Paperless Prescriptions: Safer, cheaper & time-saving

Practically everything in society has gone paperless: bills, statements, gift certificates, etc. Why not prescriptions? Health care professionals and government officials are making a strong push for more doctors to prescribe medication paperless. An electronic prescription is one where a doctor writes all the necessary information on a computer and then sends it directly to the pharmacy, eliminating the paper copy given to patients. A truly electronic prescription is paperless and not one printed out for a patient to walk in to a pharmacy.

Using electronic prescriptions is still a relatively new practice. Only ten percent of the nation’s practicing doctors use electronic prescriptions, but that number is rapidly growing. According to SureScripts-RxHub, operator of the most widely used electronic prescription network, approximately 35,000 doctors were writing some electronic prescriptions as of December 2007. The group estimates that number was more than 70,000 in December 2008 (a final count is not available yet).

One of the biggest reasons for such push toward electronic prescriptions is the safety of patients. Each year 1.5 Americans are injured due to a medication-related mistake, and the use of electronic prescriptions can cut that number drastically.

Pharmacists spend a great deal of time deciphering a physician’s handwriting. Oftentimes, an error is made in the type of medication or dosage a patient receives. A study done by Health and Human Services found that pharmacists make more than 150 million phone calls a year asking for clarification on handwritten prescriptions. The use of electronic prescriptions will save pharmacists time while filling prescriptions, as well as ensure the patient receives the proper medication with the proper dosage.

The database used for writing and filling prescriptions also lists other drugs the patient is taking. Pharmacists will have all the necessary information to determine if a new medication may negatively interact with a medication already prescribed to the patient. Additionally, the system can alert both doctors and pharmacists of any potential allergic reactions to a drug.

Also, the move to electronic prescriptions has the potential to save patients, taxpayers, and doctors a large sum of money.

A Harvard study found that the more knowledge physicians have about the price tag associated with medication, the more likely they are to prescribe the cheaper alternative. Physicians who participated in this recent study were provided with color-coded information related to the cost of the drug to the patient. For example, the cheaper medications—like generic drugs—were highlighted in green, while the more expensive medications—like brand name only drugs—were highlighted in red. When doctors were provided with this knowledge, they tended to prescribe the cheaper drug. During the course of the study, generic versions of medications were prescribed 3.3 percent more times than normal, while more expensive drugs were prescribed between 1.5-2 percent less.

If this trend continues with the long-term and widespread use of electronic prescribing, taxpayers and patients can potentially save a total of $3.91 million per year for every 100,000 people who fill a prescription.

Additionally, doctors who use electronic prescriptions spend less time and money on prescription-related tasks, like processing refill requests. A study by Medical Group Management Association found that the cost of time and resources spent each year on phone and fax processing of prescription refills can add up to $15,700 for each full time physician. The use of electronic prescriptions can offset this cost and the unnecessary use of resources.

Even with all of the benefits of using electronic prescriptions, not many doctors are using the technology. One reason is the ban of controlled substances, including narcotic painkillers. Controlled substances account for 20 percent of all prescribed medicines and are banned from being prescribed electronically. The Drug Enforcement Administration, Congress, and Medicare are all working together to finalize rules that allow the drugs to be available via electronic transfer.

Perhaps the biggest reason doctors are slow at adopting electronic prescription systems because of the cost associated with launching such a system. It is estimated that purchasing, installing, and learning how to navigate an entire system will cost $3,000 per practicing doctor, with $80 to $400 worth of maintenance per month.

With the hope of more doctors making the switch to electronic prescriptions and to help offset the initial investment, Medicare is giving doctors an incentive for submitting prescriptions electronically. While not mandatory yet, Medicare is giving doctors bonuses to begin prescribing more medications electronically. Additionally, they hope the extra money will help offset the initial investment of new technology.

Medicare is giving an extra two percent in regular reimbursement rates to doctors who prescribe medication electronically. This incentive program started January 1, 2009 and will continue through the end of 2010. Beginning January 1, 2011, and continuing through 2012, the rate will decrease to 1 percent and will continue to fall to 0.5 percent in 2013.

For doctors who decline to use electronic prescriptions and continue to give patients handwritten ones, Medicare will cut reimbursement rates by 1 percent starting in 2012. The penalties in reimbursement will continue with a 1.5 percent cut in 2013 and a 2 percent cut in 2014. Exceptions will be allowed for hardship cases.

To help physicians make the switch to electronic prescriptions, a group of medical organizations created a resource aimed at helping making the transition from paper to electronic prescriptions easier. The American Academy of Family Physicians, along with the American Academy of Pediatrics, American College of Cardiology, American College of Obstetricians and Gynecologists, and Medical Group Management Association, launched the ‘Get Connected’ program in March 2008. The program, which is centered on a Website, helps physicians who already have access to the technology to make the switch to complete electronic record keeping, while also helping those who need to purchase technology and learn how to implement it in their office. The Website includes questionnaires and interactive tools to help doctors make the change to paperless.

Electronic prescriptions are just the beginning in many changes for the medical community. Eventually, healthcare professionals and government officials are hoping for a nationwide electronic record database. The database will allow doctors to access any patient’s medical information, which is especially helpful in emergencies. The database also will give checkup reminders and provide care guidelines to patients. Creating and maintaining a nationwide electronic database is a huge undertaking that may take many years, if at all, so for now, the focus in the medical world is mastering electronic prescriptions. For a list of local electronic prescribers visit:

Amanda Knowles

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