E-Prescribing FAQs

What is E-Prescribing?
How Does E-Prescribing Work?
Is Faxing a Prescription to the Pharmacy E-Prescribing?
How Much Does E-Prescribing Cost?
How Does E-Prescribing Benefit Physicians?
Does electronic prescribing offer the patient advantages?


What is E-Prescribing?

E-Prescribing is a physician’s use of real-time, patient-specific clinical and economic information, for consenting patients, to:

• Prescribe the most medically appropriate and cost effective prescription at the point of care, and
• Transmit the prescription electronically -- from the computer at the practice to the computer system at the patient’s pharmacy of choice. Pharmacies can also request refills by sending an electronic refill request to the physician office for approval.

How Does E-Prescribing Work?

With e-prescribing, prescribers and practice staff have the potential to access clinical decision support information such as patient medication history, formulary, benefits and pharmacy eligibility information, drug-drug interaction alerts, drug-allergy interaction alerts, and other information that can result in a safer prescribing decision. By having more comprehensive and accurate information at the time of prescribing, the practice can improve the quality of care, potentially increase adherence, and also reduce the number of call backs from the pharmacist to clarify prescription information. If the practice and the pharmacy are both connected to the Pharmacy Health Information Exchange, operated by SureScripts, the prescription renewal authorization process can be streamlined; this then improves practice efficiency and the timeliness of medication delivery to the patient.

E-Prescriptions arrive directly in the pharmacy’s computer system so pharmacy technicians spend less time interpreting handwriting or re-keying information into their computer systems. Since the prescriber has better information available at the time of prescribing, there is a lower chance that a call back to the practice will be needed to clarify prescription information. Pharmacies have made significant investments to upgrade hardware and software and to train pharmacy staff because they view e-prescribing as strategically important to improving quality, safety, efficiency, and consumer convenience. Pharmacies also pay transaction fees to SureScripts, operator of the Pharmacy Health Information Exchange, to enable prescribers to exchange prescription information electronically with pharmacies through their e-prescribing and EHR systems.

PBMs are also very supportive of e-prescribing because it enables them to deliver formulary, benefits, pharmacy eligibility, and medication history information to prescribers at the time of prescribing. Having this information at the time of prescribing enables prescribers to make more informed decisions including prescribing on the patient’s formulary, prescribing medications that are covered by the patient’s medication benefits, and prescribing generic or other lower-cost medications. This ultimately enables prescription of a drug that is of lower cost and more likely to be picked up and taken by the patient. With the availability of medication history information, the prescriber also will be better informed about potential interactions. PBMs have made substantial investments to enable the delivery of this information to support safer, more cost-effective prescribing decisions; among other things, they have paid transaction fees to RxHub to deliver the information to prescribers through their e-prescribing or EHR system.

Click here for a visual demonstration of how e-prescribing works . Is Faxing a Prescription to the Pharmacy E-Prescribing?

No. E-prescribing is the two-way, computer-to-computer connection between a physician practice and a pharmacy. E-prescribing involves no faxing of prescriptions – it is paperless. Most EMR users believe that they already send prescriptions to pharmacies electronically – i.e. they are unaware that it is far more likely that their EMR is generating faxes that arrive on paper at the pharmacy’s fax machine.

An estimated 150,000 prescribers located throughout the U.S. are currently using electronic medical record (EMR) and other clinical software to fax prescriptions to pharmacies.

Computer-generated faxing of prescriptions prevents physicians from achieving gains in practice efficiency and patient safety associated with e-prescribing. Additionally, EMR and e-prescribing systems that only send computer-generated faxed prescriptions to e-prescribing-capable pharmacies do not qualify for the MIPPA E-Prescribing Incentive program. How Much Does E-Prescribing Cost?

The cost to a prescriber of acquiring a standalone e-prescribing system ranges from – no cost to $100/month.

EHRs (Electronic Health Records) offer more comprehensive functionalities, including e-prescribing. According to the Congressional Budget Office, "The few detailed studies available report that total costs for office-based EHRs are about $25,000 to $45,000 per physician (Gans et al., 2005; Kibbe & Waldren, 2005). Estimates of annual costs for operating and maintaining the system, which include software licensing fees, technical support, and updating and replacing used equipment, range from 12% to 20% of initial costs, or $3,000 to $9,000 per physician per year (Miller et al., 2005; Wang et al., 2003)."*

* Evidence on the Costs and Benefits of Health Information Technology. May 2008. Congressional Budget Office, page 17. http://cbo.gov/ftpdocs/91xx/doc9168/05-20- HealthIT.pdf. How Does E-Prescribing Benefit Physicians?

By Saving Time. Prescription refill authorization requests are sent directly to your computer. You can then review and respond to all of your pending requests with a few keystrokes. This streamlined process reduces pharmacy faxes and phone calls and allows you to complete refill authorizations in much less time.

By Enhancing Staff Productivity. The reduction in pharmacy faxes and phone calls associated with refill requests, legibility issues, drug incompatibility or ineligibility will provide you with more time to devote to patient care.

By Improving Patient Safety. According to the Institute of Medicine (IOM) 1.5 million preventable medication errors occur in the United States each year. Pharmacy connectivity can help prevent medication errors and the injuries they cause.

By Providing Access to a Single View of Patient Rx History Across Community Pharmacies. Accessing a single view of a patient’s medication across providers during a patient’s office visit helps to decrease the risk of preventable medication errors and increase your ability to manage a patient’s adherence and compliance. Does Electronic Prescribing Offer the Patient Advantages?

In a word – convenience. E-prescribing eliminates the extra trip to the pharmacy to drop off the prescription. Additionally, an important advantage of a prescription being sent electronically is that the message is already formatted in such a way that the pharmacy computer can assimilate the information for rapid dispensing. You have the comfort of knowing that an accurate, legible prescription will arrive at the pharmacy, that won't get lost, misplaced, destroyed or forgotten by the patient.