The US Congress passed the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331) in mid-July that will, for the first time ever, provide financial incentives to physicians who adopt electronic prescribing (ePrescribing), and require broad adoption by 2011. Please visit our alerts page for more information.
E-prescribing Overview:
E-prescribing has been described as the solution to improved patient safety and reducing sky-rocketing medication costs. It is estimated that approximately 7,000 deaths occur each year in the United States due to medication errors. These errors are predominately due to hand-writing illegibility, wrong dosing, missed drug-drug or drug-allergy reactions. With approximately 3 billion prescriptions written annually, which constitutes one of the largest paper-based processes in the United States, the writing of prescriptions can be streamlined and efficient by using an e-prescribing system. In addition these services are paid on a yearly basis at a cost of about $500 per provider. If a practice has more than one provider you will typically see a 20% discount for each one. This service includes formulary and a real time interface for uploading patient demographics.
What is e-prescribing?
E-prescribing is simply an electronic way to generate prescriptions through an automated data-entry process utilizing e-prescribing software and a transmission network which links to participating pharmacies.
Benefits of e-prescribing:
1) Improved patient safety and overall quality of care:
- Illegibility from hand-written prescriptions is eliminated, decreasing the risk of medication errors and decreasing liability risks.
- Warning and Alert systems are provided at the point of prescribing: It has been documented that medication errors are often the result of inadequate access to current drug reference information. E-prescribing systems can provide an overall medication management process through drug utilization review (DUR) programs. DUR programs perform checks against the patient’s current medications for drug-drug interactions, drug-allergy interactions, diagnoses, body weight, age, drug appropriateness, correct dosing; contraindications, adverse reactions, duplicate therapy alert etc. and alerts the provider if interactions are found. E-prescribing software can also include such drug reference software programs as ePocrates Rx. Pro and the PDR.
- Access to patient’s medical history. Knowing the patient’s medical history at the time of prescribing can serve as an alert to drug inappropriateness.
2) Reduces or eliminates phone calls and call-backs to pharmacies. Physician offices receive over 150 million call-backs from pharmacies with questions, clarifications and refill requests. According to an HIMSS article on e-prescribing these call-backs interrupt office flow and reduce productivity related to chart-pulls, re-filing charts, follow-up calls, faxing prescriptions etc.
3) Eliminates faxes to pharmacies.
4) Streamlines the refill’s requests and authorization processes. Refill authorization from the pharmacy can be a completely automated process and refills can usually be generated in one click. The pharmacist generates a refill request/authorization that is delivered through the network to the provider’s system, the provider then reviews the request, approves or denies the refill and the pharmacy system is immediately updated.
5) Increases patient compliance. It is estimated that 20% of paper-based prescription orders go unfilled by the patient. E-prescribing systems expedite the filling of prescription at the pharmacy and drug literature can be printed for patients as well.
6) Improves Formulary adherence. By checking with healthcare formularies at point-of-care, generic substitutions and generic first-line therapy choices are encouraged thus reducing patient costs.
7) Increases patient convenience by reducing patient trips to the pharmacy and reducing wait times.
8) Offers true Provider Mobility – Full mobility can be attained when using a wireless network to write or authorize prescriptions anytime from anywhere.
9) Improves reporting ability. Query reporting may be performed which would be impossible with a paper prescription system. Common examples of such reporting would be: finding all patients who have had a particular medication prescribed to them during a drug recall, the frequency of medication prescribed by certain providers etc..
NOTE: controlled substances are currently not permitted to be filled via electronic means. If a user attempts to send a controlled substance electronically - a system message informs the user that this medication can not be filled this way and offers options to print or fax.
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