editor'sNOTE: E-prescribing: The Need Is Here

AUGUST 01, 2008
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.