The survey, conducted by HaldyMcIntosh & Associates, for the Southeastern Michigan ePrescribing Initiative (SEMI), an electronic prescribing collaboration, reported a high level of satisfaction and consensus among physicians on the benefits of ePrescriptions in patient care.

The survey involving physicians and staff of 500 practices participating in the three-year SEMI ePrescription pilot program showed that three out of four physicians strongly believed that ePrescribing enhanced patient safety and about 70% felt that it augments quality of care. The survey also found that 70% of the physicians polled were satisfied with the technology, more than 80% of prescriptions were written electronically by these physicians, and every four out of ten surveyed wrote all of their prescriptions electronically.

Physicians seemed to have benefited most by the safety alert features of ePrescription technology, which forewarns them of potentially harmful drug interactions and allergy risks at the point of prescribing. About 65% of ePrescribers from the survey reported at least one incident of having revised their prescription due to a safety alert received through the system. This finding also reinforces earlier projections, which indicate that employing electronic prescribing systems could prevent over 2 million adverse drug events (ADEs) every year, with 130,000 of them being fatal and save on an estimated $27 billion, per year in the United States. According to the U.S. Department of Health & Human Services, ePrescription technology would result in a reduction of 530,000 adverse drug events annually in Medicare alone. These figures illustrate the potential that ePrescribing technology holds in reducing dangerous and costly adverse drug events.

The survey showed that contrary to the common concerns among physicians, regarding the difficulties and time demands involved in learning a new technology and uncertainty over its usefulness, physicians participating in the pilot found that the systems had met or exceeded the expectations of nine out of ten of those polled; more than 70% had fewer prescription related communications with the pharmacy, with 40% of them reporting a substantial gain in time; and more than half concurred on increased productivity upon using this technology.

Despite the benefits of the technology, the lack of consensus on cost saving capabilities of the system was brought to the forefront through this survey with one in four physicians skeptical about the same. Two out of three respondents however felt that they were more likely to prescribe low cost generic or plan-preferred equivalents while prescribing electronically.

Previous results from the 2007 survey SEMI ePrescribing pilot program support the findings on improved safety and formulary compliance. A review of 3.3 million electronic prescriptions found that 39% of the time physicians complied with formulary requirements, when alerts were presented. The review also showed that when presented with a drug risk alert 41% of the time, the prescribing physicians changed or cancelled his prescription. Similarly, 41% of the 100,000 medication allergy alerts were responded to.

According to Kate Kohn-Parrott, director integrated health care and disability, Chrysler LLC, a member organization in the SEMI coalition, reports of improved physician satisfaction and enhanced productivity with the program have helped in moving towards universal acceptance of ePrescribing.

Encouraged by the current results, the SEMI partners have decided to extend the initiative and enroll more physicians through June 30, 2008. Originally designed to equip about 17,000 physicians with ePrescribing technology tools, the SEMI program, lead by General Motors, Ford Motor Company and Daimler Chrysler Corp., is an employer-driven e-prescribing initiative involving a coalition of organizations including Chrysler LLC, the United Auto Workers (UAW), Blue Cross Blue Shield of Michigan, Health Alliance Plan, Henry Ford Medical Group, Medco Health Solutions, Inc., CVS Caremark Corporation, RxHub, LLC and SureScripts®.

Electronic prescribing or ePrescribing is the use of an automated data entry system to produce a prescription that will minimize avoidable errors through illegible hand-written prescriptions. The technology also helps improve quality and efficiency of the clinician’s workflow; promotes appropriate drug usage; provides information to providers and pharmacists about formulary-based drug coverage, including formulary alternatives and co-pay information; and speeds up the process of medications renewal. It may also help reduce the incidence of drug diversion by alerting providers and pharmacists of duplicative prescriptions for controlled substances. ePrescribing eliminates the back and forth clarifications that takes place with written prescriptions, and is now less time-consuming for both pharmacists and clinicians.

Many government and private organizations are working towards developing various technologies and initiatives to enforce safety and reduce errors in the prescription process. In 2006, national technology leaders entered into an alliance for the National ePrescribing Patient Safety Initiative^SM (NEPSI^SM) to provide free access to electronic prescribing software for every physician in America. In 2007, Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS), invested $31.4 million to encourage the adoption of electronic health records (EHR) and other health information technology (HIT) initiatives like e-prescription, decision support software, etc. by health centers. SureScripts, founded in 2001 by the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA), to enhance quality, safety and efficiency of the process of prescribing, established the Pharmacy Health Information Exchange™ in 2001, which is the largest network connecting over 90% of pharmacies in the U.S.

With technology initiatives introduced by both government and private organizations, the healthcare sector is aiming towards the transition from a paper-based process to a solely electronic and safer process of electronic prescribing.

Written by The HealthNEWS Team · Filed Under Industry Watch, Industry Insights, IT Adoption, eHealth

Above article published on http://www.healthnewsdirect.com/?p=274

Wireless Technology Boom: Conduit to E-Prescribing

The healthcare industry’s transition from paper-based record to electronic record is witnessing yet another revolution- Electronic Prescription. Healthcare facilities of all sizes today are employing the advantage that comes with the mobility of wireless technologies. The market for wireless technology in Europe is becoming a ‘mass market’ and is increasingly gaining momentum. With the advent of wireless networking, many organizations are exploring how wireless mobility can change the way they work. The popularity of wireless and handheld devices is increasing in healthcare for its mobility and flexibility. Mobile and wireless healthcare means the mobile access to patient health record, prescription, clinical and pharmacy order entry (CPOE) and management systems and so on. The number of medical accidents due to prescribing errors is increasing, with more than 0.1 million lives being lost every year. Electronic prescribing and computer prescribing are gaining its importance in reducing medication errors and transcription errors in the ambulatory healthcare market by providing unambiguous, clear and timely information and thus saving lives.

E-Prescribing- A Consolidating Process

Electronic prescription systems can be defined as a solution that eliminates hand-written prescriptions from the health care services provided by physicians, other prescribers, and pharmacists. It has to be seen as a combination of three other separate services- Decision Support, Electronic Transmission of Prescriptions and Electronic Medical Records. The functional capabilities of the system extend up to integration into the electronic medical records (EMR), which includes the patient’s medication history, eligibility checks, and formulary functions. Hence, an e-prescribing system is not only a simple tool to generate prescriptions electronically, but it is making the entire health care service more secure and reliable through electronic decision- making database systems. Hand-written prescriptions can be difficult to read, and also the authenticity of the prescription can be doubtful, as could be the case with prescription authorizations given over the phone and by fax. Some important information such as dosage, frequency of medication, and signature may also be missing in hand-written prescriptions. Electronic prescriptions not only consolidate the process of prescription for creating, transmitting, and checking authenticity, but it also makes it mandatory for all the important information to be present on the prescriptions for transmission.

Technology Itself as a Driver

The healthcare industry can no longer be complacent towards its technology due to the escalating costs, technology savvy patients, and also due to the healthcare regulations like the Healthcare Information Portability and Accountability Act (HIPAA). The electronic economy is finding itself a new set of opportunities, challenges, and restraints in the healthcare environment in Europe and when it comes to the usage of information systems/information technology (IS/IT) in healthcare management, the healthcare industry is finding itself in a state of turbulence and flux. The rise in healthcare expenditure has lead to the uptake of key healthcare IT solutions such as e-prescription, shared medical records, primary care information systems, triage solutions and management information systems. Pharmacists around the world have long before been facing the challenge to cope with pharmacist storage and dispense a large number of prescriptions, while increasing their practices for more patient care activities. E-Prescription has experienced a phenomenal growth in United States (US). The technology is on course to be accepted by the European healthcare system. With healthcare being the foremost concern for many, demand for faster and efficient service is on a rise. With 0.1 million lives being lost every year owing to medication errors, there is a rising demand for an infallible and dedicated technology which ensures that such errors are kept low. E-prescription provides a solution to all this and hence seems to be on the fast track now. Moreover, e-prescribing is driven by the fact that there has been an express growth in software development and usage to support health care services. The other trends that are driving this market are integration of more information systems, short life span of computers and increased electronic data interchange in healthcare. Increased uptake of e-prescription and Electronic Medical Record (EMR) systems has significantly boosted the quality of healthcare and patient safety.

Differences in Contrast Environment

Prescribers in the ambulatory care segment have increasingly realized their ability to save lives and costs through clinical automation as well as economical and consolidated e-prescribing systems. It should be noted that with the complexity in the applications increasing in terms of infrastructure, the number of actors and the skills needed by the user also increases. This leads to a substantial difference between the countries adopting e-Prescription. Denmark, with 97% of the GP’s using e-prescription has the highest rate of adoption in Europe. On the other hand, countries such as Italy has negligible rate of adoption of this technology. The difference in adoption is not just seen between countries, but also between the primary care and secondary care to a large extend. Electronic prescribing in primary care and secondary care are very different in terms of its application. A quarter of all the expenditure in primary care is on drugs. The primary care which still uses FP10 prescription, involves solutions such as clinical noting, decision support and documentation functions in its e-prescribing. Clinical decision support is more widespread in primary care. Due to the standardization of products and coherent user group, e-prescibing is more successful in primary care. On the other hand, electronic prescribing in secondary care involves a closed loop process. The systems of EP are concerned with the total medicines management process from prescribing to dispensing to medicines administration and monitoring. It incorporates the recording of drug administration or omission. The decision support required during the point of administration and prescribing is different. Since the application requires experienced physicians to use it, the key users are hard to engage. All these makes the process complicated in secondary care. Current estimates show that the number of hospitals that have fully implemented electronic prescribing is very low in Europe.

Talk the Challenge

E-prescribing systems have not experienced optimum sales because of the limitations placed on e-prescribing due to culture change between the nations. The reluctance of physicians to adapt to electronic prescription is yet another major hurdle faced today. There is a difficulty to market the new technologies in physician practices. Good change management and stakeholder engagement is vital to improve this situation. Limitations placed on controlled drugs, due to misuse and security concerns is also upsetting the sale of e-prescribing systems. As information is propagated through internet, chances of health insurance details and other private data being hacked is rather high. Hence the system demands for highest levels of encryption and data coding measures. This issue however has been resolved with the introduction of data security and privacy acts such as HIPAA. There is a high need for standardized drug name and database. The situation can be improved if facilities for online checks and authorization to ensure the process is tamper proof is offered. It is vital for the regulatory bodies to draw the guidelines and criteria that need to be satisfied for enabling the e-prescription of controlled drugs. Interoperability issues can challenge the market participants if the physician already uses clinical automation solutions, such as practice management from another vendor. To offset this concern, vendors can build a comprehensive product that includes Practice Management Systems (PMS), Computerized Physician Order Entry (CPOE), and integrated to Electronic Medical Records (EMR) to automate the entire clinical and management workflow of a physician’s practice to save workload of staff and licensing costs. Poor domain expertise among the software providers is yet another major reason for the slow growth of e-prescription in Europe. This can be overcome through increased number of publications that can showcase the potential benefits of electronic prescription through quantitative analyzes.

Legend

C – Challenge

R – Recommendation

Optimistic Future

Every country’s tradition, culture, patient expectation, and payment mechanisms shape the healthcare systems there. Healthcare organization of tomorrow must consider a wireless delivery platform as a strategic necessity, if it is to survive and thrive in today’s challenging healthcare environment. In spite of the current credit crunch that is having a holistic effect on the healthcare IT budget in Europe, we expect e-prescription to have a slow and steady penetration in the coming years. This is expected to happen with the encouragement from physicians and pharmacies to adopt the technology. E-prescribing is expected to find its huge benefits and relatively few drawbacks in the coming future. This would set this technology to find its acceptance for a broader use in the European healthcare. With contributing factors such as increased mobility, changing lifestyles and the increasing ageing population in the European nations, the market for electronic prescription is expected to grow. Regional interconnectivity to ensure prompt transfer of patient information has become the need of the hour even as the patients increasingly travel across countries. Hence, besides the obvious advantages of reducing medication errors and saving upon time and money, e-prescription is building path for a global healthcare structure

Above article published on http://www.frost.com/prod/servlet/market-insight-top.pag?Src=RSS&docid=163558282