Fred M. Eckel, RPh, MS
Mr. Eckel is professor and director of
the Office of Practice Development
and Education at the School of
Pharmacy, University of North Carolina
at Chapel Hill.
For years, the adoption of electronic
prescribing (e-prescribing)
has proceeded at a crawl. With
growing pressure from legislators to mandate
e-prescribing for Medicare, however,
we may see the pace accelerate. It
also appears that the Drug Enforcement
Administration (DEA) may finally be entering
the 21st century by recognizing the
need for e-prescribing of scheduled drugs.
The current requirement to manually
prescribe controlled drugs often has been
cited as one of the biggest obstacles to
wider adoption of e-prescribing. The DEA
has been slow to propose changes, and
its caution is somewhat understandable
given the growing abuse of scheduled
drugs due to the spread of illicit Internet
operations. E-prescribing of all drugs,
including controlled drugs, however,
will be essential as we move toward a
future based on electronic health records.
Without integrated prescription information
for all drugs, the value of these
records will be greatly reduced.
This is why the DEA's decision to publish
proposed e-prescribing requirements
is a welcome step. I encourage pharmacists
to review the DEA's proposed rule,
published June 27, 2008, in the Federal
Register, to ensure that it will work for
pharmacists and prescribers. The DEA is
accepting comments until September 25.
The DEA's proposal comes at a time
when lawmakers are displaying increasing
impatience at the slow adoption of the
technology. Even though e-prescribing is
growing, it still accounts for only a small
percentage of the nation's prescriptions.
Many in Congress see the technology as a
way to save billions of dollars while reducing
medical errors, which is why they are
considering legislation that would mandate
e-prescribing for Medicare by 2011,
with penalties for physicians who do not
quickly adopt the technology.
Another development that could advance
e-prescribing is the merger of the
SureScripts and RxHub networks to create
a unified national e-prescribing network.
Of course, e-prescribing is not free of
problems. One is the cost of transmitting
transactions, which can consume a
significant proportion of dwindling reimbursements.
SureScripts and RxHub say
that their merger ultimately could result
in lower prescription routing costs due to
increased use of e-prescribing.
The National Alliance of State Pharmacy
Associations is gathering information
about pharmacists' e-prescribing
experiences; you can help by reporting
yours at www.pqc.net/eprescribe/disclaimer.htm. As the pressure to adopt
e-prescribing grows, it will become
increasingly important for us to get
involved with the technology—and make
sure our opinions and experiences are
heard.