According to CareFirst BlueCross BlueShield, American physicians write nearly 4.5 billion prescriptions on paper each year, but if a doctors writing is illegible, errors are a possibility. In fact, medication errors account for 7,000 patient deaths each year.

For that reason, CareFirst is among the companies moving toward electronic prescription management or e-prescribing. In August, the company announced a pilot program in which it would team with DrFirst, which markets technology to physicians, to provide an e-prescription management solution to 500 “high-prescribing” physicians in the CareFirst network.

Through the use of a personal digital assistant (PDA) supplied by Owings Mills, Md.-based CareFirst, DrFirsts Rcopia software allows the physician to transmit a prescription or renewal electronically to the patients pharmacy, says CareFirst. The system also gives physicians access to a patients medication history and allergies, and will alert doctors to potentially dangerous drug-to-drug interactions.

The system will transmit legible prescriptions directly to pharmacies, minimizing the phone calls and faxes between providers and pharmacies, CareFirst explains. “Some physicians spend up to three hours a day on pharmacy issues, while on the other end, pharmacists may be on the phone for up to four hours a day.”

The result of making prescription transactions electronic, says CareFirst, is faster transactions with fewer medication errors and fewer problems resulting from those errors.

“This technology has the potential to improve one of the most basic parts of the medical process and one of the last components of the health care system to leverage the power of information technology,” said Dr. Eric Baugh, senior vice president, medical affairs and network management for CareFirst. CareFirst is an independent licensee of the Blue Cross and Blue Shield Association, serving some 3.2 million individuals and groups in northern Virginia, the District of Columbia, Maryland and Delaware.

Physicians, patients and pharmacies are not the only ones potentially to benefit from e-prescribing, however. According to Donald Gravlin, vice president and chief technology officer for New York-based Capgemini Healths payor practice, health insurers will also see reduced costs, because patients are not getting costly drugs when a generic equivalent will do the job as well. He adds that by reducing medication errors, e-prescribing “may also save on unnecessary hospitalization.”

In an attempt to accelerate the adoption of e-prescribing, a group of health care information technology solution providers announced the formation of Care Rx in August. Founding members of this new coalition include Allscripts Healthcare Solutions, Capgemini, Cisco Systems, Hewlett-Packard (HP), Microsoft, the National Council for Prescription Drug Programs, NDCHealth, RxHub and SureScripts.

While e-prescribing has yet to gain wide acceptance, it actually has been around for over 10 years, says Gravlin. “It allows the physicians to create an electronic transaction that has all the information you get on a scribbled, illegible piece of paper and send it to the pharmacy so the pharmacy has an electronic order. Theres no question about the drug dosage.”

The process of routing a prescription through pharmacies, health insurers and third-party intermediaries is complicated, Gravlin notes, and physicians may be confused on how to initiate an electronic prescription. To encourage adoption of e-prescribing, Capgemini says Caf? Rx will provide payers and physicians with successful strategies and best practice models, offering extensive information on e-prescribing through its Web site, www.caferx.org.

“Weve tried to lay it all out and form an education and outreach group,” Gravlin explains. “HP, Microsoft and Cisco are providing the plumbing and connectivity.”

Caf? Rx says it will launch a program to educate physicians and their office staffs about the value of e-prescribing, and it will support lobbying efforts to get state and federal governments to encourage adoption of e-prescribing and electronic medical records.

By reducing medical errors, says Capgemini, e-prescribing will reduce “the incidence of adverse drug reactions, saving physicians and pharmacists valuable time now spent on non-clinical administrative tasks, and enabling payors to improve formulary program compliancecollectively saving millions of dollars while potentially increasing patient and physician satisfaction.”

According to Gravlin, Caf? Rx now has 20 memberspharmacy benefits managers, industry associations, health plans and service providers”and were seeing momentum start to pick up on this.” He adds that Caf? Rx has seen “terrific response,” with new members joining and “finding benefits and value from the models we have put together.”

Membership is open to all health care IT solution providers that agree to support the groups guiding principles, says Capgemini.


Reproduced from National Underwriter Edition, October 14, 2004. Copyright 2004 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.