shows a check, and the window asks you to approve on the phone where Imprivata ID is set up. Pick up that phone.

Press Approve on your phone

In Imprivata ID, press Approve.

Imprivata Manage your face page with the message Your face is successfully enrolled and the Done button outlined

Click Done

Your face is successfully enrolled appears. Click Done, and you are finished.

Need help

Imprivata ID not prompting, or a password problem: call the IT Help Desk at 417-347-4500.

Why two factors

Multifactor authentication (MFA) means proving it is you with two different things at once: something you know, like your Freeman password, and something you have or are, like your phone or your face. A stolen or guessed password alone is not enough. For you, that means no one else can sign a controlled substance prescription under your name and DEA registration. For your patients, it keeps their records and prescriptions out of the wrong hands. That is why the DEA requires two factors for every controlled substance prescription.

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