ePrescribing Task Force Report

1
e-Prescribing Task Force Report

• Medical Subcommittee
• Jerry Miller, M.D. Dick Gourley, Pharm.D.,
  Co-Chairs

2
Risks to Current Prescribing Business Model

• Change
• Antiquated but working (not an optimum level)
• Poor mode of tracking real data
• Patient safety issues
• Too much time required of providers as well as
  pharmacists with current
• Inefficiencies in current system

3
Risks to Current Prescribing Business Model

• Part of an unsustainable health system
• Potential effects on the independent health care
  practitioner in terms of cost of hardware,
  software, staff training
• Current model does not address cost of drug
  related problems
• Current system does not have the ability to share
  information with other health care providers in a
  timely manner does not respond to IOM
  recommendations

4
Benefits of Current Business Model

• History, been around a long time
• Patient trust and comfort with current system
  most of the time?
• Seems affordable but hidden costs of an
  inefficient system as well as medication errors
  are not included in most cost calculations
• Providers do not like change!

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Barriers to Implementation of e-Prescribing

• Lack of access to and knowledge of successful
  models in e-prescribing by providers
• Legal complexities (HIPPA)
• Lack of financial models (ROI)
• Who will pay for hardware, software, training of
  staff as well as providers
• Connectivity problems
• Specialty practice issues, e.g. dermatology use
  of compounded Rx

6
Barriers to Implementation of e-Prescribing

• Potential conflict between providers over cost
  equity of e-prescribing among professions
• Corporate health care may have a significant
  advantage over independent practitioners
• Potential lack of continued freedom of choice by
  patients

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Barriers to Implementation of e-Prescribing

• Standards for sending/receiving electronic data
  must be made know to all involved
• Will providers have to input their own data or
  can they give a verbal order to a staff person
  who then inputs the data?
• Inconsistent use of e-prescribing by M.D. e.g.
  sends electronically but gives patient a written
  Rx

8
Survey Results

• Survey results are based on a scale of 1-5 with
  five (5) being the best score
• Survey document was limited to committee members

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Top Reasons to Implement e-Prescribing

• Patient safety
• Efficiency
• Cost savings
• Ability to detect prescribing patterns and
  patient activity
• Data Management (record keeping)

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Top 5 Obstacles to Implementation

• Cost
• Lack of standardization
• Lack of M.D. staff knowledge of e-prescribing
• Technology not fully integrated between
  physicians offices, pharmacies, PBMs, and Payers
• Time constraints possibility of lower
  productivity during implementation

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Answers to Questions

• Familiarity with e-prescribing 3.5
• Importance of e-prescribing 3.83
• Importance in 5 years 5
• Will M.D. support e-pres. 3.83
• Will R.Ph. Support e-pres. 4.16
• Will health plans support 3.83
• Will Pharma support 3.5
• Will patients support 3.66
• Will hospitals support 3.83
• How good is technology 3

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Preliminary Recommendations

• State-wide survey of all providers and
  pharmacists
• Limit decision making to key participants
  providers pharmacists
• Educate all health care providers, pharmacists,
  public policy makers, patients on e-prescribing
• Provide best practice models

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Preliminary Recommendations

• Identify locations (rural, urban, etc.) for
  demonstration projects on e-prescribing
• Define a financial model that does not penalize
  any health care practitioner
• Empower working groups of TMA and TPA
• Engage the Colleges of Medicine and Pharmacy in
  the state to educate current students on
  e-prescribing to make clinical education on
  e-prescribing universal across the state

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Preliminary Recommendations

• Make sure that the educational institutions have
  implemented e-prescribing in their practice
  programs
• Convert state health departments to e-prescribing
  demonstration sites
• Identify grants that are available for practices
  that want to implement e-prescribing
• Establish visible projects in all three
  geographical areas of Tennessee with
  implementation ASAP

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Next Step

• Further educate committee /or task force
• Define what each subcommittee can to with more
  focused objectives
• Draw consensus now move forward with
  recommendations aggregate answers to ? From each
  subcommittee

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Questions ?