Bringing prescriptions and medication management into the digital age
There are 652 million prescriptions written in Canada annually, costing an estimated $25.8 billion.Use of ePrescriptions by physicians has reached 88% in Denmark, 80% in Australia and is nearing 50% in the UK. Surescripts, a US company, reported its network carried more transactions in 2014 than American Express (6 billion) and PayPal (4.2 billion).
The ePrescribing general consensus
In the early 2000s, interest in funding and enabling electronic health record development took hold in both Canada and the United States. One of the first areas targeted for improvement was the medication prescribing and dispensing process. At the time, as remains the case today, the general consensus was that full electronic prescribing has clinical, financial, safety and workflow benefits for all major stakeholders in the healthcare system, including patients.
Today’s largely manual prescribing processes are not conducive to maximizing patient safety or medication adherence, and the recent opioid crisis has shone a spotlight on the need for more rigorous medication management; rigor that can reasonably only be achieved through a suite of digitally-enabled services.
Full electronic prescribing (ePrescribing) is defined as the electronic generation, authorization and transmission of dispensing directions for a drug or mixture of drugs from a prescriber to a pharmacy. For the purposes of this paper, ePrescribing does not include prescriptions that are digitally generated, but then printed by physicians to be manually delivered to pharmacists by patients.
Reducing margin for error
Particularly compelling is the potential for ePrescribing to reduce adverse drug effects. The margin for error inherent in the manual prescription process exposes patients to significant injury and even death. In 2008, more than one in nine emergency department visits were found to be due to potentially preventable drug-related adverse events.
In addition, there is a strong correlation between the number of physicians caring for a patient and the number of potentially inappropriate drug combinations prescribed. ePrescribing can significantly reduce such errors.
This is reinforced by the ePrescribing Joint Statement issued by the Canadian Medical Association and the Canadian Pharmacists’ Association in 2012, which cites, among other benefits of electronic prescribing:
- safety and quality of care improvements for patients
- safer and more efficient prescribing and refill authorizing for physicians
- reduction of re-transcription that decreases risk of errors and liability and streamlines workflow for pharmacists
A sharp contrast to the US
Canada’s lack of progress stands in sharp contrast to the US where, by 2013, 73% of office-based physicians ePrescribed, up from a mere 4% less than a decade earlier. Today, 95% of US pharmacies are able to accept electronic prescriptions, accounting for 58% of all eligible prescriptions across the country.
According to a study from the United States, ePrescribing resulted in a 10% increase in prescriptions being dispensed, leading to better medication adherence by patients.