There’s no question that e-prescribing has changed the way prescribers, pharmacists and patients interact with regard to medication therapy. It has improved efficiencies and patient safety. And not surprisingly, within the next few years, virtually all prescriptions in the U.S. will be transmitted electronically, including those for controlled substances.
But are the prescribing and dispensing processes as efficient and painless as possible? Thanks to new tools and technologies that are emerging almost daily, they’re getting there.
For example, the new NCPDP SCRIPT Version 2017071 uses technology to drive the modernization of e-prescribing even further. Enhanced utility made possible via new and/or expanded data elements, plus new functionalities such as RxTransfer, which is an electronic way of transferring a patient’s prescription from one pharmacy to another, and NewRxRequest, which allows a pharmacist to request a new prescription from a prescriber with either minimal information or expired prescription information, will be game changers. Ultimately, this new version of the standard will streamline and improve the e-prescribing process in hundreds of ways, creating more efficient and safer prescriptions, better patient outcomes and less pharmacist burnout.
Let’s take a look at the prescription journey, along with some common — and not-so-common — pain points, and see how the right tools let pharmacists and their staffs do more, faster — without sacrificing accuracy:
Step 1: Prescription arrives
Believe it or not, according to a study published in the Journal for Managed Care & Specialty Pharmacy, “Take one tablet by mouth two times daily” can be expressed more than 800 different ways — so it can be difficult for a pharmacist to know what the prescriber intends. Therefore, a margin for error is present right out of the gate. Standardized e-prescription language and the use of unique codes for specific data elements help pharmacists understand prescriber intent, avoid adverse drug events (ADEs) and reduce administrative burden for pharmacists.
Step 2: Pharmacist checks patient benefit eligibility for the medication prescribed.
Until recently, a patient without their benefit card meant wasted time and back and forth checking eligibility. But patient-matching technology now enables the pharmacist or their staff to check eligibility even when the patient is not able to present their benefit card. The pharmacist also can alert the prescriber to any potential insurance coverage problems with a prescription earlier in the process.
Step 3: Pharmacist checks for patient-specific therapeutic alternatives.
With cost a leading cause of prescription abandonment, the sooner one can identify out-of-pocket costs for patients, the more likely one will be able to get them to adhere to their medication regimen. To maximize adherence and minimize time to therapy, Real Time Prescription Benefit tools can give the pharmacist access to a patient’s medication benefits and identify more affordable alternatives — all within the fulfillment workflow — thereby maximizing adherence and minimizing time to therapy.
Step 4: Pharmacist alerts prescriber to potential insurance coverage problems with the prescription.
No one likes delays at the pharmacy, and prior authorizations are not only a pain for pharmacists but also for patients and prescribers. Prior authorizations can cause treatment delays and trigger prescription abandonment. Additionally, completing a manual prior authorization is time consuming and frustrating. Automated prior authorization transactions can eliminate these extra hours on the phone or faxing with provider offices and payer help desks. The technology integrates directly with electronic health records, enabling health care professionals to easily obtain prior authorizations in real time at the point of care — helping to relieve this administrative burden. Additionally, when combined with Real Time Prescription Benefit tools, clinicians can quickly see if a prior authorization is required and view therapeutic alternatives, including those that don’t require a prior authorization.
Step 5: Pharmacist electronically communicates and coordinates with other care team members
Gone are the days of having to break from the fulfillment workflow to call or fax another health care professional with a question or concern. For example, RxChange transactions eliminate hours on the phone with provider offices by enabling pharmacists to request a change, clarification or prior authorization from the prescriber electronically when: a therapeutic alternative is identified, a generic substitute is identified, the prescriber needs to initiate prior authorization, the drug use needs to be evaluated, the prescription needs clarification or the prescription is out of stock.
In addition, smart messaging lets pharmacists efficiently sort and handle time-sensitive communications, including refills and questions from other providers. From medication management to collaborative practice agreements to addressing controlled substance abuse, digital clinical direct messaging enables seamless care collaboration.
Step 6: Patient receives a prescription optimized for affordability, adherence and effectiveness.
When prescribers can quickly access patient medical history and records and connect with other providers regardless of location or health information exchange, patients can afford their medication, which means they are more apt to take it as prescribed and experience therapeutic benefits sought by them and their health care providers.
More than ever, pharmacists and pharmacies are being recognized for the critical role they play in health care. But they must have the right tools in place to thrive as they’re pressed to do more, faster — without sacrificing accuracy. The prescribing workflow is a challenging one, but technology is helping improve it by facilitating smarter therapeutic choices, alleviating stressors for pharmacists and enabling better care for patients.
Ken Whittemore is the vice president of professional and regulatory affairs at Surescripts.