E-prescribing involves the transmission of prescription or related information between prescriber, dispenser, pharmacy benefit manager, or health plan. This can be done directly or through an intermediary such as an electronic prescription network. E-prescribing includes two-way transmissions between the prescriber and dispenser. In order to improve the quality of patient care, E-prescribing must be accurate, error-free and clearly prescribed.

In 2007, fewer than 2% of all prescriptions were sent electronically. According to Sure Scripts, this percentage had increased to 7% in 2008. As more and more physicians begin E-prescribing, the hope is that patient deaths and adverse drug effects due to prescription errors will decrease significantly by 2017.

Some major problems in current prescription include:

• Lack of drug-allergy and drug-to-drug interactions information
• No records for patient past medication history
• Illegible writing (this causes up to 25% of prescription related medical mistakes)
• Adverse drug events
• High refill turnaround time (up to 72 hrs in some cases)
• Clarification calls at time of patient pick up / patient pick up delays (high waiting time) due to prescription error
• Pharmacist and physician coordination is necessary on as many as 40% of prescriptions

Given the existing condition of our prescription system, change is necessary. See how E-prescribing can eliminate many of these problems and improve the overall quality of patient care.

E-Prescribing Benefits:

• Reduction of medical errors (prescription error related death is as high as 7000 per year)
• Improved quality of patient care
• Clarification calls reduced and overhead costs lowered
• Improved patient safety (drug and allergy interactions information widely available)
• Reduced medication cost
• Decreased need for pharmacy-physician coordination (save staff's time)
• Accurate tracking of patients' medication history and records
• Eliminated paper work (Go GREEN!)
• Increased productivity for overall medication management process
• Provide real-time alerts for drug-allergy and drug-to-drug interactions based on patients EHR
• View patient drug and lab history

E-Prescribing Challenges:

A major obstacle to E-prescribing has been the cost. Although stand along e-prescribing systems are relatively inexpensive, the interfaces can be expensive. Another drawback is the DEA's prohibition of electronic prescription sending on controlled substances. This encompasses 10-11% of all written prescriptions in the United States today. Some physicians are hesitant to restructure their practice workflow to allow for E-prescribing and do not want to take the time to have staff trained initially in E-prescribing systems. Some E-prescribing programs require the purchase of additional hardware and software as well as extensive staff training to learn the basics of the new systems.

Qualified E-Prescribing:

Qualified E-prescribing systems must meet all of the following requirements:

• Generate complete active medication lists
• Select medications, electronically transmit prescriptions, print prescriptions, and conduct all time alerts (safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dosage or route of administration, drug-to-drug interactions, allergy concerns, warnings or cautions)
• Provide information on lower-cost, therapeutically appropriate alternatives (if any are available)
• Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan (if available)