Is Electronic Prescribing (ERX) Hitting Its Stride?

---Terri Bernacchi, PharmD, MBA,  Cambria Health Advisory Professionals 

Although some may say, “it’s about time” that the electronic prescribing patterns started to show a real impact on how medicine is practiced, I think it is important for folks to consider how much of a change in process the use of ERX technology requires in the relationship between the physician and patient. 

A common perspective on “over-prescribing” of antibiotics in the past, for example, was that the acutely ill patient had an expectation that they would leave the office with something tangible----whether drug samples, or a written prescription. The physician fulfilled this expectation by writing something that would certainly “do no harm” and which may  produce some emotional or physical benefit.  Thus, if the patient had an expectation of an antibiotic (which may have been the sole reason for the visit), he or she would leave the office unhappy without a prescription. 

But as ERX has made its gains, the patient and physician now may huddle around a computer monitor or over a handheld device as the prescription is selected, the pharmacy chosen and confirmed, and the order issued.  The dynamic is different as some eye-contact is removed from the interaction as the doctor hands over the piece of paper. Yet the expectation may be the same—only with ERX, there is  greater likelihood the patient will actually have the prescription dispensed. 

Whether one welcomes or dreads the adoption of this technology, ERX adoption is growing, and there are fewer doubts that it will become the predominant means of communicating drug orders between prescribers and dispensers of the future.  I will comment more on this in coming months. 

Some key milestones have been met by the technology this past year:  The number of electronic prescriptions in 2011 increased to 570 million, up from 326 million e-prescriptions in 2010. By the end of 2011, an estimated 36 percent of prescriptions dispensed were routed electronically, up from 22 percent at the end of 2010.
http://www.healthcareitnews.com/news/national-report-shows-surge-e-prescribing-among-health-practitioners 

Terri is the founder of Cambria Health Advisory Professionals. Among her current clients: a large health sciences firm serving payers, pharmaceutical and device manufacturers and other stakeholders, a small special needs health plan as a 5 Star Consultant, and several other health related clients. The thoughts put forth on these postings are not necessarily reflective of the views of her employers or clients nor other Health Advisory Professional colleagues. Terri has had a varied career in health related settings including: 9 years in a clinical hospital pharmacy setting, 3 years as a pharmaceutical sales rep serving government, wholesaler, managed markets and traditional physician sales, 3 years working for the executive team of an integrated health system working with physician practices, 4 years as the director of pharmacy for a large BCBS plan, 12 years experience as founder and primary servant of a health technology company which was sold to her current employer three years ago. She has both a BS and a PharmD in Pharmacy and an MBA.