The Future of e-Prescribing

I’ve recently been appointed to the Commonwealth of Virginia’s Electronic Prescribing (e-Prescribing) committee (CommonwealthRx). As a Pharmacist, I’ve been interested in the lack of adoption of e-Prescribing technologies across the US when there is substantial data detailing the benefits to both patient safety and quality. One such study predicts that a shift to electronic prescribing systems could avoid more than 2 million adverse drug events annually, of which 130,000 are life-threatening. e-Prescribing also has enormous potential to create savings in health care costs, through reduction of adverse drug events and in improved workflows.

Our committee’s mission is of course to improve patient safety within the Commonwealth through increased adoption of e-Prescribing technologies.

Although we have a long way to go in the US regarding e-Prescribing, we are making great improvements. At the end of 2008, there were ~75,000 active e-Prescribers and by now it is closer to 100,000+. (Source: SureScripts).

95% of Chain Pharmacies are ready for e-Prescribing and an optimal future state involves involvement of the independent Pharmacy community, where adoption is only at 45%.

Why is adoption of e-Prescribing technologies not higher?

Mainly, due to the inability of multiple systems to share information effectively, and the lack of a standard format and vocabulary. This reduces the effectiveness and attractiveness of using an electronic system.

Some stats I’ve come across regarding the implementation of e-Prescribing:

  • Tuffs Health Plan – 8.9 fewer safety errors per physician per year
  • Henry Ford Foundation – 1.7 million prescriptions sent electronically in 2006. 150K prescriptions were canceled due to drug-drug interaction warnings, 11K prescriptions canceled due to drug-allergy warnings and$540K estimated savings from reduced ADEs.
  • Institute of Medicine (IOM) – 1.5 million Americans are injured by medication errors. 25% of these injuries are preventable.
  • Journal of the American Medical Informatics Association – Over a 4-week period, 61% of the physicians who used clinical reference software believed that the use of the clinical reference prevented adverse drug events or medication errors 3 or more times.
  • e-Prescribing systems can avoid more than 2 million ADEs annually, of which 130,000 are life-threatening.
  • Tuffs Health Plan – Savings of up to one hour per day for pharmacists.
  • Henry Ford Foundation – Over 70K prescriptions were changed or canceled due to formulary warnings
  • AHRQ – Estimated 30% of all non e-Prescriptions require pharmacy callbacks, e-Prescribing will reduce pharmacy callbacks by 80%.
  • Hewlett Packard – Estimated 2 hours per day per Physician reduction in time spent with prescribing and Rx issues

More about our mission in Virginia:

CommonwealthRx is established to meet the immediate need of promoting state efforts to bring about the coordination for successful electronic prescribing adoption by all stakeholders in the Virginia healthcare industry. Specifically, our mission is to:

  • Create a forum that encourages the necessary dialog among the state health care implementers for the benefits and adoption of electronic prescribing.
  • Identify cross-industry coordination and electronic prescribing best practices and identification of requirements for electronic prescribing solutions and established standards-based electronic prescribing capability.
  • Serve as the primary conduit to address health care opportunities associated with the successful implementation of e-prescribing.
  • Educate the health care community about best practices through our internet website, conferences and industry outreach programs and facilitate the distribution of educational and implementation tools.
  • Establish outreach approaches for state-level initiatives by developing recommendations to address the coordination that must exist within the state to accelerate the adoption and successful implementation for electronic prescribing stakeholders.
  • Coordinate with other regional and national electronic prescribing initiatives evaluating other initiative’s recommendations and findings and identify additional barriers and opportunities for accelerating electronic prescribing.

Lastly, I chair the vendor solutions workgroup of this committee. The Vendor Solutions Workgroup provides all stakeholders access to information and tools that support the evaluation of electronic prescribing solutions consistent with the goals of CommonwealthRx. If you are interested in joining this workgroup, please email me at

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