E-Prescribing is an Incentive by the Centre for Medicare & Medicaid Services

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

However, changing perceptions of prescribers and consumers will be necessary to launch the initiative. The education of providers regarding the therapeutic equivalent and efficacy of generic medications are therapeutic substitutes is very important—prescribers will be the driving force behind adoption of generics over brand-name drugs. The use of e-prescribing provides information regarding cost, formularies and available generics at the fingertips of providers (United States Department of Health and Human Services, 2010).

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

These systems will also help cut down on medication errors by comparing the patient’s to medications or interventions so that it is given to the correct patient. Also documents the care given so there would be no human error in the case of questioning whether care had been given as long as the caregiver documents in the record. These features of the electronic health record are in place to promote patient safety by reducing errors.

The SCHC addressed meaningful use by recording patient demographics, maintaining an active medication lists and incorporating clinical lab test results into the HER, as apart of their meaningful use objectives. For recording patient demographics, they maintained data for accurate billing and ensured that the practice workflow was adjusted to capture all of the necessary patient data. They addressed active medication lists by following the requirements for e-prescribing. Patients were able to review their active medication list during their visit. Changes to the medication list were reviewed with the nurse and adjusted within the EHR system by the doctor. They communicated information for the care coordination process by making test results efficient and safe to access. Physicians were able to make real time decisions when they receive the test results from LabCorp, Quest, and other health

Electronic Prior Authorization is one of the technology-dependent trends that have encouraged the use of technology systems. Electronic Prior Authorization has two types of prior authorizations; retrospective and prospective, both making impressions on the pharmacy’s and pharmacists, just in different ways. The retrospective model is able to access a prior authorization after a claim is refused, denied, or returned by using the pharmacy software system. For example, the patient's claim could have been denied because the pharmacist did not know the prior authorization information as for the prospective model that uses electronic prescribing within the electronic health records that automatically requires the prior authorizations. Electronic Prior Authorizations make things certain, consistent, and allows more opportunities for all health care

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

In addition to the core objectives, eligible professionals must also meet 5 out of 10 from the menu set of objectives. The lists of menu objectives are as follows.

Adoption of EHR can derive a great amount of benefits in clinical outcomes such as patient safety and quality of care. Qualtiy of care can be measured with different dimensions such as patient safety, effectiveness, and efficiency. Patient safety is defined as ‘avoiding injuries to patients from the care that is intended to help them’(Menachemi and Collum, 2011, p. 49). Often times, lack of time can contribute to omission of asking patients important questions such as drug allergy information and confirming important patient identifiers such as addresses/phone numbers. Improvement of medication error is a well-noted benefit of EHR as seen in numerous researches. According to a study, researchers found that a CPOE system was contributory in reducing serious medication errors by 55% in the hospital setting (Bates, 1998). Many other studies have reported similar findings in patient safety improvement. When e-prescribing is used, prescriptions can be checked for any drug interactions with

E prescribing can be a part of the EHR in Epic, which would include patient data, and not just prescription information. When e prescriptions are utilized in Epic, the medication is checked for interactions with the patient’s other medications and allergies. Check systems within Epic look for drug-allergy, drug-drug, and how the medication reacts with the disease. In a case study of 17 physicians in an ambulatory clinic conducted by Abramson et al., error rates from prescribing decreased from 35.7 per 100 prescriptions to 12.2 per 100 prescriptions in a year of e-prescribing as reviewed in this study. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 stated that healthcare providers would have access to EHRs to ensure the meaningful use standards per the Centers for Medicaid and Medicare Services (CMS). Meaningful use is attained by increasing the quality of patient outcomes by having access to the medication data, the patient’s history, and diagnosis by the prescriber. Prescribing is safer, when the provider is aware of the patient’s history, current medications, and allergies, therefore better patient outcomes. In the United States, the HITECH Act and the meaningful use standards stated by CMS have increased the use of e-prescribing per Friedman (2009). The CMS made e prescribing a

Electronic retrieval of patient demographics, allergies, current medications, complete medical history, diagnostic and radiologic results, etc. occurs by clicking a few buttons. Electronic patient charts provide quick and easy access to physicians, hospitals, independent labs, and pharmacies. EHRs allow simultaneous access by independent providers and allow a collaborative effort for health care management of the patient. “EHRs are the next step in the continued progress of healthcare that can strengthen the relationship between patients and clinicians”. (Electronic Health Records Overview, 2011)

One of many administration burdens to physicians and medical office staff is the nees to respond to prescription refill requests. E-Prescribing gives providers acess to review, authorize and transmit several refill authorizations in a matter of seconds. In case of emergency a refill can be quickly done to aid a patient that is traveling and out of

As a result of implementing e-Rx for inbound prescriptions, patients would not need to carry prescriptions to get them filled back at the VA. Pharmacist would not have to enter the inbound prescriptions manually into the VistA, which can potentially present danger of medication errors, as reviewed in the secondary research in Chapter 2 above. Based on the qualitative

In order to obtain relevant information for implementing an electronic prescribing system, a variety of sources were reviewed. As the HITECH Act nationwide was contributory to the recent surge of adoption for e-Rx systems, the focus of the research was to find research data reflective of successful implementation and practical guidance. In order to extract retrieve necessary information, a variety of sources were reviewed; journal articles, review articles, meta-analysis, and national guidelines on implementing e-Rx systems. Due to the heightened interest for this particular topic, there is a lot of valuable information and guidance available regarding adopting electronic health records (EHR) and e-prescribing systems on HealthIT.gov website and Center of Medicare & Medicaid Services websites.

Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread