This notice is to inform you about an issue that may occur when e-prescribing a controlled substance in the state of New York when using the DrFirst e-prescribing (Rcopia) web application.

While DrFirst has not received any reports of patient harm, we take this issue very seriously and are proactively notifying clients and partners because of the possibility of a patient safety issue if the maximum daily dose information is not correctly conveyed to the patient.

Who is Impacted

Partners using the DrFirst e-prescribing web application to prescribe controlled substances in the state of New York may experience this issue.

Products impacted

Desktop e-prescribing (Rcopia)

Issue description

New York state requires that prescribers indicate the maximum daily dose (MDD) on controlled substance prescriptions. The MDD on a prescription is intended to communicate the highest amount of medication a patient is permitted to take within a 24-hour period, as directed by the prescriber.

When e-prescribing a controlled medication in New York, the system presents the prescriber with a field to capture the MDD. Currently, the system allows the prescriber to include a value in the MDD field that may not accurately align with the prescriber’s dosing instructions.

This situation occurs when the prescriber is presented with the field to enter the MDD. While the MDD field allows for either a Standard value or a Provider Defined value to be used, the Standard value is prepopulated by default. The prepopulated Standard value is sourced from a leading clinical database with reference to the patient’s age range, but that value is not calculated based on the specific dosing instructions provided by the prescriber. Accordingly, it's possible that if the prescriber indicates a Standard value, the maximum daily dosage reflected on the prescription could be larger than what is intended.

Steps to reproduce

1. Log in to the desktop e-prescribing application (Rcopia) as a controlled substance prescriber at a location in New York.
2. Search for and select a patient.
3. Select Create New Rx.
4. Search and select a controlled substance.
5. On the Prescribe Medication screen (below), notice that a Maximum Daily Dose displays the standard value as a default.

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Mitigation (action required)

Please advise your prescribers to carefully review the Maximum Daily Dose and select the Provider Defined option to manually enter the appropriate MDD.

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Corrective action in process

Our Engineering Team is actively working to address the issue, and we will share release details with you as soon as they are available.

Questions?

Please contact your Customer Success Manager if you have any questions. We value our relationship and are committed to addressing any concerns with you and your clients.