Wednesday, May 16, 2012

The State of e-Prescribing in the US

Tomorrow Surescripts issues its annual report about the state of e-prescribing in the US.

I think you'll find the summary quite valuable as it illustrates the impact of Meaningful Use Stage 1 on providers and the industry.    Here are the high points from the report:

Meaningful Use
*By the end of 2011, 58% of office-based physicians in the United States had adopted electronic prescribing – vs. less than 10% a little more than 3 years prior.
*Research suggests that the federal incentives for meaningful use of e-prescribing are well founded.
*As physicians gain more experience with e-prescribing, the data shows that they use it more.
*Prescribers who began e-prescribing in 2008 showed a 4X increase in e-prescriptions sent between 2008-2011.
*In the case of prescribers who adopted e-prescribing in 2008, the majority have met the standard for the Stage 1 Meaningful Use e-prescribing measure – over a third have already met the proposed 2014 Edition Meaningful Use measure.

Physician Adoption
*Pprimary care docs have achieved high levels of adoption.
-Internists (81%)
-Family practitioners (75%)
*Eleven different specialties have achieved adoption rates of 60 percent or more.
-Endocrinologists (78%)
-Cardiologists (76%)
-Gastroenterologists (69%)
-Urologists (68%)
-Opthalmologists (67%)
*Contradicting many survey-based studies on health IT adoption, the report shows e-prescribing adoption is highest among smaller practices:
-6 to 10 physicians (55%)
-2 to 5 physicians (53%).
*In 2011, The most significant growth in physician adoption of e-prescribing occurred among and solo practitioners – from 31% in 2010 to 46% in 2011.

Overall E-Prescribing Use
*The number of electronic prescriptions in 2011 grew to 570 million, up from 326 million e-prescriptions in 2010.
* By the end of 2011, an estimated 36% of prescriptions dispensed were routed electronically, up from 22% at the end of 2010.
*Electronic responses for prescription benefit information grew 87% in 2011.
*Electronic medication history deliveries increased 72% in 2011.
*Approximately 31% of patient visits generated an electronically delivered medication history in 2011.

Medication Adherence
*In 2011, Surescripts partnered with PBMs and retail pharmacies to compare the effectiveness of e-prescriptions and paper prescriptions on first fill medication adherence.
*The data showed a consistent 10% increase in patient first fill medication adherence (i.e., new prescriptions that were picked up by the patient) among physicians who adopted e-prescribing technology.
*The analysis suggests that the increase in first fill medication adherence combined with other e-prescribing benefits could, over the next 10 years, lead to between $140 billion and $240 billion in health care cost savings and improved health outcomes.

Thanks to Surescripts for doing this research.  It's clear that the trajectory for e-prescribing is very positive.


Colin Banas, M.D. said...

I would also contend there are A LOT of unintended consequences associated with the increased adoption of e-Rx (as there are with any new technology) - my second in command and I are working on a list of observed pain points for our Academic Medical Center and will post back shortly.

Kurt Geiger said...

I see alot of value add from Surescripts and the aggregators that analyze the transactions that are transmitted through them en-route to the pharma (abuse, over prescribing etc...). However it seems to have taken the emphasis off of leveraging the NwHin which, utilizing the C48 in conjunction with an HL7 ORM Supply Request could also be used for Medicare Part B supplies and DME.

Ahier said...

The briefing is archived here:

Surescripts Briefing

It was a very interesting discussion...

Colin Banas, M.D. said...

John - here is a punch list of the things that my informaticist team came up with related to e-Rx:

- Allergies do not transmit with the prescription, they previously appeared on the printed prescriptions we hand out

- Renewals coming back into our system lose their strict structure they originally contained and get reduced to freetext for the inpatient med list

- Recent surescripts glitches and snafus were very crippling and there were more than just a few

- SPI number expiration, renewal, dependency is clunky and created a lot of additional administrative work for our privileges folks

From Dr. Wolver,

"We still get reams of faxes from pharmacies.

We change a medication on a Wednesday, but on Friday get a request for the old dose of the medication because they don't link up the medications. Even if we ePrescribe with comments like, "This is a new dose", or this replaces the other medication.

Providers don't realize that cancelling a medication in the EHR doesn't go to the pharmacy and sometimes many medications are prescribed and then cancelled before one is decided on leading to a very dangerous situation.

I am a firm believer in ePrescribing, but I think it was pushed before the pharmacies were really ready. Generally they are overwhelmed and without a good way to elecronically communicate back and forth, we are asking for trouble. Really we have changed some problems (bad handwriting) for others (lack of allergy transmission). "

Just a list....