Connecting Communities Collaboration for Medication Management
What Problems Are We Trying to Solve?
In most care settings today, preventing prescribing errors is dependent on a system of downstream inspection, usually by the dispensing pharmacist. While pharmacists and pharmacy technicians are remarkably good at catching prescribing errors, many errors still slip through this safety net. With increased emphasis on e-prescribing as a means of improving medication management, the focus could shift up stream through built-in error checking at the point of care.
Other areas where e-prescribing would improve medication management include:
Reducing the Burden of Callbacks and Rework
- Pharmacy staff make more than 150 million calls to busy physicians each year to discuss possible errors or otherwise clarify prescriptions.
- The Medical Group Management Association conducted research on how much time is spent by physicians and their staff manually processing refills, resolving issues related to formulary (which specifies a patient's drug coverage) as well as issues related to dosage and legibility. On average, the time spent amounts to $15,700 a year for each full-time physician.
- Brown University researched the prescription renewals process before and after e-prescribing and found that the average prescriber time spent per day was cut in half from 35 to 17 minutes and the average staff time spent per day was cut in half from 87 to 43 minutes.
Electronic prescribing with access to formulary and benefits eligibility and patient medication history can dramatically reduce the burden of spending time chasing phone calls and faxes to clarify prescription information and authorize prescription renewals.
Improving Medication Adherence
According to its landmark report in 2003, "Adherence to Long Term Therapies," the World Health Organization reported that adherence among patients suffering chronic diseases averages only 50%. This has been confirmed in numerous subsequent studies including conditions such as hypertension, diabetes, congestive heart failure, hyperlipidemia, asthma and others.
Making the process of refilling prescriptions easier for patients contributes to increased adherence. According to a poll by the National Community Pharmacists Association in 2007 ("Take As Directed: A Prescription Not Followed"), nearly a third (31%) of new prescriptions are never filled. But a recent study released in October 2007 by SureScripts, Walgreens and IMS reported an 11.21% increase in patients picking up a new medication when prescribers used e-prescribing, versus relying on hand-delivered scripts.
Cost Savings
- Electronic prescribing can enables real-time availability of information on formulary, benefits eligibility, and medication history information. Health plans and health systems save money when prescribers stay on formulary and prescribe lower cost medications.
- The IOM's 2006 Preventing Medication Errors report described evidence indicating that each preventable adverse drug event taking place in a hospital costs approximately $8,750 (in 2006 dollars). According to the IOM, if there are 400,000 such events each year, a conservative estimate, the total annual cost of preventable ADEs $3.5 billion in this one group. While information technology cannot prevent every single ADE, it is clear that it can contribute to significant cost savings.
- The Center for Information Technology Leadership (CITL) projects that nationwide adoption of electronic prescribing would save $27 billion a year, primarily as a result of decreased spending on prescription drugs. In addition, $2 billion of savings would be attributable to reduced ADE-related hospitalizations and visits.
