Secure Electronic Prescriptions Implementing Technology to Improve Care, Reduce Cost and Fight Prescription Drug Abuse Presentation to the WV Health Information Network January 26, 2006
2006 Study Research Surveys & Interviews Physicians Pharmacists Hospital Administrators Technical Review Access the summary or full report at: www.concord.edu/pages/news/index.html -- click Prescription Study
Study Recommendations 1. Pursue immediate legislative action to remove legal barriers 2. Enhance WV Prescription Drug Monitoring Program for EPS 3. Initiate WV e-prescribing Program with 350-500 physicians
E-Prescribing Correct information In the right hands At the right time
The e-prescribing network provides real-time data
Benefits of E-Prescribing
Patient Safety Fewer adverse drug - drug interactions Fewer drug allergy interactions Reduced errors in drug name, dosage Physician has searchable medication history if drug recalled
Cost Savings Lower Drug Costs Higher formulary compliance Increased generic substitution 51.9% of WV pharmacists say off-formulary scripts are serious or very serious problem 5-7% increase in generics (SEP Study) $5.7 million savings over 5 years from increased generics (Henry Ford Health System)
Cost Savings Lower Health Care Costs Fewer adverse drug events requiring hospitalization or treatment 70,000 prescriptions (12%) cancelled due to drug interaction warnings (HFHS) 4,500 (1%) cancelled due to drug allergy warnings (HFHS)
Cost Savings Administrative Savings Reduces rejected claims and prior authorization requests Reduces duplicate claims 54.7% of WV pharmacists say duplicate scripts are serious or very serious problem
Time Savings Reduces pharmacy call-backs Pharmacy can t read scripts Drug - dosage issues Drug not on formulary Reduces record keeping and file access time Substantially speeds renewal of prescriptions Saves pharmacy data entry time
Reduced Diversion Reduces stolen or altered prescriptions Helps physician avoid prescribing to patient involved in diversion or abuse through convenient access to patient medication history
Trends in Adoption Top Ten States
Turning WV Blue Learn from existing programs to avoid mistakes Establish an effective program Measure progress from implementation Reward success Prove positive ROI
Mistakes to Avoid Use ineffective selection approach: If we offer it, they will come, or Select high-prescribers only Include too many vendor products, leaving doctors to evaluate Include low-functioning products Provide too little support Fail to monitor progress during the program
Effective Programs 1 Firm Commitment Senior Leadership Support Clear Goals Stated, Measurable Goals for: Patients Physician Practices Pharmacies Payers
Effective Programs 2 High Quality Management Set clear timeline Establish benchmarks Coordinate support Resolve problems Track progress Recognize results Leverage success
Effective Programs 3 Careful Selection of Participants For Early Adopter Sites --Multi-doctor practices --High volume of scripts --Technology friendly/ready --Leaders with positive attitude Success creates pull in community If you just throw incentives out, they won t pick it up. Peter Stoessel, CareFirst BCBS
Effective Programs 4 Few, Carefully Chosen Vendors Maximizes support from vendors Minimizes sales contacts with doctors Minimizes confusion for doctor Minimizes administrative problems Maximizes buzz among participants to promote program
Effective Programs 5 Rigorous Evaluation of Software Meets/exceeds functional reqmts. User-friendly Adaptable to physician workflow Supports data integration with practice s EMR or PM system Includes tracking and reporting capabilities Cost effective Proven Vendor Success
Effective Programs 6 Strong Implementation Plan Installation Workflow coordination Data Integration Training One dollar of implementation support is worth five dollars of incentives. Matt Walsh, AVP, Health Alliance Plan
Effective Programs 7 Strong Support Rapid Response to Problems Problem Logging & Tracking Intervention when needed Manage analysis and delivery of problem fixes and enhancements
Measuring Progress Satisfaction Patients Medical practices doctors, staff Pharmacies Continuing measurement Patient Safety Time Savings Formulary Compliance Generic Substitution
Rewarding Success All successful pilots are renewing support and licensing to successful users Visible credit for successful users helps expand the program
Proving ROI System data reports Changed selections due to drug-drug interactions Analysis of on/off formulary patterns Time studies Administrative costs Duplicate claims, pre-authorizations Financial Analysis Comparison of EPS users to others
ROI in successful projects Henry Ford Health System --Projected $6.2 million in savings over 5 years CareFirst BCBS (MD, DE,VA) --Estimated $2.50 to $3 saved for $1 spent
E-prescribing is leading the way to adoption of electronic health records
Contacts Mary Ratliff, Owner Mary Ratliff Consulting 723 Kanawha Blvd. East, Charleston, WV 25301 304.346.9984 mratliff@maryratliff.com Other Secure Electronic Prescriptions Study Contacts Dr. Jerry Beasley, President, Concord University 200 Marsh Hall, Concord University, Athens, WV 24712 304.384.9188 Dr. John David Smith, Professor 107 Marsh Hall, Concord University, Athens, WV 24712 304.384.5218 jdsmith@concord.edu John Waugaman, President, Tygart Technology, Inc. 1553 Fairmont Ave., Fairmont, WV 26554 304.363.6855 waugaman@tygart.com