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Trends in Electronic Drug Prescribing

By May 10, 2018Commentary

Prescription drug transactions have been ahead of other medical care categories in the use of health information technology.  Surescripts is sponsored by the major PBMs and retail drug chains and offers software to facilitate interactions between physicians, pharmacies and payers.  It has issued the latest report on use of its systems.   (SureScripts Report)   The firm has extensive reach, with 1.47 million providers connected to its system and 233 million patients in its master index.  13.7 billion transactions were completed over the network in 2017, a 26% rise from 2016.  Included were 1.74 billion e-prescriptions, 3.1 million real-time benefit verifications, 1.46 billion medication histories, and 25.9 million direct clinical messages.  A new feature is the ability to cancel a prescription electronically, which was used 3.8 million times in 2017.  Interestingly, a large number of e-prescriptions still have inadequacies in the fields being correctly or fully filled out, which forces manual interventions, but the rate of completeness is improving.

About 77% of all prescriptions were delivered electronically.  Controlled substances are e-prescribed much less frequently, probably due to ongoing concerns about abuse, but e-prescribing can actually help avoid misuse and several states are mandating e-prescribing for opioids.  98% of pharmacies and 69% of prescribers utilize e-prescribing.  Some specialties have over 80% of their members using the system.  One focus for SureScripts is to get real-time benefit information to prescribers so that they can consider the costs to the patient of various drug options.  The firm is also working to make burdensome prior authorization processes simpler.  As specialty drugs proliferate, prior authorization has become more common.  SureScripts says it has seen a 350% rise in prior authorization transactions year-over-year and that many are providing real-time approvals, with 62% of them received within 60 seconds.  The use of medication history transactions also rose, which helps with quality by avoiding drug conflicts and duplicate prescriptions.  Drug treatments are a rare example of successful use of HIT to improve quality and efficiency.

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