"However, from a PBM pharmacist perspective, we believe the real opportunity for EHRs is the ability to improve communication between pharmacists and physicians to better serve our patients," Sundar added. EHRs provide the means to improve bidirectional communications with physicians, in real-time, at the point of care and within the physician’s workflow.

The proliferation of EHRs provides Express Scripts with another opportunity to improve its innovative model by helping to improve its communication with physicians within their preferred channel and their workflow, said Sundar.

"EHRs also allow physicians to understand the patient’s benefit, and can select – at the point of care – what therapy might be most cost-effective for the patient," she said, adding that smarter, more efficient communication leads to better patient care and outcomes, more timely care and less administrative burden.

Bernadette Eichelberger, director for pharmacy affairs for the Academy of Managed Care Pharmacy, said that her organization is very interested in making sure that they can improve patient outcomes and improve the cost structure for the improved outcomes.

"This requires robust clinical data so that we can really understand how we can close gaps in appropriate use of medications, where outcome and costs are not maximized and ADEs are not minimized, Eichelberger told Healthcare IT News.

Another area where EHRs are having a positive impact is on Pharmacy and Therapeutics Committee.

Eichelberger says P&T committees often have to make decisions on drugs that gain FDA approval based on limited clinical data.

"If you think about those hepatitis C drugs, for example, where California alone would spend $20 billion per year to treat 50 percent of those patients, the effectiveness data for some genotypes was based on less than 200 patients," said Eichelberger.

She noted that having EMR data available to look at those patients a year later, using real-world data would help managed care pharmacy to assess whether it's really getting the value that they expected from those drugs.

"This of course presupposes that you have strong EMR data," she said. "It also presupposes that the data are normalized across payers so that when the incidence of the disease and associated lab results require assessment across large populations, we know we have reliable inputs."

AMCP, noted Eichelberger, is promoting measures to improve HIT adoption.  For example, they recently convened a group that looked at how they can improve transitions of care (TOC) by improving access to medication reconciliation data and using the data to facilitate seamless medication therapy management services.

"One of the findings of that group was that one the health information exchanges practice is are a serious obstacle to pharmacist-provided MTM and TOC services," said Eichelberger. "Because HIEs restrict access to 'approved' providers, they frequently exclude pharmacist-provided services."

"When we're delivering MTM services, getting an HIE to allow my patient assessment data to be bidirectional, I run into a huge stumbling block," she said. "It often takes more than a year to negotiate with the HIE to make sure that pharmacist provider information is part of the whole HIE structure."

AMCP supports the need to include pharmacists services in HIEs and they are also working on various projects designed to facilitate HIE transfer of pharmacist provided patient drug assessments.

"This means ensuring that pharmacists TOC notes become a part of a patient's EMR,"  said Eichelberger. "The corollary step is to make sure that after a patient has an MTM assessment, the physician and the retail pharmacy, via the HIE, get an update of the patients status."

AMCP is spearheading an effort to make sure that more pilot programs are established showing why HIEs are important and pharmacists' access to HIEs is crucial.

Another example of how AMCP members are actively promoting EHR and HIT strategies is in the area of electronic prior authorization.

"We held a task force last year," said Eichelberger. "We've had at least three webinars to promote the new electronic prior authorization component of e-prescribing and to make sure our members are rapidly adopting it."