Electronic prescribing Breakthrough: What Now?

The use of electronic prescribing (e-prescribing) has the obvious benefits of improving safety and reducing costs of care by alerting providers with drug-drug interactions, patient adherence to therapies, and insurance coverage information.

Deriving these benefits will require clinical decision support based on presentation of accurate and complete formulary and benefit (F&B) and medication history (RxH) data.

Because this technology is still in the early adoption phase, many providers across the U.S.are still unaware of the potential of cost effectiveness as well as reducing the risk of adverse drug events and medication errors.

The newly finalized core criteria for “meaningful use” of health information technologies include requirements for the electronic transmission of prescriptions and the maintenance of a medication history list.

The menu includes the implementation of drug formulary checks where the eligible provider must attest that this function is enabled and has access to at least one drug formulary for the entire reporting period.

Confusing as it sounds, the ultimate goal as stated is to improve quality, safety and efficiency. Reducing health disparities will include maintaining an active medication allergy list as well.

With the commitment to e-prescribing it’s interesting to note that very little is known about how the system based F&B and RxH information is used in an ambulatory care setting.  Studies have found that unrealistic expectations about the capabilities of these systems limit providers from embracing the technology wholeheartedly.

Generally, a practice using paper-based systems for tracking medications that patients had taken or were currently taking had certain protocols in place to accomplish the task.

They would ask patients to report their current medications at each office visit but found gaps when the patients’’ knowledge of their own medications were incomplete.  The use of patient portals in EMRs and communication between providers will soon be able to fill these gaps.


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