In 2013, for the first time ever, more than 1 billion prescriptions sent to retail and mail-order pharmacies were written electronically, according to newly released data from e-prescribing network Surescripts. The 1.04 billion electronic scripts represent a 32 percent increase from the 788 million Surescripts handled in 2012.
Among office-based physicians, 73 percent wrote at least some of their prescriptions electronically last year, up from 69 percent a year earlier. The biggest gains came from primary care; some 96 percent of internists were e-prescribing in 2013, vs. 79 percent in 2012, while usage among family practitioners grew to 85 percent from 71 percent and pediatricians reached 78 percent from 63 percent the previous year.
Surescripts reported high utilization of e-prescribing technology among endocrinologists and cardiovascular specialists as well.
Notably, Surescripts reports that it moved 699 million medication histories between prescribers and pharmacies in 2013, based on previous pharmacy records. That’s up by 19 percent from 586 million in 2012. Having a complete medication history at their fingertips helps doctors avoid potentially harmful drug-drug interactions for their patients, a major source of malpractice suits. A record of receiving the history often is a solid defense in a liability case.
Many of the prescriptions still written on paper are for controlled substances. Though it has been legal in most states to write Schedule II prescriptions electronically for several years, the U.S. Drug Enforcement Agency has stringent rules about it, meant to prevent diversion of narcotics and other addictive medications.
Through the end of last year, about 40 percent of U.S. pharmacies had been certified on the Surescripts network to handle electronic prescribing of controlled substances. However, prescribers also have to have certified technology to prescribe controlled drugs.
Another reason why e-prescribing isn’t yet universal is a tired, old excuse: physician stubbornness. A recent article in the journal Perspectives in Health Information Management found that cost remains the No. 1 reason why primary care docs haven’t ditched the error-prone paper prescription pad. “A major barrier, reported by more than 80 percent of primary care physicians, has been lack of financial support. New technology requires training and information technology support for installation and upkeep,” the article says.
But the researchers also reported this: “E-prescribing improves the efficiency of the prescribing process. Though the actual entering of a new prescription takes about 20 seconds longer per patient than writing a prescription, this time is offset by the time saved because of the fact that less clarification is needed for electronic prescriptions.” The need for clarification represents another potential point of error — and liability risk.