Electronic prescribing is the term used to describe the electronic exchange of prescription and medication history information, computer-to-computer, between prescribers, pharmacies and insurance payers/pharmacy benefit managers (PBMs). Prescriptions are prepared using certified E-Prescribing software run through a computer, EHR, or mobile device (such as a handheld mobile device) and then electronically transmitted through a secure network to the patient’s choice of pharmacy to be filled. In turn pharmacies can send requests for prescription refills to prescribers where they can be reviewed and responded to without the need for fax or phone communication. The HITECH Act of 2009 created a financial incentive program to encourage adoption and meaningful use of EHRs. The legislation is accelerating the demand for and use of E-Prescribing as an integral part of the healthcare reform process.
In order to avoid Medicare payment cuts in 2012 and 2013, all prescribers must be using E-Prescribing by June 2011 in order to avoid 1 and 1.5% payment cuts. The Medicare Fee Schedule for 2011, which was published in November 2010, requires physicians to e-prescribe 10 times by June 30, 2011, and 25 times by December 2011, and submit G-code G8553 on their claims. The cuts and e-Rx incentive program were authorized by the Medicare Improvements for Patients and Providers Act (MIPPA), and will impose a 1% penalty for 2012 and a 1.5% payment cut for 2013 for the failure to E-Prescribe.
Benefits of E-Prescribing
E-Prescribing is viewed by many clinicians as high value. Not only does it provide physicians and other prescribers with the ability to easily access and manage prescription benefit information (eligibility and formulary), but also there are many patient care benefits, such as the ability to review past prescriptions and medical history and perform drug-drug interaction checking as an integral part of the prescribing process. There are also efficiencies for the patient, prescriber and pharmacist by being able to manage prescription refill requests and authorizations electronically. Legibility of prescriptions is no longer an issue and this helps reduce dispensing errors by providing pharmacists with clear instructions for specific drugs.
E-Prescribing can be managed using a standalone E-Prescribing application, or as component of an EHR. Some clinicians have chosen to start with a standalone E-Prescribing tool that allows the user to manage prescriptions using a web-based interface or through a smart phone or wireless device. The advantage of this approach is that it is easier and quicker to get started if you work in a paper-based medical practice or if your EHR does not have integrated E-Prescribing capabilities. However, if you are using an EHR or are considering the purchase of an EHR, having E-Prescribing as an integrated part of your EHR is the way to go.
If you are looking for an E-Prescribing system make sure it includes drug-benefit checking, formulary checking, medication history from outside sources, drug-drug and drug-allergy checking, and bi-directional electronic routing with pharmacies. One of the best places to begin looking for an E-Prescribing system is Surescripts. Search for certified software solutions by name or type: http://www.surescripts.com/connect-to-surescripts/prescriber-software.aspx
- To find out more about E-Prescribing, AmericanEHR Partners has several good resources: http://www.americanehr.com/education/education-resources/e-prescribing.aspx
- CMS has detailed information describing the Medicare Improvements for Patients and Providers Act (MIPPA), an E-Prescribing incentive program that went into effect in January 2009: https://www.cms.gov/ERxIncentive/01_Overview.asp#TopOfPage
- AMA also provides an E-Prescribing learning center: http://www.ama-assn.org/ama/pub/eprescribing/home.shtml
- A significant number of additional E-Prescribing communication tools and resources are available on the Surescripts website: http://surescripts.com/about-e-prescribing.aspx
- HIMSS has created an e-prescribing Wiki: https://himsseprescribingwiki.pbworks.com/
This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.