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Christopher Jason


An increase in interoperability and access to patient data triggered an ePrescribing increase in 2019.


The introduction of ePrescribing in 2003 brought a more convenient, cheaper, and safer prescribing alternative for doctors, pharmacies, and patients.

“With electronic prescribing, or ‘e-Prescribing,’ health care providers can enter prescription information into a computer device – like a tablet, laptop, or desktop computer – and securely transmit the prescription to pharmacies using a special software program and connectivity to a transmission network,” according to The Office of the National Coordinator for Health Information Technology (ONC).

Once a pharmacy receives a request for a prescription, it can start filling the medication immediately.

Momentum began for ePrescribing when it was introduced in the Medicare Modernization Act (MMA) in 2003. It then became more prevalent, and it garnered more publicity when a July 2006 Institute of Medicine report said it reduced medical errors, which helped build further awareness of ePrescribing’s role in increasing patient safety.

According to CMS, adopting the standards to streamline ePrescribing is an essential government item to accelerate the adoption of EHRs and build a national health IT infrastructure in the US.

In short, an increase of ePrescribing aims to allow for improved workflow, increased patient safety, and more drug price transparency in the future.

In 2019, healthcare professionals saw the benefits of greater access to patient data information, according to a Surescripts 2019 National Progress Report. As a result of this access, ePrescribing rates increased between 2017 and 2019, alongside improved workflows, increased drug transparency, and increased automation.

EPRESCRIBING ADOPTION, USE TAKES OFF IN PROVIDER OFFICES

ePrescribing rates climbed from 1.49 billion in 2017, to 1.64 billion in 2018, to 1.79 billion in 2019. That brings the total rate of ePrescribing up from 66 percent of all prescriptions in 2017 to 80 percent of all drug prescriptions in 2019.

Clinicians used ePrescribing for both non-controlled and controlled substances at a higher rate in 2019 than the prior two years.

ePrescriptions for non-controlled substances are up from 76 percent in 2017 to 86 percent in 2019.

“With the COVID-19 pandemic impacting patients and providers across the globe, a trusted nationwide health information network has never been more critical,” Tom Skelton, chief executive officer of Surescripts, said in a statement.

USING EPRESCRIBING TO CURB THE OPIOID CRISIS

In response to the country’s opioid crisis, paper opioid prescribing rates have declined recently.

Opioid overdose rates have quadrupled between 1999 and 2015, meaning the opioid epidemic has shown no signs of slowing down.

What’s more, tracking appropriate opioid prescriptions — one of the primary drivers of the opioid epidemic — can be challenging.

In 2019, 13 states enacted e-prescribing requirements, meaning more than half of all states now require ePrescribing for opioids, all controlled substances, or all prescriptions. Also, more opioid prescriptions were written electronically, which helped protect patients against prescription fraud and abuse.

Since 2017, the number of ePrescriptions written for opioids increased 36 percent, from 33.2 million to 67.7 million.

Furthermore, the introduction and usage of Electronic Prescribing of Controlled Substance (EPCS) technology intended to help providers integrate opioid prescription information into EHRs, which can boost patient safety and help prevent diversion and fraud. ECPS technology can also streamline clinician workflow and reduce patient burden.

A 2019 study conducted by ONC found the number of clinicians that utilize EPCS increase 29 percentage points from 2015 to 2017 with the help of EPCS technology.

ONC found that only three percent of Medicare prescribers used EPCS in 2015, 11 percent in 2016, and then 32 percent in 2017. While the total EPCS use is still low, the increase is a step in the right direction.

Policymakers expect the use of EPCS technology to increase under the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, which they passed in 2018.

The bill would require clinicians to electronically prescribe Medicare Part D prescriptions of opioids and other controlled drugs by the start of 2021.

“The value of EPCS technology – streamlined prescriber workflow, improved medication safety, and reduced drug diversion and fraud – should be available to all clinicians,”  ONC doctors Andrew Gettinger, MD, and Thomas A. Mason, MD, said in a statement.

“We are also intrigued by the potential for EPCS technology to make prescriber identification both assured and easier. This can permit a single workflow for prescribing both controlled and non-controlled drugs, which can improve the usability of the current process. To that end, ONC will continue to work with our federal partners and clinical stakeholders to advance the adoption of EPCS technology.”

While the use of ePrescribing is currently ascending, this form of prescribing will allow for more drug price transparency, increased patient safety, and an improved workflow for clinicians in the future.