The Status of e-Prescribing in the US

On May 12, Surescripts released the National Progress Report on e-Prescribing and Interoperable Healthcare.

For the past 3 years, Massachusetts has led the country in e-prescribing due to the combined efforts of our payers and our healthcare information exchange.    I follow the evolution of e-prescribing with great interest.

Key findings in the Surescripts report include:

Electronic Prescribing Use
* Prescription Benefit: Electronic responses to requests for prescription benefit information grew 125% from 188 million in 2009 to 423 million in 2010.
* Medication History: Prescription histories delivered to prescribers grew 184% from 81 million in 2009 to 230 million in 2010.
* Prescription Routing: Prescriptions routed electron- ically grew 72% from 191 million in 2009 to 326 mil- lion in 2010.
* EMR vs. Standalone E-Prescribing Software: About 79 percent of prescribers used EMRs in 2010, up from 70 percent in 2009.

Electronic Prescribing Adoption
* Prescribers: The number of prescribers routing prescriptions electronically grew from 156,000 at the end of 2009 to 234,000 by the end of 2010—representing about 34 percent of all office-based prescribers.
* Payers: At the end of 2010, Surescripts could provide access to prescription benefit and history information for more than 66 percent of patients in the U.S.
* Community and Mail Order Pharmacies: At the end of 2010, approximately 91 percent of community pharmacies in the U.S. were connected for prescription routing and six of the largest mail order pharmacies were able to receive prescriptions electronically.

Surprising findings to me include
*Family practitioners and small practices have high rates of e-prescribing compared to other specialties and practice sizes
*Specialists including cardiologists and ophthalmologists are using e-prescribing more often that I expected

E-prescribing is a unique interoperability success story.  The standards are clear (NCPDP) and are required by regulation (Medicare Part D and the Standards and Certification Final Rule).   Incentives are aligned (saves clinicians time and saves pharmacies money while making the entire process safer and more convenient for the patient).       Let's hope our other interoperability efforts such as clinical summary exchange follow this same adoption trajectory over time as we provide unambiguous standards and change the culture to make interoperability an expectation of patients and providers.