By all measurable criteria, e-prescribing surged in 2009 because of government incentives and adoption of the technology by large organizations, but there's still plenty of work left to do if that momentum is to be maintained.
An annual survey of the market by Surescripts, which operates the nation's largest e-prescribing network, showed the number of providers using e-prescribing doubled to 156,000 by the end of the year, against just 74,000 at the end of 2008.
Electronic requests for prescription benefit information indicated an even more explosive picture, at a total of 303 million against just 79 million for 2008.
Deliveries of prescription histories, prescriptions electronically routed and the growing use of EMRs for e-prescribing all showed the same kind of growth. At the end of 2009, Surescripts said it could provide electronic access to benefit and history information to around two-thirds of patients in the U.S.
The company said key drivers for all of this were incentives available through such things as the HITECH Act, and effect of the broadening of programs by the Certification Commission for Health Information Technology (CCHIT) to qualify EMRs for meaningful use standards.
By the middle of 2009, CCHIT had certified more than 200 EMR technologies representing three-quarters of the entire industry, Surescripts said. In addition, it gave users more choice by also beginning certification of stand-alone e-prescribing technologies.
Government and other education and awareness programs, various payer initiatives, and state and regional initiatives also played a role.
But there's still a lot more that's needed if e-prescribing is to be considered a standard industry practice, Surescripts said.
One glaring barrier is the Drug Enforcement Administration's continued restriction on the use of e-prescribing for controlled substances, which forces prescribers to maintain a dual electronic/paper-based workflow. There's no clear idea of when this will be resolved, Surescripts said.
More also needs to be done to close the adoption gap at independently owned pharmacies and small practices, which are constrained by both the time and cost involved in taking on e-prescribing. Most state Medicaid programs also lag in being able to provide eligibility and formulary information to prescribers electronically.
Among other efforts that Surescripts believes will help e-prescribing along are support for development of regional health information exchanges, encouraging states to set measurable goals around adoption, and encourage EMR providers to certify for all e-prescribing services.
