E-Prescribing

E-PRESCRIBING

Electronic prescribing of prescriptions is gaining momentum in the USA. Congress has passed legislation to support this health care initiative. Essentially e-prescribing provides an electronic flow of information between the prescriber, intermediary, pharmacy, and health plan. The health plan can provide information on patient eligibility, formulary, benefits, costs, and sometimes, a medication history. The prescriber selects the medication, strength, dosage form, quantity, and directions for use and the prescription is transmitted to the pharmacy where the appropriate data fields are populated. The pharmacist reviews the order and, if appropri-ate, dispenses the prescription. The electronic system must be Health Insurance Portability and Accountability Act (HIPAA)-compliant, and there needs to be a business association agreement between the parties involved.

Prescribers can obtain decision support information such as disease-drug and drug-drug interaction information or cost infor-mation prior to prescribing as part of the health plan information. Prescriptions can be clear in their writing, but pull-down drug lists can create new errors. Prescription renewals can be processed electronically and drug misuse or abuse may be identifiable. Theoretically, time to process prescription orders should be reduced and patients would have their medication ready when they arrive at the pharmacy.

The Drug Enforcement Administration has begun to issue tentative rules for e-prescribing of controlled substances. Currently, only registered prescribers can e-prescribe, and there will be several independent identification proofing sources required: a unique pin number, or retinal scan, or a finger print. The objective is to prevent drug diversion. Pharmacies currently can order controlled drugs via computer using a specific form once they are certified.