Rhode Island Deploying Next Step In E-Prescriptions

The state is readying a transaction engine that provides secure connectivity.

Next month, 70% of the pharmacies in Rhode Island will be able to accept electronic prescriptions from the state's 2,100 physicians.

Rhode Island will be the first state in the country to launch a transaction engine from SureScript Systems Inc., which provides secure connectivity for the transmission of electronic prescriptions for doctors and independent and chain drug stores.

SureScripts Messenger Services transaction engine provides the format for messages to be electronically routed from doctor's offices to pharmacies, and vice versa. The software also allows pharmacies to automatically send monthly reminders to physicians' offices alerting them to patients whose prescriptions will need renewal, allowing the doctors more flexibility in handling those refills.

Until now in Rhode Island, the lack of a standard transaction engine for electronic prescriptions has meant that even doctors who have had software to write prescriptions electronically are having those transactions handled manually at the pharmacy.

"Right now, when a doctor hits the button to send an electronic prescription, that information is faxed to the pharmacy, and then needs to be manually re-entered into the pharmacy's system, which opens the door for mistakes and calls back to the doctor," says Laura Adams, president and CEO of the Rhode Island Quality Institute, a collaborative of leaders from health care, government, business, academia, and the insurance industry with the goal of improving patient safety, quality of care, and the technology infrastructure in health care. Adams says 30% of all prescriptions result in the pharmacy needing to call the doctor to double check or clarify information.

The institute has spearheaded this electronic prescription project. The institute includes members from the Rhode Island medical society, which has a great deal of influence with doctors in the state who are being encouraged to use the electronic system.

The new program doesn't mean all eligible Rhode Island doctors will send prescriptions electronically. Participation is voluntary for physicians and the state's hundreds of pharmacies alike. However, SureScript's transaction engine makes it easier to do so by providing the connectivity.

On their end, physicians still need to use third-party electronic prescription or electronic patient medical-records software to send the orders to pharmacies. SureScript doesn't provide those applications, although it does provide the interfaces allowing most electronic clinical software to communicate through its transaction engine, says SureScript CEO Kevin Hutchinson.

In the hospital arena, there's also movement, through pressure by industry watchdog groups such as the Leapfrog Group, for the adoption of electronic drug systems that can reduce medication errors.

Because of costs and other constraints, hospitals have been slow in adopting computerized drug-ordering systems that help reduce drug errors related to illegible handwriting and other mistakes, although interest and actual deployments have been growing.

Still, individual doctor's offices have been even slower to adopt electronic prescriptions, says SureScript's Hutchinson. "There's nothing new about electronic prescriptions, it's been attempted for nine or 10 years," he says. "What's been missing is the ability for pharmacies and physicians to connect."

The adoption of the transaction engine by pharmacies and doctors in Rhode Island represents one less hurdle in that state.

SureScripts' transaction engine is being tested by pharmacy chains in other states, including neighboring Massachusetts and Connecticut, as well as regions in Ohio, Indiana, and Illinois, Hutchinson says.

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