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Rise in e-prescriptions reported to curb healthcare costs and benefit patient outcomes

Robin Wulffson MD's picture
e-prescribing, Internet, IPad, Surescripts, healthcare costs

The use of the Internet via computers and handheld devices such as the iPad continues to increase. On May 17, Surescripts, which operates a nationwide network connecting the computer systems of physicians and pharmacies, released its annual report. Surescripts’ study of approximately 40 million prescription records between 2008 and 2010t found that the percentage of physicians using e-prescribing technology soared by an astounding 67% in 2011. Surescripts notes that this technology improves the rate at which patients actually pick up their prescription at the pharmacy. This surge, which is spurred by federal incentives and penalty programs, could also result in a reduction of healthcare costs and an improvement in patient outcomes.

The report noted that patients picked up their medications 69.5% of the time among when generated by physicians who telephoned in, faxed, or hand-wrote new prescriptions, In addition, among physicians who e-prescribed between 30% and 40% of the time, this "first fill" rate increased to 76.5% (marking a 10% increase). A problem with paper prescriptions is that a number of patients lose or misplace them. As a result of the unfilled prescription, these patients may get sicker and incur higher medical costs because of their worsened condition. Surescripts estimates that this 10% increase in first-fill rates combined with other e-prescribing efficiencies could save between $140 billion and $240 billion in healthcare costs over the course of 10 years.

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According to the pharmaceutical analyst, the technology also helps researchers better understand and cure the problem of medication noncompliance. With e-prescribing, the physician and pharmacist can determine whether a prescription that was sent to the pharmacy was actually picked up by the patient. In addition to noting the increase in medication compliance, the report noted other benefits that resulted from the growth of e-prescribing:

  • By the end of 2011, approximately 317,000 physicians were e-prescribing by the end of 2011. These doctors represented 58% of all office-based physicians. Internists, family physicians, cardiologists, and endocrinologists were the highest utilizers; 75% or more of these physicians e-prescribed. e way with adoption rates of 75% or more.
  • In total, approximately 390,000 healthcare professionals, including nurse practitioners and physician assistants, used e-prescribing software in 2011; this marked a 156,000 increase from 2010.
  • The number of e-prescriptions rose from 326 million in 2010 to 570 million in 2011 (a 75% increase).

Surescripts notes that an electronic connection to the pharmacy allows physicians to receive information on their patients’ medication history; if a patient has health insurance with prescription coverage, the doctor can be apprised of drug benefits, including the plan formulary (i.e., which medications are covered by the insurer).

One factor impacting e-prescribing is a restriction imposed on controlled substances (i.e., narcotics), which comprise almost 20% of all prescription medications. In 2010, the US Drug Enforcement Administration (DEA) removed its long-standing ban on the e-prescription of controlled substances; however, Surescripts notes that the DEA’s requirements for physicians are complicated and deterring. Furthermore, entities using the technology such as pharmacies and developers of e-prescribing software are still in the process of coming into compliance with the federal guidelines. At the state level, nine states do not allow physicians to electronically prescribe schedule 1 or schedule 2 drugs; in 13 other states, the regulatory status of e-prescribing any controlled substance is unclear. Because of the foregoing, most doctors still write paper prescriptions for controlled substances; furthermore, when they prescribe controlled substances together with uncontrolled substances, they are prone to write paper prescriptions for all of them.
Reference: Surescripts