E-Prescription Adoption Picking Up

Over the past two years, tens of thousands of U.S. clinicians have traded in their paper prescription pads for electronic prescribing software.
More doctors have traded in their paper prescription pads for e-prescribing over the last two years. However, the bulk of e-prescriptions are being generated by doctors using standalone e-prescribing software, not more comprehensive, integrated e-medical record systems, says a new study.

Just two years ago, only about 19,000 U.S. doctors and other clinicians were prescribing drugs for patients electronically. That number has soared to 103,000, according to a new report from Surescripts, the nation's largest e-prescribing network.

Those e-prescriber figures represent doctors, physician assistants, and nurse practitioners mostly in physician practices, and don't reflect clinicians in hospitals who order patient prescriptions using computerized physician order-entry systems.

And while the e-prescription statistics also do not include clinicians processing transactions via other e-prescribing networks besides Surescripts, the company's network is the dominant platform in the country supporting these transactions. Surescripts, which was founded in 2001 by the National Association of Chain Drug Stores and the National Community Pharmacists Association, merged last year with another major e-prescription player, RxHub, which was formed in 2001 by CVS Caremark, Express Scripts, and Medco. Surescripts' network supports e-prescribing in all 50 states.

According to the company's National Progress Report On E-Prescribing, there were 240 million e-prescriptions in 2008, double the volume in 2007. In just the first quarter of 2009, there were about 134 million e-prescription messages exchanged among e-prescribers, pharmacies, and payers in the United States. Those messages include a number of exchanges, including doctors electronically confirming patients' prescription plan benefits with payers, checking patients' prescription history, and sending e-prescription orders to pharmacies.

Surescripts has found that about 80% of standalone e-prescribing products allow prescribers to perform those three critical information exchanges, versus 30% of more comprehensive e-medical record systems that include e-prescribing features.

The relative popularity of standalone software for e-prescribing, versus doctors using integrated e-medical record systems for processing e-prescriptions, reflects the scarce adoption of fully functional EMRs in U.S. doctors' offices right now.

Still, the fact that more doctors have begun using electronic processes for writing patient prescriptions is a step in the right direction, since e-prescriptions can help cut costs and improve patient safety by automatically flagging potential drug allergies and interactions, reducing errors related to illegible handwriting, bettering adherence to benefit formularies, and stemming the number of callbacks between pharmacies and doctor offices.

Key drivers in the increased volume of e-prescribing include new incentive programs by Medicare that recently went into effect rewarding doctors who prescribe electronically, as well as various educational and other programs by states, payers, and benefit providers pushing for more widespread adoption of e-prescribing.

"There's no question that incentive programs are working" to help propel adoption of e-prescribing, said a Surescripts spokesman.

That could be an encouraging sign for the federal government in its plans to spend about $20 billion over the next several years on stimulus programs that include incentives for doctors and hospitals that use e-medical record systems.

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