Medical prescriptions are legal documents that physicians should prepare with care. Medical transcription service providers exercise utmost caution when transcribing prescriptions and making medication log entries. When paper-based records gave way to electronic health records (EHRs), electronic prescribing or e-prescribing got a significant boost. Meaningful Use Stage 2 required physicians to use ePrescribe for 50 percent of their orders. The case for more e-prescribing is that it provides a confidential, secure, accurate and error-free method of communicating physicians’ orders and improves patient safety and workflow. With the coronavirus pandemic, companies are supplying telehealth platforms with a wide range of tools, including e-prescribing capabilities, to help practices reach their patients at home.
Rapid Growth of E-prescribing
The approval of the Medicare Modernization Act (MMA) in 2003 put the spotlight on e-prescribing, and the Medicare Improvements for Patients and Providers Act of 2008 also included incentives for e-prescribing. As a result, e-prescribing has grown rapidly over the years. EHR Intelligence reports that the total number of ePrescriptions increased from 1.49 billion in 2017, to 1.64 billion in 2018, to 1.79 billion in 2019. The rate of e-prescribing rose from 32 percent to 49 percent during 2018-2019.
Advantages of Electronic Prescriptions
A Surescripts 2019 National Progress Report has noted that interoperability, patient data exchange, and e-prescribing have improved across the healthcare industry (www.ehrintelligence.com). In 2019, healthcare providers benefited from better access to health information, which resulted in a higher e-prescribing rate with enhanced automation, improved workflows, and greater drug price transparency.
An article in the US Pharmacist listed several benefits of electronic prescriptions:
- Prevents errors associated with written prescriptions: Conventional prescription can cause errors such as selection of an incorrect or unavailable drug, dosage form, or dosage; duplication of therapy; omission of information; and order misinterpretation caused by illegible handwriting, all of which can lead to adverse drug events (ADE).
- Saves money for patients: A study found that prescriptions written using software cost less than those that were manually written. Alerts in the software informed physicians of more cost-effective options, allowing them to discontinue unnecessary expensive medications and optimizing prescriptions before they were sent out.
- Ensures patient prescriptions are readily available in an emergency: When patient safety is threatened in situations such as natural disasters, electronic prescriptions are readily available to support patient care.
- Improves workflow and saves time: Quality issues in written prescriptions necessitate callbacks to prescribers for clarification. E-prescribing reduces such ambiguity and comes with enhanced safety, shorter wait times, improved pharmacy consultation services, and reduced medication costs, which can increase patient satisfaction.
A study published in AHIMA’s Perspectives in Health Information Management in 2015 touted e-prescribing as an expected and preferred option for older patients, many of whom manage multiple medications on a daily basis (ehrintelligence.com). Over 80 percent of the patients in the study preferred electronic prescriptions to paper based ones, citing reasons such as convenience, speed of obtaining medications, and elimination of hassles related to losing paper prescriptions or misreading written instructions.
The researchers said that their study shows that “nearly all patients are satisfied with their prescriber and pharmacy in sending and dealing with e-prescriptions, and e-prescribing is now preferred by a majority of older adults over paper prescribing because of the added convenience to the patient.”
In addition to patients and community pharmacies, e-prescribing benefits physicians, insurance companies, malpractice insurers, and employers. E-prescribing saves time spent verifying handwritten orders and provides easier access to a patient’s insurance coverage information.
Medicare and E-prescribing
E-prescribing is a prescriber’s ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care – and is an important element in improving the quality of patient care, notes the Centers for Medicare and Medicaid (CMS) in its website. Implementing measures to facilitate e-prescribing is one of the key action items in the government’s plan to expedite EMR adoption and build a national electronic health information infrastructure in the U.S.
In June 2019, CMS released a proposed rule that would update e-prescribing standards and implement new prior authorization transaction standards for the Part D e-prescribing program beginning in January 2021. Under the proposed change, clinicians would be able to complete prior authorizations online, reducing burden for providers through a more streamlined process for performing prior authorization for Part D prescriptions. CMS says that this change will help ensure that patients do not come to the pharmacy only to find that their prescription cannot be filled.
HME news reported on Medicare’s recent move to accept e-prescribed orders for inexpensive or otherwise routinely purchased DME. This is a departure from Medicare’s traditional practice of requiring fax, pen and ink, or electronically maintained images of signed orders. Using e-prescriptions is expected to benefit to suppliers of inexpensive or otherwise routinely purchased DME quite significantly. It is improve efficiency in order processing as well as in the storage, retrieval, documentation, verification, and audit of orders.
Recent events highlight the crucial role of telehealth and electronic modalities like e-prescribing in the delivery of healthcare. Outsourcing medical transcription is a feasible option to ensure accurate patient records in the digital environment.