Webinar: Panel discusses future of e-prescribing
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“E-prescribing is the best instance of an incremental or modular application to drive us towards meaningful use,” said Webinar moderator Rohit Mayik, vice president for physician technology solution at health IT company MedPlus. "More importantly, when combined with lab result information, e-prescribing forms the foundation of a real solution for care coordination management,” stated Mayik.
The Webinar was ponsored by the Mason, Ohio-based MedPlus. Presenters included:
- Robert Mayes, senior advisor on health IT issues for the Agency for Healthcare Research and Quality, Health IT Program;
- Mary Kay Owens, president and principal consultant for Southeastern Consultants, a pharmaceutical and health care consulting and data services firm in Tallahassee, Fla.; and
- Thomas A. Wolf, MD, Prairie Fields Family Medicine in Fremont, Neb.
Opening the Webinar, Mayik stated that providers have to modify their thinking from all the conversation around recruiting to an actual discussion of e-prescribing utilization. “What is it going to take to get our physicians to use e-prescribing in a manner that helps from an efficiency standpoint and a patient management standpoint?” said Mayik.
Mayik said that the discussion has to be around e-prescribing and the context of patient management and not just script delivery. In concluding his opening remarks, Mayik reviewed the initiatives needed to increase the utilization of e-prescribing:
- A discussion on how e-prescribing can help the provider from a care coordination or chronic coordination management perspective;
- A pathway to demonstrate how modular solutions can begin delivering on the needs for meaningful use; and
- A modular, migration approach toward EHR; starting with laboratories with built-in interoperability.
Mayes commented that potential drivers for e-prescribing adoption could include the alignment of incentives, a sustainable business case and ROI, proven value and benefits to prescribers and pharmacies, tools that fit provider workflow and practice style, easy to use decision support systems, and the implementation of uniform standards.
While these drivers may push greater use of e-prescribing, Mayes also said that potential barriers to adoption could include e-prescribing's cost, the disruption of office workflow it might create, the lack of integration of systems and the lack of uniform standards.
Presenting data from a population claims analysis conducted by Southeastern Consultants, Owens shared an analysis which found that 10 percent of total direct care costs can be saved if the most extreme uncoordinated care patients are better coordinated via medical homes, health information exchange of data, targeted interventions and other combined strategies.
Southeastern’s study analyzed approximately 330 million claims for uncoordinated care patterns, medical/drug utilization and cost drivers. The study examined more than 9 million patients in the states of Virginia, Florida, Ohio, New Jersey and Pennsylvania.
Owens and colleagues found that, on average, extreme uncoordinated care patients account for approximately 30 percent of all medical costs, 45 percent of all drug costs and 32 percent of total plan costs. Owens said that at least 35 percent of costs for the uncoordinated care groups represent potential savings.
In a state example of a pre-Medicare group whose population age was 55-64 years old, 28 percent represented uncoordinated care patients. This 28 percent took 71 percent of the prescription costs, 44 percent of all medical costs and 52 percent of all costs (drug and medical). "This tells you where you need to focus your efforts on costs and quality improvements that can be made in a health plan," said Owens.
Between 2010-2018, Owens estimated that uncoodinated care costs an average of $240 billion per year from combined national public (Medicare and Medicaid) and private programs. Public programs alone, Owens stated, cost $133.5 billion per year.
From a practitioner’s standpoint, the idea of e-prescribing represents safety, effectiveness and efficiency, said Wolf. Challenges for the widespread adoption of e-prescribing include consistent pharmacy adoption, support for electronic script delivery and system cost, he said.