Benefits of a “true” e-Prescribing System

E-Prescribing is more than just sending a prescription to a pharmacy electronically.  It is the tools involved in the e-Prescribing process that can increase the quality of care and save money for all stakeholders involved in our healthcare system.  Since gaining popularity in 2003, numerous studies have been conducted on the benefits of “true” e-Prescribing.   

So, what is “true” e-Prescribing?  A “true” e-Prescribing system is interfaced with a practice’s practice management (PM) and/or electronic health record (EHR.)  The interface supplies the pertinent patient information into the e-Prescribing system, including insurance information.  Lack of an interface will actually create more of a prescribing work flow for the clinician’s office, instead of eliminating workflow in an interfaced e-Prescribing system.

A “true” e-Prescribing system will have several medication tools for the clinician to utilize, such as the following:

• Electronic Medications:  The ability to route a prescription to a pharmacy electronically.  Benefits:  Legible and timely prescriptions from the clinician.  Medication database that is updated at least once a quarter.  The electronic script pad has several features:  dosage calculator, alerts for potential dosage, frequency and route errors and all prescriptions are automatically added to the patient’s medication list.  Not to mention, increased patient compliance with prescribed medications.
• Electronic Refill Requests:  The ability to refill a prescription electronically from a centralized refill basket in system.  Benefits:  Automation of this process saves time and money by eliminating costly chart pulls and clinical/staff time to manage a manual paper process.  An audit log is automatically kept in the “true” e-Prescribing system.  With an ASP system, refills can be worked from anywhere with an internet connection.  
• Medication History:  The ability to upload and reconcile a patient’s current medication list to the SureScripts RX Hub database.  Currently, SureScripts RX Hub receives medication information from 95% of pharmacies and pharmacy benefit (PBM) manager groups.   Benefits:  Clinicians no longer have to try to figure out what blue pill the patient is talking about.  Clinicians are able to upload history into e-Prescribing system and they are able to make informed decision of course of treatment based on the full medication history. 
• Insurance Company Formularies:  The ability to check a patient’s insurance formulary information at the time of prescribing.  Benefits:  The clinician and provider are able to make an affordable and informed decision about the course of medication treatment.  Also, formularies increase the prescribing of generic medications, which saves the patient and insurance company money.  The pharmacy will no longer have to investigate a formulary issue on behalf of a patient when the medication prescribed is too expensive.
• Drug-to-Drug, Drug-to-Allergy, Drug-to-Disease and Duplicate Therapy Interactions:  Clinical decision support for prescribed medications.  Clinician is alerted of possible interactions.  The clinician must acknowledge the interaction before completing the transaction.  Benefits:  Reduction of preventable Adverse Drug Effects (ADE.)  The Agency for Healthcare Research and Quality (AHRQ) published a study that 770,000 injuries and deaths each year are caused by ADEs and cost hospitals alone an estimated 5.6 million dollars per year.  According to AHRQ, up to 84% of dose, route and frequency errors could be eliminated by implementing e-Prescribing.*
• Medication Audit Logs:  The ability to report the medications prescribed under a clinicians name by patient.  Benefits:  In a paper world, a clinician would stumble over a fraudulent medication written in their name by pharmacy suspicion or accident.  In an electronic world, the clinician can actually oversee everything that is being prescribed under their name. 

E-Prescribing is a beneficial if utilization of the quality and cost saving tools are utilized.  Clinicians need to know the benefits of “true” e-Prescribing systems and provider adoption is crucial.  

** Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs.  Research in Action, Issue1.  AHQR Publication Number 01-0200, March 2001.  Agency for Healthcare Research and Quality, Rockville, MD.

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