Electronic Prescribing - Benefits

Benefits

E-prescribing offers clinicians a powerful tool for safely and efficiently managing their patient's medications. Compared to paper-based prescribing, e-prescribing can enhance patient safety and medication compliance, improve prescribing accuracy and efficiency, and reduce health care costs through averted adverse drug events and substitution of less expensive drug alternatives. This is of key importance because in 2000, the Institute of Medicine identified medication errors as the most common type of medical error in health care, estimating that this leads to several thousand deaths each year. E-prescribing also has the potential to improve beneficiary health outcomes. For providers who choose to invest in e-prescribing technology, the adoption could improve quality and efficiency and could show promise in reducing costs by actively promoting appropriate drug usage; providing information to providers and dispensers about formulary-based drug coverage, including formulary alternatives and co-pay information; and speeding up the process of renewing medications. E-prescribing also may play a significant role in efforts to reduce the incidence of drug diversion by alerting providers and pharmacists of duplicative prescriptions for controlled substances.

More specifically, the benefits of e-prescribing to both patients and clinicians include:

• Improving patient safety and quality of care - Illegibility from handwritten prescriptions is eliminated, decreasing the risk of medication errors while simultaneously decreasing risks related to liability. Oral miscommunications regarding prescriptions can be reduced, as e-prescribing should decrease the need for phone calls between prescribers and dispensers. Causes of medication errors include mistakes by the pharmacist incorrectly interpreting illegible handwriting or ambiguous nomenclature, and lapses in the prescriber's knowledge of desired dosage of a drug or undesired interactions between multiple drugs. Electronic prescribing has the potential to eliminate most of these types of errors. Warning and alert systems are provided at the point of care. E-prescribing systems can enhance an overall medication management process through clinical decision support systems that can perform checks against the patient's current medications for drug-drug interactions, drug-allergy interactions, diagnoses, body weight, age, drug appropriateness, and correct dosing. Based on these algorithms, the system can alert prescribers to contradictions, adverse reactions, and duplicate therapies. The computer can also ensure that clear and unambiguous instructions are encoded in a structured message to the pharmacist, and decision support systems can flag lethal dosages and lethal combinations of drugs. E-prescribing allows for increased access to the patient's medical records and their medication history. Having access to this information from all health care providers at the time of prescribing can support alerts related to drug inappropriateness, in combination with other medications or with specific medical issues at hand.

• Reducing time spent on phone calls and call-backs to pharmacies - According to estimates, almost 30 percent of prescriptions require pharmacy callbacks. This translates into less time available to the pharmacist for other important functions, such as educating consumers about their medications. In response, E-prescribing can significantly reduce the volume of pharmacy call-backs related to illegibility, mistaken prescription choices, formulary and pharmacy benefits, decreasing the amount of time wasted on the phone. This ultimately impacts office workflow efficiency and overall productivity in a positive manner.

• Reducing time spent faxing prescriptions to pharmacies - Both prescribers and pharmacists can save time and resources spent on faxing prescriptions through a reduction in labor costs, handling costs, and paper expenses waste due to unreliability.

• Automating the prescription renewal request and authorization process - With e-prescribing, renewal authorization can be an automated process that provides efficiencies for both the prescriber and pharmacist. Pharmacy staff can generate a renewal request (authorization request) that is delivered through the electronic network to the prescriber's system. The prescriber can then review the request and act accordingly by approving or denying the request through updating the system. With limited resource utilization and just a few clicks on behalf of the prescriber, they can complete a medication renewal task while enhancing continuous patient documentation.

• Increasing patient convenience and medication compliance - It is estimated that 20% of paper-based prescription orders go unfilled by the patient, partly due to the hassle of dropping off a paper prescription and waiting for it to be filled. By elimination or reducing this waiting period, e-prescribing may help reduce the number of unfilled prescriptions and hence, increasing medication compliance. Allowing the renewal of medications through this electronic system also helps improve the efficience of this process, reducing obstacles that may result in less patient compliance. Availability of information on when patient's prescriptions are filled can also help clinicians assess patient compliance.

• Improving formulary adherence permits lower cost drug substitutions - By checking with the patient's health plan or insurance coverage at the point of care, generic substitutions or lower cost therapeutic alternatives can be encouraged to help reduce patient costs. Lower costs may also help improve patient compliance.

• Allowing greater prescriber mobility - Improved prescriber convenience can be achieved when using mobile devices, that work on a wireless network, to write and renew prescriptions. Such mobile devices may include laptops, PDA's, tablet computers, or mobile phones. This freedom of mobility allows prescribers to write/renew prescriptions anywhere, even when not in the office.

• Improving drug surveillance/recall ability - E-prescribing systems enable embedded, automated analytic tools to produce queries and reports, which would be close to impossible with a paper-based system. Common examples of such reporting would be: finding all patients with a particular prescription during a drug recall, or the frequency and types of medication provided by certain health care providers.