Home Forums Discussions General Discussion Want your prescriptions filled? You should e-prescribe

We like to think that when we write a prescription, the patient might actually be filling it and taking the medication. In fact, they often do not. Some interesting data published by Surescripts suggests that significantly more prescriptions are actually filled when they are sent electronically. To briefly summarize the data:

Out of 100 prescriptions written:
Before eRx, 73.2% made it to the pharmacy and 69.5% were picked up.
After eRx, 81.8% got to the pharmacy and 76.5% were picked up, representing a 10% increase.

Note that in this study, even after adoption of eRx only 81.8% of the prescriptions made it to the pharmacy because in the early stages of use, the physicians didn't always use that modality. Presumably as the number actually e-prescribed rises, the improvement in "pick-up" will increase.

A 10% increase in the number of prescriptions picked-up could have a significant impact on patient health. Other interesting data is in the press release.

I would say our percentage is definitely higher, although I haven't read the article.

I say WOW to those percentages of Rx's actually picked up.
I am sitting in a national meeting where a study was described: Aetna paid 100% (therefore patient cost was 0) for post MI drugs (BB, statins, ACEi).
You would think a first MI would get a patient's attention.
Less than 50% of patients IN A STUDY picked up their first Rx, and of those who did pick up the first, only 60% picked up subsquent refills.

Well if that many people aren't even getting their scripts to the druggist, why am I getting all these notices that the drug I prescribe is not tier 1!

Actually, I do get a lot of these notices, but have been using the e-scribe in AC, and liking it.

Tom

We started ePrescribing on 5/17/10 and everything went eRx. On 6/1/09, this became a mix and match of eRxing and faxing (although we were not aware. Slowly, it became slightly noticeable that are almost 97% rate was declining. On 5/17/11, one year to the day of starting ALL our eRxs went by fax. This was when we started becoming frustrated as our patients were calling all the time. The combination of our instructing them to inform the pharmacist it was ePrescribed and the fact that pharmacists were less likely to check their fax machine was leading to this problem. One Saturday about two weeks ago, I ePrescribed medications for eight patients. All eight patients called saying the pharmacy had not received the medication. I call the pharmacist to ask, and he/she had not had an eRx come through.

I went into the office and saw eight patients with all of their meds in queue. Why they hadn't gone through, I don't know. I then checked back and saw months of fax -- sucess with a few ePrescribed -- Verified.

I spoke with tech support, and New Crop had to make a few changes to our account. Now 100% of all meds which are codified are going through. Almost two years of fancy faxes.

I found a couple things striking about these numbers. First, I think it is eye-opening to see how often the patient never gets the prescription filled. (And of course, filling it is NO guarantee they will actually take it). Bert, the sample size is pretty large here, so there may be variation from practice-to-practice or by specialty, geographic area, etc, but the overall number speaks for itself.

Second, you can significantly increase the frequency that the patient actually gets the medication in his hands simply by e-prescribing. I assume that is because they only have to make one trip to the pharmacy (maybe because they can pick it up on their way home before it slips their mind). This is one of the rare win-win-wins in healthcare: easier for the provider, more convenient for the patient, and with a better outcome.

Ever since getting ePrescribe back on track, a) the scripts are getting their MUCH faster, b) there is a much higher % of scripts getting there and c) we are now getting notified when refills are due rather than having to remember to look at them.

I also finally did what one pharmacist advised doing. I wrote a letter to all the pharmacies outlining the waste of time for everyone by making the patient call me to tell me the script was not there. Since, the major reasons (according to this pharmacist), was) not wanting to go through the answering service which can be inefficient and b) some doctors do NOT want to be bothered (we have to be bothered either by the pharmacist or the patient) if we want to keep our pediatric patients; I made it easier to contact me.

I gave my cell phone number and direct line to my pager (asking for a 99 at the end if a pharmacist) and told them they could call me at any time after 4:30 am. I have already received calls on my cell phone and received faxes and phone calls from pharmacists telling me how happy they are with the system.

So, what was once a patient being told the script was incorrect (looks bad on me), the patient calling my office but getting the service, the service not erroneously deciding it was an after hours refill, the service putting the call out to me, my having to call the patient (who may or may not still be at the pharmacy), the patient explaining the problem then having to ask for the phone number or I have to find it and finally after navigating their audex I get to the pharmacist.

Now, the pharmacist looks at the script, calls me on my cell and asks what strength I wanted for the cefprozil. I tell him 250 mg/5mL, and the whole thing is over in 30 seconds, and the patient is none the wiser.