Physicians Extol Medical and Financial Benefits of e-Prescribing

70%—Percentage of US pharmacies that are equipped to receive e-prescriptions.(SureScripts, 2008)

If a tool were available that would enable your medical practice to run more efficiently, generate more revenue, and improve patient satisfaction while reducing medical errors, you’d be on board for that, right?

Well, maybe not.

The tool is e-prescribing, and it provides physicians’ offices with the ability to submit a ‘clean’ prescription directly to a pharmacy from the point of care, usually by computer-generated fax or email. However, despite the benefits detailed above, the Center for Information Technology Leadership estimates that less than 10% of US doctors are using e-prescribing. Why?

“I think [e-prescribing] goes hand in hand with electronic medical records,” explains Charles Crutchfield, MD, medical director of Minnesota-based Crutchfield Dermatology. “Part of the problem is that with a lot of the EMR systems, their ability to e-prescribe is very limited. That’s what happened to us for two years.”

An Easy FixOne day out of frustration, Dr. Crutchfield turned to his information technology guru and complained, “My wife is on the computer all the time, and she can send an email fax, so why can’t I?” Told that he could do the same, Dr. Crutchfield had a ‘eureka’ moment.

“Through my electronic medical records, I can bring a prescription up on the computer screen, take that image and email or fax it via email to a pharmacy,” Dr. Crutchfield explains. “Most computers that are Internet-capable can e-prescribe, so that’s what we do.”

Physicians at Ear, Nose and Throat Associates of Southeastern Connecticut, PC, do the same thing. They ‘write’ their prescriptions on a tablet computer through software integrated within their medical records software, and send them via a fax server on the computer directly to the pharmacy.

“When my partners and I realized we could sit right in front of the patient and, with a couple of clicks, send the prescription off to the pharmacy literally before the patient left the office, that really hit home for all of us,” explains David Boisoneau, MD. “And the patients think that’s great.”

Streamlining OperationsDr. Crutchfield recalls the frustration he experienced prior to e-prescribing. His practice has high patient volume, and the average patient receives two or three prescriptions. And since each prescription needed his signature, he was spending a lot of time practicing his autograph.

“It was insane,” Dr. Crutchfield explains. “It became a huge burden to my practice. My staff was waiting for me to sign something, so our rooms weren’t being filled with new patients. Now, conservatively, I can probably see one to two patients more per day, because our rooms are being turned around faster and I’m not spending all my time signing prescriptions.”

Dr. Boisoneau says that the ability to e-prescribe has been most beneficial in Southeastern’s surgical practice. Following operations, pain medication, antibiotics and other post-operative medications are often prescribed. Patients leaving the hospital, sometimes feeling sick and nauseous, do not want to wait a half hour at a pharmacy for a prescription to be filled; they want to go home and recover.

“As soon as the patient is awake from the anesthesia, I’m sitting at a laptop computer in the operating room, signed into our electronic system, and I have the prescription faxed off to the pharmacy,” says Dr. Boisoneau. “Patients just have to pull up to the drive through and the prescription is there for them. We’ve had nothing but positive feedback from patients because of that.”

The Numbers are UpA 2007 study conducted by drugstore chain Walgreen, SureScripts and IMS Health revealed that pharmacists in a five-state area saw an 11% increase in the number of prescriptions filled at their stores when area physicians began using electronic prescribing systems. According to a news release issued by Walgreen and SureScripts, an estimated 20% of new prescriptions go unfilled, and an even higher percentage of prescription refills are not even picked up at pharmacies. In effect, physicians who e-prescribe are getting more medications in the hands of patients who need them.

And what about the claim that switching to an e-prescribing system is a hassle? Physicians who have switched put the kibosh on that theory.

“Compared to the other hassles that we had to swallow—had to adapt to when we went to a totally paperless, totally electronic health system in our office—e-prescribing was the simplest adjustment,” explains David Donnersberger, MD, JD, of Evanston Northwestern Healthcare. “Within a week or two, e-prescribing and e-scheduling were the two fastest and easiest changes that occurred within our office.”

Echoes Dr. Crutchfield, “Everybody resists change. But once you try [e-prescribing] a couple of times and realize how great it is, then it’s easy.”

For those doctors who resist the change, the trend is not your friend. According to SureScripts’ National Progress Report on E-Prescribing, “although the annual e-prescription transaction growth is significant, only 2% of the estimated 1.47 billion new prescriptions and renewals eligible for electronic routing in 2007 were transmitted electronically. In 2008, SureScripts estimates that the number of e-prescriptions will exceed 100 million, increasing the percentage of the nation’s new Rxs transmitted electronically to 7%.”

Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at edwardr@ptd.net.

“Paper prescriptions are a key cause of cost, errors, and inefficiency in our healthcare system. Electronic prescribing should be the rule not the exception."—Glen Tullman, CEO, Allscripts