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The Foundations of ePrescribing

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Page 1: The  Foundations of ePrescribing

T

e-Prescribing

he healthcare IT industry has witnessed somee-prescribing programs succeed, while othershave failed. In aggregate, these programs haveprovided a body of learning that has served to

refine a business model poised for broad adoption.The reasons some programs have failed include lack

of broadband access, difficulties of managing the appli-cation in a client/server environment, undercapitalizede-prescribing vendors, lack of incentives for physiciansto adopt the technology and a lack of access to formu-lary and eligibility information for a meaningful percent-age of practices.

Health Plans See ValueHealth plans realize that e-prescribing brings many ben-

efits to their providers as well as their members. Thesebenefits include: cost savings from reduced drug spend-ing due to increased formu-lary compliance; stricter ad-herence to prescribed drugutilization review reports;point-of-care messaging forpreferred alternative drugs;and avoidance of catastrophicadverse drug events due to illegible prescriptions or druginteractions. These factors provide a meaningful returnon investment to health plan sponsorships.

Beyond the return on financial investment, plans knowthe value of meaningful, forward-thinking relationshipswith providers, as well as increasing patient safety andconvenience. Enabling providers to begin their digital jour-ney with e-prescribing can be an important element to arobust provider satisfaction program.

e-Prescribing programs should initiallytarget high-prescribing physicians in an

effort to drive near-term value.

The right combination of technology, people, process andcommitment drive success for electronic prescribing.

Physicians and Physician OrganizationsRecruiting. e-Prescribing programs should initially tar-

get high-prescribing physicians in an effort to drive near-term value. Targeting physician practices focused on familypractice, internal medicine and pediatrics will enable theprogram to recruit high-prescribing physicians. Early adop-tion can be critical to building momentum in the pro-vider community.

Recruiting independent physician practices to deploy e-prescribing is, in essence, a sales activity. As such, an e-pre-scribing vendor will need to have its sales staff introduce thetechnology to practices of all sizes, from solo practitionersto large, multispecialty, multilocation clinics.

Physician’s organizations, such as IPAs, IDNs and MSOs,can vary in charter and intensity of affiliation. However,they have proven to be pivotal in endorsing and introduc-ing the technology to their physician communities.

Incentives. As practicesacross the U.S. increasingly facefinancial pressures, some healthplans have chosen to provide in-centives to physicians to rewardbehavior that controls costs.Incentives designed to reward

providers for not only deploying but also utilizing e-prescrib-ing can be an effective tool in accelerating adoption.

Penetration. An e-prescribing program should seekdeep penetration in a targeted community. This means itis incumbent on the e-prescribing software partner todevelop a deployment model that has different method-ologies to accommodate practices of all sizes.

For example, deployment challenges at a 100-physi-cian multispecialty, multilocation clinic will be dramati-

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e-Prescribing

cally different from those at a three-physician, one-lo-cation family practice. In the former, the recruitmentand deployment process will likely involve practice lead-ership (administrator, CEO or a managing partner), ITstaff and a practice and/or billing manager who overseestaff members who are critical for a successfulenterprisewide deployment.

Smaller practices, such as a three-physician practice,present different challenges. Often the IT infrastructurehas grown in phases, based on the addition of legacy sys-tems, and therefore resides on different platforms. Prac-tice staff, both prescribers and non-prescribers, often havelittle available time for new projects. Successful recruit-ment and deployment in this practice requires a specificset of skills and tools to deal with a different business model.

A Confluence of TechnologySeveral early e-prescribing programs failed because they

relied on technology that was not scalable. An e-prescrib-ing program must be driven by technology. Several fac-tors have served to provide a confluence of positive eventsthat will help to make e-prescribing programs further po-sitioned for success, namely broadband access, wirelesstechnology and the next generation of software.

Broadband, DSL and high-speed cable access has be-come more readily available,and today, many practiceshave robust high-speed accessto the Internet. When high-speed access is established ina practice, the practice canuse e-prescribing technologythroughout the entire clinic,including all points-of-care. This is important for the phy-sician office staff. Browser access also can be providedfor patient registration and renewal requests.

Mobility provided by a handheld device connectedwirelessly enables e-prescribing at the point of care, in-cluding access to important data relative to care and cost

(e.g. drug dispensed his-tory, eligibility and formu-lary compliance).

With advancements inprogramming languages

and the advent of the Internet, e-prescribing software is easyto learn and easy to navigate, intuitively reflecting theworkflow of most practices. These improvements have com-bined to make current e-prescribing programs a mission criti-cal application that is deployable, scalable and affordable.

Commitment to Change ManagementSuccessful deployment depends on three factors:Commitment to change on the part of the practice.

Utilization requires both prescribers and staff to makecommitments to train on the application and to makechanges in daily workflow. It’s imperative to place em-phasis on building commitment to the project for suc-cessful implementation.

One source of accountability. e-prescribing vendorsthat choose to use local subcontractors in different mar-kets tend to have varying levels of success. Deploying in-formation technology to physician practices requires a pre-cise process developed and followed each time so thatpractices have a consistent, positive experience.

Flexible but consistent training. Training should bemodularized to target various staff members ranging fromprescribers to administrators. Early involvement in thechange required to broadly adopt e-prescribing will enablethe practice to achieve savings and patient care goals faster.

Utilization Sustains SuccessExperience indicates that the first eight weeks of e-

prescribing use is critical. Incubating these new users canmake or break the implementation. Frequent contact fromthe supplier, by phone or in person, is crucial. Setting goalsfor prescribing and getting physicians who experienceproblems “over the hump” is also important.

Once users are trained and use e-prescribing, it re-mains important for the ven-dor to have an ongoing rela-tionship with the practice,and to help the practice witha helpdesk or technical sup-port group as well as dedi-cated account managers.Practices should expect an

account manager to monitor the practice’s progress andcontinually help to refine the dynamic marriage of soft-ware and practice workflow.

Information technology like e-prescribing can im-prove efficiency and effectiveness in the delivery ofcare. When successfully deployed and adopted by phy-sicians, e-prescribing can share value among all stake-holders and lead to immediate returns on investmentand improved patient care. However, adopting a newtechnology and changing the workflow in a physician’soffice requires the right foundation, and there are fewshortcuts. The payoff of success, however, is certainly

worth the effort—for health plans,physicians, office staff and, most im-portantly, patients.

For more information about e-prescribing solutions from Zix Corp.Phone: 866.257.4949Email: [email protected]

Utilization requires both prescribersand staff to make commitments to train

on the application and to makechanges in daily workflow.

Kirk Paul Kirkman is vice president ofphysician recruitment and retention forZix Corp., Dallas. Contact him [email protected].

Reprinted from Health Management Technology, April 2005Copyright © 2005 by Nelson Publishing Inc. • www.healthmgttech.com