E-Prescribing Trends in the United States

It should not surprise anyone that we've seen a significant increase in e-prescribing at the national and state level between December 2008 and June 2012. According to the ONC, 48% of physicians are e-prescribing using an EHR on the Surescripts network.

States that had the highest growth in percent of physicians e-prescribing using an EHR include New Hampshire, North Dakota, Wisconsin, Iowa, and Minnesota from December 2008-June 2012.

Massachusetts (77%), New Hampshire (74%), and Iowa (73%) had the highest rate of physicians e-prescribing through an EHR.

View the ONC report "State Variation in E-Prescribing Trends in the United States" here (PDF)

AHRQ Implementation Toolsets for E-Prescribing

AHRQ funded the development of two electronic prescribing (e-prescribing) implementation "toolsets;" one aimed at health care provider organizations, ranging from small independent offices to larger medical groups and "safety net" clinics, and the other aimed at independent pharmacies.

Find those resources here.

Emdeon Supports DEA Option Two for Electronic Prescribing of Controlled Substances

Emdeon Announces Support for Electronic Prescribing of Controlled Substances Using the DEA-Allowed Quicker-to-Market Approach

Emdeon promotes use of a quicker, compliant adoption path for pharmacies and prescribers strapped with competing technology demands

NASHVILLE, Tenn. (August 15, 2011) -- Emdeon Inc. (NYSE: EM), a leading provider of healthcare revenue and payment cycle management and clinical information exchange solutions, today announced its support for the U.S. Drug Enforcement Administration’s (DEA’s) quicker-to-market option for electronic prescribing of controlled substances (EPCS).

On June 1, 2010, prescribers became legally allowed to electronically transmit controlled substance prescriptions to the pharmacy of a patient’s choice, and pharmacies were allowed to electronically receive these prescriptions so long as certain required security measures were in place. Over a year after the DEA Interim Final Rule (IFR) enabling EPCS became effective, the healthcare industry still has not completed implementation of the electronic prescribing software systems necessary to transmit controlled substance prescriptions pursuant to the IFR. Emdeon believes many of the challenges faced by prescribers and pharmacies may be addressed expeditiously through an option that is currently offered within the IFR.

Errors associated with outpatient e-prescribing

Physicians are jumping to switch from paper scripts to e-prescribing. The government is using both the carrot and the stick to motivate providers to make this switch, but we need to remember that e-prescribing has its limitations. In a recent study, researchers found that outpatient e-prescribing was associated with a 11.7% error rate where 35.0% were considered potential adverse drug events.

Here's the abstract from the study:

Abstract
Objective To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. Materials and methods This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Results Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). Discussion About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Conclusions Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors.

A Clinician's Guide to e-Prescribing

A Clinician's Guide to e-Prescribing Understanding the Regulations & Making the Transition
Monday, June 13, 2011 at 1:00 PM ET

Since the original release of A Clinician's Guide to e-Prescribing, the health care environment has changed dramatically. Recently, five partner organizations released an updated 2011 edition of the Guide. This "how-to" guide helps health care professionals make informed decisions about how and when to transition from paper to e-prescribing systems. This webinar will present an overview of the guide components, including information on the changing healthcare information technology (HIT) environment.

BIO-key and Lumidigm Bring Reliable E-Prescribing to Genesis HealthCare

Electronic Medical Records (EMR) and Single Sign-On (SSO) Applications Protected by BIO-key Fingerprint Identification and Lumidigm Multispectral Fingerprint Sensors

WALL, NJ, and ALBUQUERQUE, NM — February 16, 2011 (GLOBE NEWSWIRE) — BIO-key International, Inc. (OTC Bulletin Board: BKYI.OB), a leader in finger-based biometric identification solutions and Lumidigm, Inc., the multispectral imaging biometrics company, have partnered to provide a strong authentication solution for e-prescriptions at Genesis HealthCare System. Today, Genesis HealthCare is utilizing BIO-key’s biometric identification software with Lumidigm fingerprint sensors so staff may quickly, conveniently and securely establish identity when ordering, verifying or administering medications as required by Ohio law.

Genesis HealthCare System, based in Zanesville, Ohio, is a not-for-profit organization that operates two hospital sites -- Genesis-Bethesda and Genesis-Good Samaritan -- in Zanesville, Ohio, and several affiliated health care organizations across a six-county region of southeastern Ohio. For years, doctors and pharmacists in Ohio have been required to use two-factor authentication when electronically prescribing controlled substances and as of June 2010, the DEA has also mandated two-factor authentication for electronically prescribing controlled substances nationwide. Genesis HealthCare is able to meet these requirements using BIO-key’s biometric fingerprint identification software and Lumidigm biometric sensors.

AMA ePrescribing Learning Center

Have you seen the AMA ePrescribing Learning Center? If you're still using the old pen and paper method of writing prescriptions, then it's time to get ready for a chance. ePrescribing is here to stay. The AMA ePrescribing Learning Center can guide you through the process so that you can learn how to choose the right system and implement ePrescribing into your clinical practice. Do you know which ePrescribing system will work for you?

ePrescribing can make a difference in your day-to-day workload—helping you save time. And thanks to the Medicare ePrescribing Incentive Program, you can receive a special incentive payment every year through 2013.

I still run into physicians who are reluctant to try ePrescribing.  Soon, more patients will be asking for ePrescribing so that they can request a refill online. Wouldn't your life be easier if your patients could request medication refills online?

Quest Diagnostics comes out with an EHR (Electronic Health Record)

Quest Diagnostics came to my wife's office the other day to try to sell their electronic health record (EHR) solution called Care360 EHR. Here's a snippet about Care360 EHR:

With Care360 EHR (Electronic Health Record) we deliver the capabilities necessary to effectively document a full clinical encounter today, while preparing your practice to maximize the business incentives of tomorrow. With a wide range of capabilities that include electronic lab order management, clinical messaging, ePrescribing, clinical documentation tools, document management and multi-system interoperability, Care360 EHR provides just what your practice needs to make the right clinical decisions at the point of care.

With Care360 EHR, Ambulatory Practices Can:

• Order and receive laboratory diagnostic tests electronically
• Write prescriptions and manage medications electronically
• Send and receive clinical messages (including to referring Physicians)
• Send clinical information to a patient's personal health record (PHR)
• Document a full patient encounter (SOAP Notes, vitals, progress notes)
• Scan/Import and manage paper documents, electronically
• Access information via iPhone® (labs and meds)
• Receive radiology results electronically
• Generate enhanced reports and informatics
• Share a patient's health information across the community 

Quest also offers Care360 Labs & Meds and Care360 ePrescribing. It still amazes me that so many providers are not using e-prescribing when it's readily available today.   Click here to learn more about these Quest Healthcare IT services.

Free e-Prescribing with Practice Fusion (free EHR)

You may have already heard this, but Practice Fusion (free EHR) now offers a free e-Prescribing solution. Have your DEA and NPI numbers ready.

Practice Fusion Launches Free e-Prescribing

e-Prescribing system integrated into free, web-based EHR. Available to all doctors. Helps avoid medication errors, qualifies for Medicare incentives, saves time and serves patients.

Practice Fusion's free e-prescribing system includes:

    * Connection to over 50,000 pharmacies
    * Continuously updated medication library
    * Same-day enrollment for most providers
    * Flexibility to use e-prescribing as a stand-alone feature or as part of the comprehensive free EHR system
    * Easy pharmacy look-up with filters for proximity to the practice or patient address
    * Refill requests delivered back to the practice directly from the pharmacy
    * Instant prescription details delivered to the patient Personal Health Record online
    * Unlimited free set-up assistance, migration help, training and support
    * Qualification for the Medicare e-prescribe bonus

You can read the full press release here.

Medicare e-Prescribing Incentive Program: Fax Requirements

Do you fax prescriptions to the pharmacy and call that e-prescribing?

Here's another Q&A about the Medicare e-Prescribing Incentive Program: "What are the fax requirements for the Electronic Prescribing Incentive Program?"

Answer: Prescriptions must be sent electronically via an e-prescribing system that meets the criteria for a qualified system. If the receiving network at the pharmacy converts an electronic prescription transmittal into a fax because the pharmacy cannot receive electronic transmittals, this counts as e-prescribing. If the eligible professional's (EP's) e-prescribing system is only capable of sending a fax directly to the pharmacy, the EP's system is not a qualified e-prescribing system.

So, if your e-prescribing solution isn't capable of sending prescriptions electronically (other than via fax), it seems like it would be a good time to look for some new options if you want to go after the Medicare incentives.

e-prescribing in Massachusetts

Boston has several different medical schools and affiliated hospitals. Can you name all of them? You have Harvard, Boston University, and Tufts (the UMass medical school is in Amherst). Is it any surprise that Massachusetts has been named the top e-prescribing state for the second year in a row by Surescripts? According to Surescripts, prescribers in Massachusetts sent more than 6.7 million prescriptions electronically in 2008, representing 20.5 percent of all eligible prescriptions in the state. That number is only going to increase because of ARRA (American Recovery and Reinvestment Act). Here's some more interesting info from Healthcare IT News:

Top 10 e-prescribing states

1. Massachusetts
2. Rhode Island
3. Michigan
4. Nevada
5. Delaware
6. North Carolina
7. Pennsylvania
8. Connecticut
9. Maine
10. Arizona

The top five most improved states:

1. Vermont
2. Tennessee
3. Kansas
4. Illinois
5. Missouri

Is your state on any of these lists? It's going to be very interesting to see all the changes that occur as President Obama channels money to improve the utilization of e-prescribing.

Learn About E-Prescriptions

Medicare has been pushing for e-prescriptions for a while now. Both doctors and consumers need to get motivated to want e-prescribing.

Want to learn more? Take a look at this website:
LearnAboutEPrescriptions.com

It's primarily a consumer website, but you can also find names of doctors in your area who e-prescribe.

Physicians who are interested in learning more should visit:
http://www.GetRxConnected.org/