E-Prescribing: What is it and Why you should Care

E-prescribing is a method by which we could improve patient care. E-prescribing helps to improve safety in prescribing many ways, as described here. One important way it helps is by eliminating the illegibility problem of many doctors’ handwriting. It also helps by providing a warning and alert system at the point of prescribing with the most updated information about a drug, thus helping to stop the filling of a prescription that may be unsafe.

Sen. Whitehouse will be chairing hearings on this subject tomorrow in Washington, D.C. From the Whitehouse press office:

Washington, D.C. – U.S. Senator Sheldon Whitehouse (D-R.I.) will chair a Senate hearing next week to explore a major barrier to improved health outcomes and cost savings in the health care system – the federal prohibition on electronic prescribing of controlled substances.

While e-prescribing could reduce adverse drug events, increase adherence to prescription regimens, and save billions of dollars each year, federal regulations still require paper prescriptions for controlled substances often used to treat attention-deficit disorder, anxiety, pain, and other ailments. This requirement means that many doctors default to writing all prescriptions by hand, rather than maintaining two systems.

Whitehouse and the Senate Judiciary Committee will hear from federal regulators and health information technology experts on the progress of rule-making in this area and the potential benefits and challenges of an e-prescribing system for controlled substances.

EVENT: Sheldon Whitehouse Chairs Senate Judiciary Committee Hearing on “Electronic Prescribing of Controlled Substances: Addressing Health Care and Law Enforcement Priorities�

WHEN: Tuesday, December 4th

10 a.m.

WHERE: Dirksen Senate Office Building Room 226

Washington, D.C.

Witnesses at the Washington, D.C. event will include Laura Adams, President and CEO of the Rhode Island Quality Institute, an organization Whitehouse founded that is a leader in the state’s efforts to improve health care quality and health information technology utilization.

Whitehouse served as U.S. Attorney for the District of Rhode Island from 1994-98 and as the state’s Attorney General from 1999-2003. A longtime supporter of health information technology, he has introduced Senate legislation to establish a private, non-profit corporation tasked with developing a national, interoperable, secure health IT system (S. 1455).

While I am all in favor of better accuracy in prescription writing and filling, and believe that there is merit in public health tracking the use of prescriptions in order to see how safe and effective they are, a couple of major categories of concern come to mind right away:

1) Confidentiality — Will this make electronic information about patient pharmaceutical use more available to third parties? How would fraud be prevented?

2) Corporate Influence — Will this increase corporate influence from the pharmaceutical industry on people’s lives?

These are broad questions — probably not really answerable by anyone, but meant to provoke thought and discussion as e-prescribing moves forward.

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  1. Whitehouse provided this press release today, with more detailed information on how e-prescribing could help prevent adverse drug interactions and other problems.

    Washington, D.C. – The president and CEO of the Rhode Island Quality Institute testified before the Senate Judiciary Committee today on a major barrier to improved health outcomes and cost savings in the health care system – the federal prohibition on electronic prescribing of controlled substances. The forum was chaired by U.S. Senator Sheldon Whitehouse (D-R.I.), a Judiciary Committee member, former prosecutor, and strong advocate for health information technology.

    “Health information technology’s potential for better-coordinated care, reduced medical errors, and increased patient satisfaction and peace of mind is enormous,� Whitehouse said. “We have to tackle the roadblocks that prevent this extraordinary technology from being available nationwide.�

    Laura Adams, of the Quality Institute, asked the committee to push for regulations allowing electronic prescribing of controlled substances in a way that allows for future changes in technology and security safeguards. Whitehouse founded the Quality Institute, a leader in the state’s efforts to improve health care quality and health information technology utilization, during his tenure as Attorney General.

    “In short, the industry’s ready. And the need has never been greater,� Adams said. “We’re asking for your help to bring about the electronic prescribing of controlled substances and all of the benefits it affords consumers, providers and payers.�

    Allowing doctors to write and submit drug prescriptions electronically costs less, saves time, and helps avoid dangerous medical errors and drug interactions. E-prescribing, used today in about 18 percent of doctors’ practices, is often cited as a necessary first step towards a national health information technology infrastructure.

    Studies show a fully-operational health IT system could generate an estimated $80 billion in health care savings each year. E-prescribing alone could save $20 billion annually, as patients would experience fewer adverse drug events (ADEs) and would be more likely to adhere to a medication regimen. The Center for Information Technology Leadership (CITL) found that a national e-prescribing system could prevent 2.1 million ADEs – 130,000 of which are life-threatening – and 190,000 hospitalizations per year.

    But federal rules governing dispensation of controlled substances such as pain medications, antidepressants and some drugs used to treat asthma in children require that doctors write paper prescriptions for these pharmaceuticals. The result is that most doctors resort to writing all their prescriptions by hand rather than maintain a paper system for controlled substances and an electronic system for non-controlled substances. The Drug Enforcement Administration (DEA), the agency responsible for investigation and prosecution of crimes involving the illicit use of controlled substances, has been developing regulations to allow e-prescription for controlled substances for more than four years. They have offered no deadline for completion of these regulations.

    “Billion-dollar transactions are done electronically; highly classified national security information travels electronically; military attack aircraft are targeted electronically. Don’t tell me we can’t figure out a way for a doctor to prescribe Vicodin electronically,� Whitehouse said.

    In October, during consideration of a bill appropriating funds for DEA and the Justice Department, Whitehouse engaged in a Senate floor colloquy with Appropriations Subcommittee Chairman Barbara Mikulski (D-Md.), Health, Education, Labor, and Pensions Committee Chairman Edward M. Kennedy (D-Mass.), and Senator Debbie Stabenow (D-Mich.) to discuss electronic prescribing for controlled substances. During that colloquy, Whitehouse proposed a joint report by the DEA and the Department of Health and Human Services assessing the status of rule changes that would permit this practice.

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