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E-Prescription Quality: An Industry Issue

November 14, 2013

E-Prescribing is not a small, niche technology any longer. The clinical benefits of this technology, coupled with governmental incentives, and a wave of highly impactful innovations have made e-prescribing an integral and permanent aspect of the healthcare industry. Most of e-prescribing’s earliest advocates knew that as e-prescribing technology continued to evolve and the e-prescribing industry’s significance continued to grow, a number of potentially contentious issues were bound to emerge regarding industry best practices and the new technology’s role within the clinical environment. I am writing this blog series because I believe that the e-prescribing industry has reached this tipping point, and we need to begin engaging in proactive conversations to ensure that our industry as a whole remains healthy and robust going forward.
I was recently asked to deliver one of the keynote addresses at the first quality forum for the National Council for Prescription Drug Programs (NCPDP) in Scottsdale, Arizona. They asked me to speak about prescription quality in the e-prescribing industry, and to consider how we can continue to make prescriptions safer. One of the major themes of my presentation was the need to change the way industry insiders talk about and think about the issue of quality prescriptions.
For instance, the subject of quality prescriptions in e-prescribing is often framed as solely a provider issue by pharmacists and Pharmacy Benefit Managers (PBM)—two parties that would both prefer to defer responsibility for potential issues that exist within the e-prescribing loop. As a practicing pharmacist and an executive for a health IT vendor known for its innovative e-prescribing solutions, I can categorically reject this premise as self-serving and false. The fact is, we all have a role to play in improving the e-prescribing process, and making the conscious or unconscious decision to avoid examining industry issues from all of the various angles only weakens our industry as a whole.
In order to get my discussion started, I proposed five primary areas of conversation which I believe the industry needs to consider going forward. Should we:

  • Mandate prescribing fields?
  • Change the way we determine certification requirements?
  • Force usability standards or specific workflows?
  • Attempt to alter provider behavior to reduce common errors? If so, how?
  • Require that vendors mandate more rigorous training regimens for providers and their staff prior to authorizing the use of their specific e-prescribing solution?

Many of my colleagues from across the industry who attended the NCPDP’s quality forum talked about how excited they were to have someone addressing these important issues, and over the course of the day, my presentation was referenced multiple times. I’m not trying to suggest that I solved all of the industry’s problems in a 20-minute keynote address, and it would be intellectually dishonest to suggest that there are not many different opinions on each of these areas of discussion. The point is that these are issues the industry is facing and we need to begin facilitating dialog on these larger questions.
Based on the positive feedback I received following my presentation I decided to launch this blog series in an effort to further explore these critical questions. My next installment will focus on the question of mandatory fields, and each of my subsequent blog posts will address the other subjects which I explored in my presentation. I hope that this will help further the conversations that we began at the NCPDP quality forum, and, hopefully begin to help reposition the industry in order to get in front of the dilemmas that have emerged around these subjects.

  1. E-Prescription Quality: An Industry Issue
  2. Should the E-prescribing Industry Require Mandatory Standards?
  3. Change the way we determine certification requirements?
  4. Force usability standards or specific workflows?
  5. Attempt to alter provider behavior to reduce common errors? If so, how?
  6. Require that vendors mandate more rigorous training regimens for providers and their staff prior to authorizing the use of their specific e-prescribing solution?