Through Meaningful Use, ePrescribing Grows

Thanks in part to increasingly aligned regulatory mandates and improved medication adherence statistics, ePrescribing has grown steadily among office-based physicians, according to a new report issued by industry network provider, Surescripts (Arlington, Va.). The report, which was jointly conducted by independent data research firm SK&A (Irvine, Calif.), says 58 percent of office-based physicians actively ePrescribe, up from 36 percent last year.

The growth of ePrescribing can be partially be attributed to incentives in Stages 1 and 2 of meaningful use under the American Recovery and Reinvestment Act/Health Information Technology for Economic and Clinical Health Act (ARRA/HITECH),  as well as the Centers for Medicare and Medicaid Services’ (CMS) official ePrescribing incentive program. These corresponded regulatory acts, which in 2011 were closely aligned by CMS, have gotten many in healthcare to hop aboard the ePrescribing train. According to the report, nearly 60 percent of physicians who began to electronically prescribe in 2008 have met Stage 1 measures, 38 percent meet Stage 2 measures.

The report, titled “The National Progress Report On ePrescribing and Interoperable Health Care,” focused on several areas of ePrescribing’s growth, including a look at early adopters. Not only did those early adopters meet meaningful use, the researchers found their ePrescriptions per month grew over time. In 2008, the users were ePrescribing an average of 49 per month; in 2011, it was an average of 213 per month. The research found most ePrescribing users who adopted the technology did so through an integrated EHR (80 percent).

In a conference call that discussed the results of the survey, a panel of outside industry observers said the ePrescribing meaningful use results aren’t surprising. Health IT evangelist at The Dalles, Ore.-based Mid-Columbia Medical Center and industry blogger, Brian Ahier, speaking on the panel, said for a lot of providers, ePrescribing is the greatest thing they can do among practices that achieve meaningful use. He said it provides a lot of “immediate value,” as seen by both providers and patients, and for early adopters, it was the first thing the practitioners adopted for meaningful use.

Michael Fischer, M.D., an assistant professor of medicine at Harvard Medical School and an associate physician in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham & Women’s Hospital in Boston, said ePrescribing helps a lot of doctors, who are otherwise not accustomed to health IT, show where it can help them in a reliable, better documented, consistent way.

However, there’s not complete acceptance of ePrescribing across the board. According to panelist Patricia Hale, M.D., an associate director of medical informatics at Albany Medical Center, there are many sub-specialty doctors, such as those in orthopedics, who are having trouble ePrescribing controlled substances. Then there are those specialty doctors, such as those in internal medicine, who are finding to ePrescribing to be a huge benefit, she says. Fischer agreed with Hale in saying there were many sub-specialties where ePrescribing didn’t fit in as smoothly and there are some where it comes naturally.

Another emphasis of the report was ePrescribing’s affect on medication adherence. According to the report, ePrescribing improved first fill adherence by 10 percent, which the authors say could save between $140 billion to $240 billion over the next 10 years. According to Fischer, ePrescribing can give practitioners an idea why a first fill prescription was never picked up by a patient, something that they were previously not able to track. He said there is a potential for ePrescribing to drive interventions in this regard.

In the long term, increasing medication adherence, Ahier said, could lead to decreased cost-savings and improved patient outcomes. ePrescribing, he said, as a result, is one of the lynchpins to achieving that.

Another statistic from the report showed that 83 percent of the 570 million prescriptions routed electronically by Surescripts were new prescriptions. Only 17 percent, or 96 million, were prescription renewals. This suggests, a report from the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) that said many providers and pharmacies sought to avoid renewals because of Surescripts’ transaction fees, is not entirely off.

Additionally, the report found physicians use of programs within ePrescribing systems that help show their patients’ prescription benefits in real-time was up 87 percent. Also, the authors of the report stated 31 percent of patient visits generated an electronically delivered medication history last year, while 15 million medication histories were delivered to clinicians.