Your Chapter in Action is a streamlined communication distributed every two weeks to members of the New York Chapter of the American College of Physicians. Each communication is focused on the Chapter’s three core missions: Education, Advocacy and Quality Improvement and provides you with resources, tools and ways to connect. For more information or direct discussion of any issue listed – call our office at 518-427-0366.


August 14, 2014

NYSDOH Ebola Virus Update and Opportunity For Conference Call Participation
Update on Management, Prevention, And Containment

In recent weeks, there has been a growing concern over the potential spread of Ebola Virus disease (EVD) from its native locus of Western Africa (Guinea, Sierra Leone, Liberia, and Nigeria) to the United States and other parts of North America. The Centers for Disease Control and New York State Department of Health have both released guidelines for proper care and handling of patients with potential cases of EVD along with any laboratory material with suspected EVD exposure. Consequently, the NYSDOH will be hosting a conference call outlining the latest information regarding the spread, treatment, containment, and world disease status of EVD on Monday August 18, 2014 @ 10:00 AM. Members simply have to dial 1-855-279-5488 at 10am on Monday, there is no code required for attending and it is free for all. The conference call was recorded for those who were unable to attend to access the recording please dial  (855) 859-2056 or (404) 537-3406 and provide Conference ID# 88792246. It will be available from 08/18/2014 to 09/18/2014.
 
Ebola Virus is transmitted via bodily fluids of those infected with Ebola and through the handling of rodents and primates infected with the virus (primarily in Western Africa); it is NOT transmitted through the air or respiratory droplets. Clinical criteria includes pyrexia along with severe headache and generalized muscle pain and malaise, GI upset including vomiting and diarrhea along with potential hemorrhage. It is important to note that while there have been a total of 1,323 cases of EVD as of July 27th, 2014; there have been no reported cases of the virus in North America. However, it is prudent to understand the guidelines and regulations in handling suspected cases of the virus as international spread is always a possibility.
 
For any patient with suspected features of EVD with recent travel to known areas of primary EVD disease (Western Africa), the attending physician should take extreme caution when examining patient, place patient in private room with a closed door, instruct patient on how to use rubber gloves and surgical mask and to abstain from touching items in the exam room. All medical staff should be alerted of the potential EVD case on premises, the amount of staff that come in contact with said case should be limited and those who do should use the proper personal protective equipment (gloves, fluid impermeable gown, eye protection, facemasks, leg and shoe coverings) in cases with open wounds or bodily fluid, clean room suits should be used.
 
Once patient is sequestered and safely kept, the attending physician should call the Local Health Department with the following information:
  • The patient’s risk factors and travel history, including dates, destinations and other potential contact including contact with animals and other people.
  • The patient’s current status including physical and mental along with pressing concerns for the patient’s immediate health.
The Local Health Department will then confer with the attending physician regarding the testing procedures (as outlined below) and any further information regarding a potential transfer to another medical facility.
 
Laboratory guidelines are as follows:
  • When possible, tests should be done in patient’s isolation room using Point-Of-Care (POC) instruments and testing methods. Transferring specimen from isolated room to other rooms should be done as minimally as possible and should be done with extreme caution using Clean Room Suits and hand carried in a container that has been thoroughly wiped down with 10% bleach. All specimen manipulation must be done in a Class 2 biosafety cabinet (BSC2)
  • Guidelines for specific laboratory procedures can be viewed in the attached NYSDOH Brief.

Practice Management

More Information on Mandatory Electronic Prescribing Effective March 27, 2015

By March 27, 2015, all prescriptions (including prescriptions for non-controlled substances) issued in New York State must be electronically transmitted, with certain limited exceptions. 

For electronic prescribing of controlled substances (EPCS), the regulations require a practitioner to register their certified electronic prescribing computer application with the New York State Department of Health, Bureau of Narcotic Enforcement (BNE). To register your computer application with BNE, please complete the enclosed EPCS Registration form and email it to narcotic@health.state.ny.us with "Practitioner EPCS Registration" in the subject line.


For physician practices who don’t already have an electronic medical records system that can provide electronic prescriptions,
see a list of “stand alone” e-prescribing software (HERE)   (You will still need to complete the NYS EPCS registration as above) available here:
https://www.health.ny.gov/forms/doh-5121.pdf
 


The DEA requires two-factor authentication for signing controlled substance prescriptions. The factors must include two of the three following authentication modalities: Something you know (password, key, security question); Something you have (PKI smartcard, key fob token); or Something you are (biometric). For example, a key fob token and password would work as they combine two different modalities: something you have and something you know.  The e-prescribing software vendors who are certified for EPCS will support at least one of these options for two-factor authentication.

Identity Proofing and Registration - Once you have ePrescribing software that’s been audited and certified, and have put in place supported two-factor authentication technologies, physicians must also go through an identity proofing process.

  •  Individual care providers using their own DEA numbers need to go through an identity proofing process to get their EPCS signing credentials. If they are using their own DEA number, they need to use a federally approved Credential Service Provider (CSP) or certificate authority (CA).
  • Care providers in healthcare organizations like hospitals can use the institutional DEA number if it is combined with a unique “internal code” assigned to that prescriber. In this case, the practitioner gets EPCS signing credentials from the hospital credentialing office.

Care providers must then register their authentication credentials and request EPCS privileges. Any security breaches, including a lost or stolen token, must be reported within one business day. If an electronic prescription is unsuccessful, the replacement process must indicate that the original electronic attempt was sent unsuccessfully to the pharmacy.

New York State Regulations related to Electronic Prescribing of Controlled Substances may also be accessed electronically.  Specific regulations pertaining to issuing electronic prescriptions for controlled substances may be accessed in 10 NYCRR 80.64

If you have met all federal security requirements and would like to register the application with the Bureau of Narcotic Enforcement, send an email to narcotic@health.state.ny.us. Include "Electronic Prescribing" in the subject.


Education

NYACP Webinar: Understanding the Changes to ABIM's MOC Program

Tuesday, September 16, 2014
12:00 noon - 1:00 pm


In an effort to help NYACP members understand the recent changes to the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program impact them, ABIM staff member Kevin Caviston will give a presentation focused on the MOC program and will discuss the reasons behind the changes to the program, how the changes impact board-certified physicians and identify ways in which physicians can meet the MOC requirements.

To Register, please go to: MOC Webinar

International Medical Graduate Symposium

Thursday, August 14, 2014
Time: 5:30 - 7:30 PM

Icahn School of Medicine at Mount Sinai
The Leon and Norma Hess Center for Science and Medicine
Davis Auditorium, 2nd Floor
1470 Madison Avenue
New York, NY 10029
To Register and for more information- click here for flyer

 

Last Updated 8.7.14

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New York Chapter of the American College of Physicians
744 Broadway, Albany NY 12207
Tel: 518-427-0366
Fax: 518-427-1991
Email: info@nyacp.org