Medication errors cause avoidable harm in approximately 1 in 30 patients, with 25% of these patients experiencing severe or life-threatening harm. Aiming to prevent these errors, Drug Enforcement Administration. provided prescribers with the option to use e-prescriptions for controlled substances (CS) based on an interim final rule published in 2010. Since this rule became effective, a majority of states now require e-prescriptions for at least some medications. As demand for digital prescriptions increases, it is important to be aware of new developments in the e-prescribing landscape.
Trending Toward Digital
According to a Surescripts national progress report, 94% of all prescriptions in the United States were electronically filled in 2021, and 92% of prescribers have adopted e-prescribing methods. Key e-prescription trends include:
- The rising frequency of e-prescription systems integrating with electronic health records
- The adoption of cloud-based digital record keeping
- AI growing focus on patient safety, including drug interaction and allergy alert features
- An increasing demand for mobile-based prescription solutions as smartphones and tablets become more prevalent in health care settings.
The use of artificial intelligence (AI) in digital prescription systems, which can potentially recommend treatment solutions and detect medication errors, may come to fruition soon as well.
Giving Pharmacies an Edge
A major benefit of e-prescribing is the reduced possibility for human error, as typed prescriptions are easier to interpret than handwritten ones. In addition, e-prescribing allows for more efficient processing of prescriptions and may eliminate steps in the dispensing process, saving pharmacy employees time and effort. In some cases, e-prescriptions can bypass the entire order entry process, eliminating a step in dispensing where human errors are commonly introduced.
Another possible benefit is that e-prescribing could decrease the amount of falsified prescriptions. Bad actors have grown increasingly sophisticated with their methods of faking prescriptions throughout the past several years, and many can now even reproduce watermarks on prescription pads. Although e-prescribing has the potential to decrease prescription forgery, it doesn’t come without online security concerns.
Addressing the Challenges
The challenges of e-prescription systems consist primarily of security and privacy concerns, the lack of interoperability between various systems, and the high cost to implement some e-prescription systems. E-prescriptions contain sensitive patient data. The risk that this data could become compromised cannot be ignored. Privacy violations remain an added risk to easily accessible electronic records.
Further, a lack of interoperability between pharmacy systems can prevent electronic data sharing between competing pharmacies, which can be frustrating for patients, prescribers, and pharmacy staff when prescriptions are sent to the wrong pharmacy or the patient decides to have the prescription filled elsewhere.
Electronic systems are also expensive for prescribers and pharmacies to purchase initially, and system maintenance is likely to result in additional expenses.
e-Prescription Legal Mandates
A total of 35 states require e-prescribing in some form by state law. In California, Delaware, Florida, Iowa, Michigan, Minnesota, and New York, e-prescribing is mandated for all prescriptions, both CS and non-CS.
More commonly, states such as Illinois, Rhode Island, and South Carolina require e-prescriptions for all CS. In other states, including Kansas, Maine, Virginia, Arizona, and Tennessee, e-prescribing is required for certain types of CS.
The e-prescription landscape is developing and progressing with each passing year. Major benefits, including decreased medication errors, increased efficiency, fewer forged prescriptions, and simplified prescription transfers and cancellations, are apparent. Drawbacks, from concerns about security and privacy to lack of interoperability and the costs of system implementation and maintenance, are also essential to discuss.
The rise of e-prescribing among practitioners, patients, and pharmacists, paired with laws requiring e-prescriptions ensures that e-prescribing will persist far into the future.
This blog was adapted from an article that originally appeared in the January 2024 issue of Innovations.