ePrescribing Status Report

Electronic prescribing is the subject of a CMS incentive plan for physicians and other health professionals.  The benefits of eprescribing include administrative efficiencies, the potential ability to avoid medication errors and interactions and lowering health costs by greater generic use and avoidance of redundant prescriptions.  A Center for Studying Health System Change report based on a survey of 24 actively eprescribing physician practices reveals that there is a way to go to maximize the benefits.   (CSHSC Report) Physicians use a variety of eprescribing systems, some stand-alone and many embedded in larger electronic medical systems.  Two key features which to a large extent rely on external data bases are medication history and formulary management.  Those databases are largely accessed via SureScripts, which also routes most eprescriptions.

Somewhere around 30 percent of all physicians currently routinely use eprescribing and the number should continue to grow rapidly due to the incentives and payer expectations.  Of physicians using the SureScripts network, about 62 % had access to medication history and 60% to formulary information, but many of these doctors did not use the features.  According to the current survey, only 4 of the 24 practices indicated that physicians accessed the external data sources to augment medication history at the point of prescribing.  Some doctors were not aware of the feature’s availability and many had concerns about the completeness and accuracy of the medication history data.  In addition, there were system design issues that made use less than intuitive, which is a particular concern given the time pressures most physicians feel.

Similarly, although more practices had access to formulary data, only about half of doctors used it when available.  Again, issues included lack of complete data or not having access to the formulary directly covering the specific patient.    Some physicians felt they didn’t need it because they so frequently prescribed generics.  To increase the overall utility of eprescribing, the authors suggest a need to increase, standardize and make data more current.  Mandating payer and PBM participation in creating databases would help.  In addition, vendors need to work with doctors to make the systems they sell as user-friendly as possible.  Finally, more education and training of doctors might increase their use of all the features of eprescribing systems.