Today, prescribers (physicians and others who write prescriptions) make their drug-prescribing decisions using whatever medical, medication, and eligibility information is known or available to them. Then they give a handwritten prescription to the patient or fax it to the dispenser (patient’s pharmacy of choice). At the dispenser, tasks are somewhat more automated. Through electronic claims, eligibility, and benefits submission, the dispensing pharmacist may learn about contraindications, the need for prior authorization, or lower cost alternatives. The dispenser then contacts the prescriber by phone for approval of changes, refills, or renewals. According to some estimates, almost 30 percent of the 3 billion prescriptions written annually require such dispenser call backs.This equals 900 million prescription-related telephone calls annually.
Many have identified that the current prescribing process is prone to errors. Prescribers may not have access to the latest drug knowledge. They often do not have a complete or accurate medication list or even medical history for their patient, and, as a result, can miss potential contraindications or duplicate therapies. Dispensers often have difficulty reading handwritten prescriptions and frequently have little or no information about the patient’s condition for which the prescription is written. Contacting the prescriber by phone to clarify what is ordered and to make changes often results in delays for the patient and is time-consuming for the prescriber and the dispenser. There are disconnects between the prescriber and patient in the medication process, and little or no feedback to the prescriber on whether a prescription was filled. As a result, the current process leads to an estimated 8.8 million adverse drug events (ADE) in ambulatory care each year, of which over 3 million are preventable.
HIMSS Responds to CMS E-Prescribing Proposed Rule
In a response released today, the Healthcare Information and Management Systems Society (HIMSS) supports and “enthusiastically shares” the vision for E-Prescribing as described in the Notice for Proposed Rule-Making (NPRM), issued by the Centers for Medicare and Medicaid Services on Feb. 4, 2005.
