What is E-Prescribing?
Electronic prescribing, or e-prescribing as it is commonly called, is the use of an automated data entry system to generate a prescription that is then transmitted through a special network to the pharmacy in such a way that the data goes directly into the pharmacy’s computer system. It is not simply e-mailing or electronically faxing a prescription.
The Medicare Part D prescription drug program more formally defines e-prescribing as:
“E-prescribing means the transmission, using electronic media, of prescription or prescription-related information between a prescriber, dispenser, pharmacy benefit manager or health plan, either directly or through an intermediary, including an e-prescribing network. E-prescribing includes, but is not limited to, two way transmissions between the point of care and the dispenser.”
For the prescriber, e-prescribing happens when a physician uses a computer or hand held device with software that allows him or her to—with a patient’s consent—electronically access information regarding a patient’s drug benefit coverage and medication history; electronically transmit the prescription to the patient’s choice of pharmacy; and, when the patient runs out of refills, his or her pharmacist can also electronically send a renewal request to the physician’s office for approval.
Benefits of E-Prescribing
By eliminating paper, e-prescribing creates a more efficient and safer process for patients to access their medications. This electronic process helps to prevent, and in some cases eliminate, the top reasons for prescription errors—including illegible hand-writing, incorrect dosing, and missed drug/allergy reactions—which improves patient safety and helps to control ever increasing medication costs due to medication errors.
Through electronic prescribing, all health care stakeholders—including providers, patients, pharmacies, and payors/PBMs—expect to see prescription related benefits such as:
Payors/PBMs: Increased generic/formulary usage, efficiency, Rx compliance and prevention of ADEs (reduced costs)
Patients: Increased safety, efficiency and compliance, lower co-pays
Providers: Increased efficiency, improved care, patient satisfaction and potential short and long-term incentives
Pharmacies: Increased efficiency, improved care, improved patient satisfaction
Key functionalities of an E-Prescribing System
E-prescribing involves far more than an electronic connection. In order to see an increase in both quality and efficiency that can be attributed to e-prescribing, the system must be capable of performing key functions related to:
Medication selection/decision support capabilities (e.g., diagnosis-based medication menus, evidence based information, drug interaction checking, safety-alerts, formulary checking, prescription renewal, and dosage calculation)
Patient-specific information capabilities (e.g., current patient medication list, access to patient historical data, patient identification)
System integration capabilities (e.g., connection with various databases, connection with pharmacy and pharmacy benefit manager systems)
Educational capabilities (e.g., patient education, provider feedback)
The Journey of an E-Script
The journey of an e-script begins when the patient and physician review history and discuss the current issue and treatment options. As the physician electronically writes the prescription, the e-prescribing system connects electronically to Rx Hub to determine whether the patient is eligible for a particular payor. The patient’s up-to-date formulary and medication history is then presented to the provider at the point-of-care.
The physician then reviews clinical alerts, formulary, reference, prescription history, eligibility, and prior authorization information with the patient and selects therapy and verifies the patient’s preferred pharmacy.
Once the prescription is finalized, the e-script is generated and the physician routs it to the patient’s pharmacy of choice. The pharmacist fills the prescription and sends a fill notification to the physician.
If the pharmacy is online and has the ability to accept electronic prescriptions, the two-way connectivity provides for the transmission of new prescriptions, refill authorizations, and denials and change requests between the pharmacy and the provider’s office.
What Will This Look Like in My Office?
The Physician:
Signs onto the e-prescribing system. The sign-on process maintains the security of the system and is required in order to prove identity and verify legal prescribing permissions.
Selects the patient and reviews current patient data, including current and past medication data based on information from other providers and pharmacies.
Selects medication. He or she can either work with current medication (change dose, refill prescriptions, discontinue medication, etc.) or choose a new medication either by selecting from a predetermined list or searching for specific drugs based on search results, warnings, and/or favorites.
Signs the prescription and transmits it electronically to the patient’s preferred pharmacy.
