The electronic prescribing rate in upstate New York increased from 12 percent in 2009 to 17 percent in the first quarter of 2010, representing 3.6 million new and renewed prescriptions on an annual basis, according to a new report. The report suggests that this number will grow significantly as the result of the technology becoming more affordable, due in part to the government's incentives for health IT adoption. 

Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, which finances and delivers healthcare services to 1.7 million people across upstate New York, conducted the report.

The report estimates that 18 percent, or 3.8 million, prescriptions are still telephoned or faxed and 65 percent, or 13.7 million, prescriptions are handwritten or printed on paper. Estimates were based on an FLRx (the pharmacy benefit management division of Excellus Health Plan, Inc.,) review of a sample of claims submitted for new and renewed prescriptions from January 2010 through March 2010.

With manual and verbal handoffs still predominant, medical errors are more likely to occur, the report suggests. According to the nonprofit Institute for Safe Medication Practices, handwritten prescriptions and drugs with similar names are among the most risky conditions associated with medication use.

The report finds that more than two million adverse drug events could be avoided in New York state if all physicians in the region made the switch to e-prescribing.

"Handwritten prescriptions can lead to errors that can potentially put patients at risk and also waste time and precious healthcare dollars," said Joel Owerbach, PharmD, vice-president and chief pharmacy officer for Excellus BCBS.

The report finds that e-prescribing's ability to alert prescribers to money-saving opportunities with generic or other lower-cost alternatives to prescription drugs has the potential to save healthcare dollars.

"If e-prescribing alerts raised the generic fill rate by just one percent, healthcare spending in upstate New York could be reduced by more than $64 million a year," Owerbach said.

"Based on numerous national studies, our analysis of upstate data shows that e-prescribing holds the potential to annually prevent 35 deaths, 160 permanent disabilities, 400 hospitalizations and 3,000 physician office visits," he added. "Right now, about 17 percent of prescriptions are sent electronically, but we're on the verge of seeing explosive growth that will save lives, time and money."

Earlier this year, when Alexandria, Va.-based Surescripts released its 2009 National Progress Report on E-Prescribing, its CEO and President Harry Totonis, said the past year had been the "tipping point" for e-prescribing. He noted that one of the top drivers to e-prescribing growth were the federal incentives for adopting information technology in a meaningful way.

On Tuesday the Centers for Medicaid & Medicaid Services and Office of the National Coordinator released the final rules for achieving meaningful use. More flexibility for meeting requirements were built into the final rules, including the lowering of e-prescribing requirements for eligible professionals from 75 percent of prescriptions transmitted electronically to 40 percent. The final rule also included the adoption of the National Council for Prescription Drug Programs's (NCPDP) SCRIPT Standard for the secure, electronic transmission of prescriptions and prescription-related information.

"The final rules will help clinicians achieve better and more effective patient care," said Lee Ann Stember, president of NCPDP. "We are very pleased with the final rule as it relates to e-prescribing and using the NCPDP SCRIPT Standard to achieve meaningful use."

The Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt said that while they applauded the final rule as a step forward they said they hoped regulators "will do more down the road to ensure that the full safety and savings benefits of e-prescribing are realized on behalf of America's patients. We believe, for example, that providers who receive HITECH payments should perform 'e-prescribing safety checks' to prevent dangerous medication errors, and think that certified EHR products should support – and providers should use – all the safety and savings components of e-prescribing as defined in Medicare Part D."

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