The state of Delaware credits a decision a year ago to fund e-prescribing start-up costs for the top Medicaid providers in the state for a 150 percent jump in the number of Medicaid providers now using the e-health service.

The top-down approach, which included offering e-prescribing technology and training services to the top 50 Medicaid providers in the state, has sparked adoption of prescribing by one in five Delaware Medicaid providers, according to state healthcare officials.

“It surprised us even that the level of participation actually more than doubled in such a short period of time,” said Rita Landgraf, secretary of the Delaware Department of Health and Social Services.

The number of medication history inquiries also rose from an average of 500 a month in the first three months of the program to more than 11,000 a month in October 2009, she said. “We believe that we’ll continue to see this growth.”

The Delaware Medicaid E-Prescribing Network, which went live a year ago, was launched by the Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance (DMMA) with a $1 million Medicaid Transformation Grant from the Centers for Medicare and Medicaid Services (CMS).

The network was built and is being managed by HP Enterprise Services (formerly EDS), Delaware’s fiscal agent since 1989.

The network is integrated with the state’s Medicaid Management Information System and enables physicians to securely verify Medicaid benefit eligibility, access medication history from Medicaid and other third-party payers, view the Medicaid formulary and transmit electronic prescriptions to pharmacies.

Landgraf credits the pilot project as a big driver for getting physicians to start using e-prescribing. It involved providing e-prescribing hardware, software and training to the 50 highest-volume Medicaid providers in the state.

Although the physicians in this group represented only 2 percent of the state’s Medicaid providers, they were responsible for 20 percent of the total annual paid pharmacy claims volume, she said.

“With this approach, we’re first getting the high-volume prescribers connected first and then working our way down, so that we may be able to use those practitioners to do the training as well, like the ‘train the trainer’ model so we can leverage our resources across the board,” Landgraf said.

The Medicaid network also expanded e-prescribing features available to the estimated 200 providers that had already adopted an e-prescribing system offered through the State Employees Health Plan and Blue Cross Blue Shield of Delaware.

The new system offers them access to the full medication histories of Medicaid patients and Medicaid formularies, among other things.

As the Medicaid-e-prescribing network expands, DMMA officials are hoping to conduct studies that validate the advantages of e-prescribing. These include fewer errors, increased patient safety, time and cost savings and a reduction in fraud.

Landgraf said she would like to continue to provide additional financial incentives to other providers who have yet to adopt e-prescribing. Her department is also looking to see how grant funding through the American Recovery and Reinvestment Act of 2009 might be applied.

“I think it’s necessary to provide physicians that additional support to bring them into the system in order to overcome their reluctance,” she said. “Not just giving them money, but also the technical assistance and training to help them get the hardware and software, incorporate it into their practice and get them up to speed quickly.”

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