E-Prescribing: Current State And Impact On Healthcare

Just over 70 percent of physicians are currently using electronic prescription services and 90 percent of pharmacies are accepting e-prescriptions. While these numbers certainly are promising for the future of e-prescribing (EP) in the healthcare industry, the functionality of EP is still in its infancy.

Healthcare providers, pharmacies, and hospitals continue to link EP software to electronic health records (EHR) systems, data analytics modules, and drug formularies (lists of drugs, both brand name and generic, and their uses). As the interconnectedness of these various systems strengthens, the benefits of EP will flourish.

The healthcare industry, in an effort to facilitate EP technology’s transition into better, more inclusive functionality offering better insight and improved performance, will require an increasing number of executives holding a master’s degree in health administration.

E-Prescriptions And Advanced Functionality

Thanks to the 2008 Medicare Improvements for Patients and Providers Act (MIPPA), also known as the eRx Incentive Program, healthcare providers are now offered financial incentives to implement the use of EP technology.

Because of this act, the percentage of physicians using EP systems for their patients’ prescriptions increased from almost nothing in 2006 to 70 percent just eight years later, according to Meghan Hufstader Gabriel, Ph.D., and Matthew Swain, MPH, in “E-Prescribing Trends In The United States” on HealthIT.gov.

Advanced clinical functions are now available through EP systems, incorporating EHRs and drug formulary benefit information into one cohesive program for physicians to use when working with their patients. These functions are capable of tapping into patient medical history at the point of care, the result of which is a more effective and efficient prescription system.

“Electronic prescribing systems not only need to connect with electronic health records systems, but they must integrate all of the needed advanced clinical functionality directly into a clinician’s workflow by enhancing it, not making it more difficult,” First Databank (FDB) clinical applications expert Dewey Howell, MD, writes in his FDBhealth.com article, “E-Prescribing Has Arrived But It Really Has Not Taken Off – Yet.”

“For example,” Howell continues, “solutions that automate and simplify the steps required to complete an electronic prescription – such as integrating multiple lists from multiple sources, checking the patients’ formulary before prescribing to ensure the medication is covered, and automatically sending the order via the appropriate method to the pharmacy – will help e-prescribing to reach its potential.”

In practice, EP systems should identify the patient and review current patient data. The physician can then select drugs from the formulary and discuss each drug with the patient.

Alerts, such as allergy notifications, can also be presented at this point to the physician and also cross-checked with the patient’s record. From here, the doctor and patient can select a pharmacy and send the prescription information. (Process for managing prescriptions electronically provided by Medical Practice Insider’s “7 Tips For ePrescribing.”)

Healthcare administrators will be responsible for coordinating the efforts of both the physicians and the pharmacies. Duties include ensuring the proper software is used, networks are secured, and that all employees, including the physicians themselves, are properly trained to use EP software.

EP Impact On Healthcare

The two most formidable advantages of electronic prescription technology are improved levels of safety and a reduction in medication errors. When used correctly, EP systems are capable of considering a patient’s entire record and formulary when devising lists of potential drugs.

For instance, patients who see a multitude of primary and secondary (specialty) providers often come away with several prescriptions, all from different providers. Medications don’t always react well with each other. Before the advent of EP, doctors were not always aware of everything patients were taking. Now drug interaction warnings are available immediately, allowing doctors to look for substitutes that don’t present any dangers.

EP software also positively affects the bottom line, especially in pharmacies. “E-prescribing increases the efficiency of filling and refilling prescriptions, which lowers operational costs,” explains McKesson Corporation in “E-Prescribing Enables Pharmacists To Improve Medication Adherence” on its company blog, “Additionally, when e-prescribing improves patients’ medication adherence, more prescriptions are filled and refilled, and that increases pharmacy revenue.”

Primary medication non-adherence (PMN) has been reduced by EP technology. PMN refers to situations in which a patient is prescribed a new drug but does not receive the medication (or a generic alternative) within a reasonable amount of time. This usually occurs when a prescribed medicine is not covered by a patient’s insurance plan. EP software bounces potential drugs off each patient’s insurance to avoid PMN.

Unfortunately, EP implementation has created some new, unwanted consequences in healthcare. “International evidence shows that EP may improve the safety of inpatient medicines, management processes, reduce medication errors and, to a lesser extent, reduce ADEs [adverse drug events]. However, unintended consequences, including new errors, may occur,” clinical pharmacist Zamzam Ahmed, et al., writes in “Impact Of Electronic Prescribing On Patient Safety In Hospitals: Implications For The UK” on Pharmaceutical-Journal.com.

“New medication errors can occur when prescribers pick from a drug list (drop-down menu) or while filling free-text fields in an electronic prescription,” claims Ahmed.

Essentially, because EP systems require human input, human error is still possible. A physician might accidentally choose the wrong medication from a long list or mistype something into the EP software’s text fields (wrong address, misspelled name, or account number typo). Potential problems, however, pale in comparison to the benefits EP offers to the healthcare industry.

Maryville University’s Master of Health Administration

Administrators at an office, clinic, or pharmacy that have successfully implemented electronic prescription technology should find their ability to manage a healthcare business greatly improved.

Maryville University’s online MHA program familiarizes students with current technology and software. Graduates can enter the workforce fully prepared and tech savvy for careers in the healthcare management industry.

Maryville’s program offers four concentrations – Data Management, Healthcare Strategies, Population Management, and Senior Services – as well as a General MHA. Contact Maryville University to learn more.

Sources:

E-Prescribing Trends In The United States – https://www.healthit.gov/sites/default/files/oncdatabriefe-prescribingincreases2014.pdf

E-Prescribing Has Arrived But It Really Has Not Taken Off – Yet – http://www.fdbhealth.com/blog/2016/october/eprescribing-has-arrived-but-it-really-has-not-taken-off-yet/

7 Tips For ePrescribing – http://www.medicalpracticeinsider.com/news/7-tips-eprescribing

Impact Of Electronic Prescribing On Patient Safety In Hospitals: Implications For The UK – http://www.pharmaceutical-journal.com/research/review-article/impact-of-electronic-prescribing-on-patient-safety-in-hospitals-implications-for-the-uk/20201013.article