E-Prescribing for Medical Group Practices

Electronic prescribing (a/k/a e-Prescribing) is cutting edge information technology that should be on the strategic planning agenda of medical group practices. Although it has “been around” for a few years, only recently has it evolved to become a widely marketable and useful tool for patient care.

What is it comprised of?

E-Prescribing is IT software, data base, and peripheral equipment used to monitor, evaluate, and issue patient drug prescriptions by healthcare providers. It most often is utilized on PCs but may also be used on PDAs. It can be on a site- based service or web based. It may be a freestanding application.
What are its advantages?

E-Prescribing offers several advantages and opportunities over manual systems, some of which have been already proven by field testing, and includes the following:

1. Improving quality of care. This is accomplished through information provided almost immediately from the patient data base and from a shared data base of information relative to specific illness, diagnosis, and medications. In one or two screens, the doctor or non-physician provider can be updated as to current medications prescribed to the patient, current diagnoses being treated, patient allergies, alternative formularies and nonformularies, side effects, complications, and conflicts with specific prescriptions. All this information aids in making more informative and timely clinical decisions. Obviously, when interfaced with an EMR or EHR system, more information can be accessed.
2. Reduction in medical errors. It has been estimated that, nationwide, millions of preventable adverse drug events (ADEs) occur due to complications with conflicting medications, drug and diet complications, duplicate medications, inappropriate doses and inappropriately prescribed medications. It is estimated that between 5 and 18{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all ambulatory patients experience significant ADEs every year. Impact studies have indicated that properly implemented e-Prescription can reduce these by a factor of three within two years.
3. Efficiencies in the office. Studies suggest that e-Prescription can save almost three minutes of personnel time per prescription, reduces error rates by 88{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and reduces callbacks from pharmacies for corrected or missing information by 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}.
4. Reduction in drug costs. By displaying formulary and nonformulary drugs, the system offers alternative or generic brands of the same medication. It can also indicate name brands that the patient’s insurance carrier won’t reimburse for. This provides immediate cost savings to both the patient and the insurance company. A side benefit may be that offering lower cost alternatives may reduce the incidence of patients not filling prescriptions because they can’t afford them and instead go without treatment.

Who Benefits Most?

Patients and insurers are the immediate major beneficiaries of this system. The concept provides significant opportunities for enhancing the quality and cost-effectiveness of health care. Unfortunately, the benefits to doctors are not so immediate, direct and significant in terms of measurable dollars. This raises the question of why doctors would want to buy and install such systems. Aside from concern for patients and third-party payers the benefits to doctors is less tangible and more strategic.

Disincentives to Doctors

The concerns of doctors include the cost of buying and installing a system, the loss of time spent in the training and learning curve phase, concern over compliance and liability issues, and the absence of measurable economic benefits. Today it is estimated that only about 18{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all physicians in the U.S. are using some form of e-Prescription. Doctors are the hub of this whole process because without them it will not go forward. In the next issue we will discuss current proposed incentives and initiatives to bring doctors to the table.

James B. Calnan, CPA, is the partner-in-charge of the Health Care Services Division of Meyers Brothers Kalicka, P.C., Certified Public Accountants and Business Consultants, in Holyoke; (413) 536-8510