E-prescription FAQ

What is e-prescribing anyway? Like many things within the world of electronic healthcare, it depends on who you ask.

In simple terms, it's the computer based, electronic generation, transmission, and filling of a prescription. If that seems a little too basic for you, let's take a look at the definition that the Medicare Part D prescription drug program offers:

"E-prescribing means the transmission, using electronic media, of prescription or prescription- related information between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary, including an e-prescribing network. E-prescribing includes, but is not limited to, two-way transmissions between the point of care and the dispenser."

So now that we have a general idea of what e-prescribing means, why would an organization be interested in having such a system? There's a few good reasons, and let's start with the financial incentive.

In 2009, Medicare will begin offering a financial incentive for prescribers using a "qualified" e-prescribing system. In order for a system to be qualified, it must be capable of performing all of the following functions:

• Generating a complete active medication list incorporating electronic data received from applicable pharmacy drug plan(s) if available
• Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all safety checks (safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration, drug-drug interactions, allergy concerns, or warnings or cautions)
• Providing information related to the availability of lower cost, therapeutically appropriate alternatives (if any)
• Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan

According to the E-prescribing Incentive fact sheet (pdf) available via the Centers for Medicare & Medicaid services, eligible professionals who successfully report the e-prescribing measure in 2009 may be eligible to receive an incentive payment equal to 2% of all of their Medicare Part B (Fee-for-Service, or FFS) allowed charges for services furnished during the reporting period.

There are a few caveats to the program, and organizations clearly need to determine eligibility, as well as look at the ROI related to an e-prescription system before making a final decision. Organizations also need to consider the pros and cons of a stand alone e-prescription system vs. a Electronic Health Record (EHR) system that has an integrated e-presciption component.

That said, there are many benefits to an e-prescription system, and although saving money is good, improving the quality and safety of care is even better.

Additional e-presciption benefits include:

• Improving patient safety and quality of care
• Reducing time spent on phone calls and call-backs to pharmacies
• Reducing time spend faxing prescriptions
• Automating prescription renewal request and authorization
• Increasing patient convenience and medication compliance
• Improving formulary adherence permits lower cost drug substitutions
• Allowing greater prescriber mobility
• Improving drug surveillance / recall ability

By avoiding unnecessary medication injuries, Health and Human Services Secretary Michael Leavitt has estimated that widespread e-prescribing could save as much as $156 million over five years.

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