Wednesday, August 19, 2009

E-Prescribing Overview

I am certain that meeting the "meaningful use" criteria will include e-prescribing. A prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care is an important element in improving the quality of patient care.

Electronic prescribing, or e-prescribing is the computer-based electronic generation, transmission and filling of a prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, nurse practitioner, or physician assistant to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. A more formal definition of e-prescribing is provided in the Medicare Part D prescription drug program:
E-prescribing means the transmission, using electronic media, of prescriptionor prescription-related information between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary,including an e-prescribing network. E-prescribing includes, but is not limited to,two-way transmissions between the point of care and the dispenser.
You have basically two choices available when you consider an e-prescribing system: either a stand-alone system, or e-prescribing within an EHR system. To qualify for financial incentives under ARRA prescribers will need to be using a “qualified” e-prescribing system. A “qualified” e-prescribing system must be capable of performing all of the following functions:
  • Generating a complete active medication list incorporating electronic data received from applicable pharmacy drug plan(s) if available
  • Selecting medications, printing prescriptions, electronically transmitting prescriptions, and conducting all safety checks (safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration, drug-drug interactions, allergy concerns, or warnings or cautions)
  • Providing information related to the availability of lower cost, therapeutically appropriate alternatives (if any)
  • Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan
Most e-prescribing systems and many EHRs have these capabilities. Certainly vendors are working to meet these criteria so that users will be considered "meaningful users" and thus qualify for incentive payments. For further resources on e-prescribing see:

E-Prescribing report to congress

Draft 2010 EHR E-Prescribing Measure Specifications