E-prescribing accelerates as U.S. adoption efforts converge

WASHINGTON —Health care’s lumbering shift to electronic prescribing and health information technology has been a long time coming. But a confluence of recent events is accelerating the transformation, as health IT gains thousands of new converts among the physician and health plan payer communities.

One breakthrough came Sept. 29, when nine national pharmacy organizations unveiled a joint task force to grapple with the challenges and opportunities posed by information technology. The new group, called the Pharmacy e-Health Information Technology Collaborative, will focus on the pharmacy profession’s technology needs “to ensure that they are addressed and integrated into the framework of the U.S. health information technology infrastructure,” the groups noted in a joint statement. “In doing so, the collaborative is committed to creating a comprehensive and unified approach, ensuring optimal integration of pharmacy’s requirements and contributions into the electronic health record.”

Among the collaborative’s founding members are the American Pharmacists Association, the National Community Pharmacists Association, Academy of Managed Care Pharmacy, Accreditation Council for Pharmacy Education, American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, American Society of Consultant Pharmacists, American Society of Health-System Pharmacists and National Alliance of State Pharmacy Associations.

“In order for patients to receive optimal care, pharmacists need to have the ability to access and contribute to relevant, patient-specific information from the EHR. The work of the collaborative will focus on achieving this goal,” said Tom Menighan, EVP and CEO of APhA, who chairs the group.

In a separate, but no less critical advance, pharmacy benefit management giant Medco Health Solutions and the California Public Employees Retirement System, or CalPERs, unveiled the results of an 18-month pilot project on Sept. 28 that tracked a huge jump in e-prescribing by thousands of network physicians—and a corresponding increase in efficiency, accuracy and generic dispensing rates. “Doctors participating in a CalPERS e-prescribing pilot program saw a dramatic increase in e-prescribing use over the last 18 months,” declared Medco spokeswoman Lindsey Scharf. “The number of doctors using e-prescribing in the pilot surged 79%, and overall prescription renewals were up 104%.”

What’s more, she said, paperless prescribing among the more than 12,000 physicians serving CalPERS—the nation’s second-largest public health purchaser after the federal government—was found to boost efficiency and medication safety. “Fifty percent of [participating] physicians changed at least one prescription after receiving a safety alert,” Scharf noted.

The project also led to lower prescription costs through an 11% increase in generic dispensing rates among doctors who converted to eprescribing during the pilot. Said Kim Malm, interim assistant executive officer for health benefits for CalPERS, “the e-prescribing technology…notifies prescribers of generic drug equivalents so that the provider can suggest these to our members, and the members can realize savings.”

A high-profile event on Capitol Hill last month highlighted the changes sweeping through health care. At the fifth annual Safe-Rx Awards ceremony, e-prescribing platform provider Surescripts announced that more than 200,000 office-based prescribers, or 1-outof-every-3 physicians, nurse practitioners and physician assistants in the United States, have thrown away their prescription pads.

“Today—and over 1 million times a day—pharmacies, health plans, physicians and patients in communities throughout the country benefit from the improved safety, efficiency and lower cost associated with e-prescribing,” said Surescripts president and CEO Harry Totonis. “But e-prescribing is just the first step in the nation’s plan for health information technology, and it is only one component of an electronic health record.”

Designed to draw attention to the need for paperless prescribing and recognize its supporters, Safe-Rx awards went to Massachusetts and nine other states for their adoption of e-prescribing. An award also was presented to Sen. Sheldon Whitehouse, D-R.I., who received the Safe-Rx Evangelist Award for his efforts to promote the technology. Whitehouse, who founded the Rhode Island Quality Institute, and whose home state is the first in the nation to achieve 100% adoption of e-prescribing, led a successful drive in Congress to convince the Drug Enforcement Administration to allow paperless prescribing of controlled substances.