Maximizing Prescription Quality Through ePrescribing
A Closer Look at ePrescribing
10.24.13 | By Liz Magsig
Today, PhRMA will be hosting a stakeholder action group meeting with the National Council for Prescription Drug Programs (NCPDP) called “Maximizing Prescription Quality Through ePrescribing.” NCPDP is a non-for-profit, American National Standards Institute (ANSI) certified standards development organization. NCPDP is made up of diverse stakeholders who are dedicated to developing and promoting industry standards and business solutions that improve patient safety and health outcomes, while also decreasing costs. Prior to this stakeholder action group meeting we spoke to its moderator, Brian Bamberger, from Point of Care Partners, about the history of ePrescribing and where it is now.
Q. How did ePrescribing come to be?
A. The need for ePrescribing has been growing as the need to eliminate handwriting issues and fraud from counterfeit prescriptions grew. This capability has actually been around for years, but it took government incentives to get ePrescribing adoption to grow, and then once electronic health records came into the picture, more physicians started using this technology and more prescriptions were sent electronically.
Q. Since the inception of ePrescribing, what kind of improvements has it brought to the healthcare delivery system?
A. Two big improvements have been made since ePrescribing began. The first is the removal of handwriting errors – pharmacists can now read all of the material on the prescription. The second is that electronic transmission has also increased the pickup of prescriptions. Now, 100 percent of prescriptions reach the pharmacy and pharmacists are helping to reduce the number of abandoned prescriptions by patients.
Q. What are some areas for improvement for ePrescribing?
A. There are a few different ways that ePrescribing can be improved. The first area is the clarity of the scripts written. Just because the instructions for a prescription can be clearly read doesn’t mean they won’t require additional clarification. ePrescribing uses third party drug databases to provide drug lists, strengths, quantities and typical patient instructions, which can be limiting and confusing. Additonally, there are instances when prescribers choose conflicting information for a prescription, and then there are times when prescription quantities can be very confusing for non-tablet prescriptions.
Secondly, there ePrescribing may pose some barriers to prescribing what exactly the physician wants. For example, a medication may be available in 2mg and 4mg doses but may have an approved indication for 6mg (2mg + 4mg). With ePrescribing, there isn’t a way to easily and clearly prescribe this as one prescription to get the patient a single copay. Two prescriptions are needed or free text notes.
Lastly, ePrescribing may need to make some changes to accommodate specialty pharmacy products where the prescription information needed might be more than what is usually required for traditional prescriptions.
Q. Is there any research taking place right now that looks at ways to reduce errors in ePrescribing?
A. NCPDP has a number of taskgroups looking for specific ways to improve ePrescribing by providing guidance on the use of the standard.
Q. What are the most common errors made in ePrescribing?
A. While we’re still collecting information on this, one common error that we’ve found is that the quantities for non-tablet products tend to be incorrect and there is conflicting information between dose selected and the patient instructions.
Q. What’s on the horizon for ePrescribing?
A. At this meeting, we’re hoping to build upon the success ePrescribing has played in reducing medication errors and continue to find ways to improve prescription quality for patients.