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WSJ BLOG/Health: Surescripts: Electronic Prescribing Improves Medication Pick-Up Rates

(This story has been posted on The Wall Street Journal Online's Health Blog at http://blogs.wsj.com/health.) By Timothy W. Martin Electronic prescribing is helping to boost the likelihood that people actually pick up their new medications, as more doctors adopt the new technology. New research shows that 76.5% of patients pick up their prescriptions at the pharmacy when the doctor e-prescribes, seven percentage points higher than when the old pen-and-pad method is used. That's according to Surescripts (which handles nearly all U.S. e-prescriptions) citing a report to be released this month or early next year. Surescripts is owned by two retail pharmacy trade groups and the three largest pharmacy benefit managers, Express Scripts, Medco Health Solutions and CVS Caremark. Drug stores pay for-profit Surescripts each time an e-prescription is accepted. PBMs are charged a transaction fee when a doctor uses e-prescribing software to access information about a patient's insurer or formulary. Researchers looked at so-called "first fills" -- or those prescriptions which aren't refills of a previously-used drug. Surescripts analyzed 40 million prescription requests from 2008 to 2010, collaborating with half a dozen drug stores and pharmacy-benefit managers. Researchers compared the likelihood people get their medications when doctors e-prescribe versus more conventional methods: paper, phone or fax. E-prescriptions are beamed via a secured internet network directly to pharmacies from computers or hand-held devices. The instantaneous transmission means patients don't have to tote a prescription with them, making it a faster, seamless process. When people don't go directly to the drug store from his office, they sometimes forget about their prescriptions, says Sal Volpe, a primary care physician in Staten Island, N.Y. "Out of sight, out of mind," he says. E-prescriptions now represent about one-third of all prescriptions, totaling 149 million for the three-month period ending in September, according to Surescripts. E-prescribing has tripled in the past three years, as doctor's offices rush to meet federal requirements they offer such technology. Adopting e-prescribing is one of several objectives health professionals must meet to demonstrate meaningful use of electronic medical records in order to qualify for certain Medicare and Medicaid incentives. Providers that don't demonstrate meaningful use by the beginning of 2015 will be subject to Medicare reimbursement reductions. The majority of office-based physicians -- or 350,500 of them -- are now using e-prescribing, a 72% increase from the previous year, according to Surescripts. E-prescribing software lists cost information, revealing whether a drug is covered by a patient's formulary and at what tier of co-pay. That can save pharmacies and doctors time, because there's less confusion over what drug has been prescribed. The software also cautions doctors when they try to prescribe a drug not covered by a particular formulary. Drug stores, which stand to benefit if more people take their medications, say e-prescribing cuts down on the time pharmacists must spend on the phone with doctor's offices. "We're not dealing with the interpretation when e-prescribing," says Robert Thompson, Rite Aid Corp.'s executive vice president of pharmacy. While e-prescribing saves time, it's not quite a perfect system. Not all formularies are loaded into e-prescribing software. Some software, for instance, limits the text length of comments, truncating medication directions. And human error -- clicking on the wrong drug from a drop-down list -- is still a problem, says Stuart Levine, who specializes in medical safety technology at the Institute for Safe Medication Practices, a nonprofit working to prevent medication errors. Bonus: IOM Recommends Independent Safety Agency for Health IT Image: iStockphoto -For continuously updated news from The Wall Street Journal, see WSJ.com at http://wsj.com.

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