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Emerging and Encouraging Trends in E-Prescribing Adoption Among Providers and Pharmacies
Meghan H. Gabriel, PhD; Michael F. Furukawa, PhD; and Varun Vaidya, PhD
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Emerging and Encouraging Trends in E-Prescribing Adoption Among Providers and Pharmacies

Meghan H. Gabriel, PhD; Michael F. Furukawa, PhD; and Varun Vaidya, PhD
Using nationally representative transactional e-prescribing data, this study describes the trends of e-prescribing adoption by providers and pharmacies.
In addition to the challenges faced by urban providers, rural providers and pharmacies face unique issues with access, resources, and connection. With this in mind, the RECs have worked with over 50% of eligible providers in rural areas to provide assistance regarding e-prescribing and other requirements of meaningful use. Additionally, the State HIE Program has reached out to rural pharmacies to help facilitate e-prescribing. Our study found no current major differences in provider adoption by rurality. This is in agreement with 2 early studies of physician offices which showed that Health IT adoption and use in rural offices was not lower than in urban offices.24,25

Despite the progress made in the use of e-prescribing, there is also a concern of lack of ability to receive and process e-prescriptions by independent or rural pharmacies for reasons such as availability of broadband Internet and concern over transaction fees. Studies have suggested that incentive programs or grants to help with infrastructure would help to overcome that issue.26 It is important to note that our study reports no difference in ability of pharmacies in rural and urban counties which are actively e-prescribing. This indicates the potential success of incentives, grants, and technical assistance provided to such pharmacies.

With the increase of health IT use among providers and pharmacies, concerns have been raised regarding patient privacy and increased third-party access to health information. It is of note that in the period of this study, those issues do not appear to impede rapid growth in utilization and adoption. However, questions regarding the cost and health benefits of health information technologies such as e-prescribing and EHR use continue to be voiced. This analysis suggests that increasing experience with various HIE technologies such as e-prescribing results in their rapid growth. This is a trend encouraging continued exploration of the clinical and economic benefits of HIE.

Limitations

Data used for this analysis were generated from prescribers and pharmacies connected to the Surescripts Network and e-prescribing transactions that flow through the network. Due to the strength of market share, Surescripts can serve as a proxy for national trends analysis. While Surescripts captures the vast majority of outpatient transactions, it may not include transactions from a number of sources such as inpatient e-prescribing where the prescription goes directly to the hospital pharmacy, e-prescribing that occurs within a closed integrated delivery network (eg, Kaiser Permanente), and transactions that occur solely on competing networks.

CONCLUSIONS

E-prescribing is proving its potential to create a gateway to the improved patient care that health IT promises. The majority of pharmacies in the United States are able to accept e-prescriptions and nearly half of providers are e-prescribing via an EHR. These percentages have increased significantly as pharmacy and prescribing practitioner experience have grown. This study shows positive emerging trends in electronic prescribing by demonstrating accelerated growth in adoption of electronic prescribing at both provider and pharmacy level. Continuous efforts and focused investments can be expected to diminish most of the barriers to implementation in the future.

Author Affiliations: From Office of the National Coordinator for Health IT (MHG, MFF), Washington, DC; College of Pharmacy (VV), University of Toledo, Toledo, OH.

Funding Source: This study was funded by the Office of the National Coordinator for Health Information Technology. The data used for this analysis were procured by ONC/HHS. MFF and MHG are federal government employees at ONC/HHS.

Author Disclosures: The authors (MHG, MFF, VV) report no relationship or financial interest with any entity that would pose a  conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (MHG, MFF); acquisition of data (MHG); analysis and interpretation of data (MHG, MFF, VV); drafting of the manuscript (MHG, MFF, VV); critical revision of the manuscript for important intellectual content (MHG, MFF, VV); statistical analysis (MHG, VV); obtaining funding (MHG, MFF); administrative, technical, or logistic support (MHG); and supervision (MFF).

Address correspondence to: Meghan H. Gabriel, PhD, Office of the National Coordinator for Health Information Technology, US  Department of Health and Human Services, 200 Independence Ave, S.W. Washington, DC 20201. E-mail: Meghan.Gabriel@hhs.gov.
1. Centers for Medicare & Medicaid Services. E-Prescribing overview. https://www.cms.gov/eprescribing. Revised April 2, 2013. Accessed January 2013.

2. Ryan J. Nuts and bolts of e-prescribing. American Academy of Orthopadic Surgeons. http://www.aaos.org/news/aaosnow/oct08/managing6.asp. Published October 2008. Accessed Accessed January 2013.

3. Institute of Medicine. To Err is Human: Building a Safer Health System. National Academies Press; November 1999.

4. Kaushal R, Kern LM, Barron Y, Quaresimo J, Abramson EL. Electronic prescribing improves medication safety in community-based office practices. J Gen Intern Med. 2010;25(6):530-536.

5. Abramson EL, Barron Y, Quaresimo J, Kaushal R. Electronic prescribing within an electronic health record reduces ambulatory prescribing errors. Jt Comm J Qual Patient Saf. 2011;37(10):470-478.

6. Leavitt M. Medscape’s response to the Institute of Medicine Report: crossing the quality chasm: a new health system for the 21st century. MedGenMed. 2001;3(2):2.

7. The Center for Improving Medication Management. A Clinician’s Guide to E-Prescribing. http://www.ama-assn.org/resources/doc/hit/clinicians-guide-erx.pdf. Published 2011. Accessed January 2013.

8. Centers for Medicare & Medicaid Services. Medicare E-Prescribing Incentive Program. http://www.cms.gov/Medicare/E-Health/Eprescribing/Medicare-Incentives.html. Published 2013. Accessed January 2013.

9. Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. N Engl J Med. 2010;363(6):501-504.

10. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood). 2008;27(3):759-769.

11. Williams C, Mostashari F, Mertz K, Hogin E, Atwal P. From the office of the national coordinator: the strategy for advancing the exchange of health information. Health Aff (Millwood). 2012;31(3):527-536.

12. Health IT website. http://www.healthit.gov/providers-professionals/regional-extension-centers-recs. Accessed January 2013.

13. Cresswell KM, Bates DW, Phansalkar S, Sheikh A. Opportunities and challenges in creating an international centralised knowledge base for clinical decision support systems in ePrescribing. BMJ Qual Saf. 2011;20:625-630.

14. Sengstack PP, Gugerty B. CPOE systems: success factors and implementation issues. J Healthc Inf Manag. 2004;18(1):36-45.

15. Surescripts. http://www.surescripts.com/. Accessed January 2013.

16. Area Resource File (ARF) US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Rockville, MD; 2011-2012.

17. SK&A. A Cegedim Company. http://www.skainfo.com/. Accessed January 2013.

18. Gold MR, McLaughlin CG, Devers KJ, Berenson RA, Bovbjerg RR. Obtaining providers’ ‘buy-in’ and establishing effective means of information exchange will be critical to HITECH’s success. Health Aff (Millwood). 2012;31(3):514-526.

19. Hsiao CJ, Hing E, Socey TC, Cai B. Electronic health record systems and intent to apply for meaningful use incentives among office-based physician practices: United States, 2001-2011. NCHS Data Brief. 2011(79): 1-8.

20. Devine EB, Hollingworth W, Hansen RN, et al. Electronic prescribing at the point of care: a time-motion study in the primary care setting. Health Serv Res. 2010;45(1):152-171.

21. Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America; September 2012.

22. E-prescribing shown to improve outcomes and save healthcare system billions of dollars [news release]. Arlington, VA: Surescript; February 1, 2012. http://www.surescripts.com/news-and-events/pressreleases/2012/february/212_eprescribing. Accessed January 2013.

23. Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff (Millwood). 2011; 30(3):464-471.

24. Singh R, Lichter MI, Danzo A, Taylor J, Rosenthal T. The adoption and use of health information technology in rural areas: results of a national survey. J Rural Health. 2012;28(1):16-27.

25. DesRoches CM, Campbell EG, Rao SR, et al. Electronic health records in ambulatory care-a national survey of physicians. N Engl J Med. 2008;359(1):50-60.

26. Friedman MA, Schueth A, Bell DS. Interoperable electronic prescribing in the United States: a progress report. Health Aff (Millwood). 2009;28(2):393-403.
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