ePrescribe has become an important part of many EHR systems, and with good reason. E-prescribing helps ensure prescriptions are legible and error-free. Some ePrescribe systems provide support for prescription decisions and trigger warnings if the selected drugs have interactions. And perhaps the simplest benefit of all: eprescriptions are more likely to actually make it to the pharmacy. Recent studies have shown that in outpatient settings, 28% of paper prescriptions never get delivered to the pharmacy. In contrast, using ePrescribe reduces that number by 12%.
Now, a recent study published in The Journal of the American Medical Informatics Association shows that Medicare patients with diabetes whose doctors more frequently used eprescribe were less likely to have adverse drug events (ADEs). While previous research has demonstrated the benefits of ePrescribe, this study was one of the first to examine the effects on ADEs in ambulatory, rather than hospital settings.
The researchers looked at the cases of Medicare patients receiving treatment in outpatient facilities and divided them into two groups; those whose doctors used ePrescribe for more than 50% of prescriptions and those who used it for less than 50% of their orders. That 50% cutoff point of course comes from the Meaningful Use requirements. Meaningful Use Stage 2 requires physicians to use ePrescribe for 50% of their orders.
The study results give statistical support to that Meaningful Use requirement. Researchers found that the patients of doctors who used ePrescribe more than 50% of the time had fewer adverse drug effects.
The Meaningful Use program has lately been under attack. And that’s understandable – physicians are overwhelmed with technology requirements on top of their day-to-day clinical duties. Meeting these requirements is no small task, and takes countless resources that many small practices just don’t have. The complications created by this program are incredibly complex.
But it’s important to remember that many of these requirements do have real value. As this study shows, hitting that 50% mark for ePrescribe could make a real difference for patients — reducing ADEs that land them in the hospital. And now, that finding is consistent across both hospital and ambulatory settings.
There’s still a lot of room for improvement when it comes to e-prescribing. The study also showed that certain patient populations (lower income, African American) are less likely to have a doctor who meets that 50% threshold for e-prescribing. Those same patients are the ones who are already at higher risk for ADEs. More widespread adoption of ePrescribe systems, especially among providers serving these patient populations, could make a big difference in unnecessary hospitalizations and overall medication adherence.
As it stands, outside of the Meaningful Use requirements, New York has mandated ePrescribing state-wide. However, the state delayed that mandate by one year this past March.
Wherever you stand on Meaningful Use, the fact remains that e-prescribing whenever possible could significantly improve patient outcomes, increase medication adherence, and ultimately lower our healthcare costs from avoidable hospitalizations.
References:
http://jamia.oxfordjournals.org/content/early/2015/05/05/jamia.ocv036
http://www.fierceemr.com/story/study-supports-mu-stage-2-threshold-e-prescribing/2015-05-06
