Expanding clinical connections: Prescriptions

Every day, I pick up drug/drug inter-actions with my e-prescribing program," says Salvatore S. Volpe, a solo med-peds specialist in Staten Island, NY. For the past year and a half, Volpe has been using the PocketScript program from the Dallas-based ZixCorp.

While the electronic-prescribing system has improved the efficiency of his office by speeding refills and cutting pharmacy callbacks, he's most impressed by how it helps him avoid adverse drug events. "There's no way a doctor can remember every interaction. I'm looking up not only the scripts I write but also scripts written by other doctors," he says.

He can do that because PocketScript gives him access to many patients' dispensing histories. ZixCorp obtains this data from RxHub (a company formed by three leading pharmacy benefit managers) and from other PBMs and health plans. Other electronic-prescribing vendors use the RxHub service, which also includes formularies of many health plans.

Because his prescriptions are complete, legible, checked against formularies, and screened for drug interactions and allergies, Korbey gets few callbacks from pharmacies. In fact, since he's been e-prescribing, the number of pharmacy calls handled by each of the nurses in his four-doctor office has dropped from about 20 a day to only one or two. As a result, he figures the practice is saving at least 15 minutes of overtime per nurse per day. The savings on that alone was about $11,000 last year, he says.

And Korbey isn't even online with pharmacies yet. Like most doctors who e-prescribe, he faxes his scripts to the drugstores from his computer-which means scripts might still get lost or be incorrectly keyed into the druggist's computer system. But pharmacies across the country are gearing up to go online with physicians in the near future, and some have already done so. When that happens, what doctors write is exactly what pa-tients will receive. Moreover, pharmacists will be able to send refill requests online to doctors' offices, which should save more staff time.

One physician who's starting to take advantage of this new approach is cardiologist Thomas E. Sullivan, immediate past president of the Massachusetts Medical Society. Sullivan, who uses the Rcopia e-prescribing program from DrFirst of Rockville, MD (and is a consultant to the firm), likes the two-way communications with pharmacies because it's faster and more efficient than the old way.

"It's cheaper than using my fax machine, and it provides an electronic turnaround for refills and queries," he says. "If there's a question for me, it'll come back on my computer. And when a patient calls the pharmacy and asks for a refill, the pharmacy sends me an electronic message, and as soon as I turn on my application, it comes up right in front of me and it's all written out."