ePrescribing: Improve Quality Now Before Dreaming About the Future

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Written by Michael Burger

ePrescribing insiders read with pride the Surescripts statistics showing 69% of providers ePrescribing and 44% of prescriptions transmitted electronically in 2012. But truth be told, it’s taken much longer than any of us would have expected to get to this point. The temptation now is to lean back, congratulate one another on a job well done and start dreaming about ways to “meaningfully use” this process in the future.

Even though (measured by sheer volume) we are well on our way to the future, the reality is that ePrescribing today is still primitive. Ask many pharmacists and they’ll tell you that the quality of the ePrescriptions that they receive today is subpar. We’ve heard from some pharmacists that the benefits gained by ePrecribing (no more illegibly scribbled Rx’s, no more waiting until the patient brings in a slip of paper, etc) is negated by ill-defined and improperly formatted ePrescriptions that require phone calls to busy offices for clarification.

ePrescribing areas for improvement

ePrescribing systems in use today were designed to manage the majority of medications that are tablets/capsules. Trying to ePrescribe liquids, creams, powders, inhalers and injectable medications in most ePrescribing systems today is the equivalent of the proverbial square peg in a round hole. Innovation is needed to make ePrescribing as efficient and as high quality for these other medication forms as it is for for tablets and capsules.

In the very near future, specialty medications, nearly all of which require prior authorization, will approach half of the total drug spend. Current ePrescribing technology isn’t ready for ePA (electronic prior authorization), and is inadequate for many specialty drugs.

Even a basic tenet of high quality ePrescribing, the structured and codified SIG, is not widely supported or mandated by the leading Rx RDI network. It’s of little surprise then, since SIGs today are free form text, that concerns about ePrescription quality are being raised.

We advocate that before we turn our attention to ePrescribing of the future that we do more to improve the ePrescribing of today.

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