E-Prescribing: Payers Giving, but are they Getting?
March 2005
Dee Carter, M.D., like many of her family practitioner peers, has a drug problem. But she has been getting comfort and support from an unexpected source in her time of need. Carter, who practices solo at Lexington, S.C.-based Living Well Family Medicine, must treat patients with numerous conditions during the course of a day and, in the process, prescribe an ever-expanding number of drugs.
As a result, it's difficult for her to track medications her patients are taking to ensure she is not prescribing drugs that will cause harmful interactions. In addition, Carter tries to keep the out-of-pocket expenses of her patients as low as possible by adhering to the drug formularies of the managed care organizations with which she deals. That in itself can be a full-time job, she says.
But she's getting help. Since early last year Carter has been using e-prescribing software-for free-through an initiative from Blue Cross Blue Shield of South Carolina, Lexington. The Blues plan is offering electronic prescription software from iScribe Inc. to a targeted group of high prescribers. The payer is picking up the cost of the software license for two years. iScribe is a division of Caremark RX Inc., Nashville, Tenn.
Carter now uses the PDA-based software to write e-prescriptions and check for adverse drug interactions at the point of prescribing. The application also enables her to instantly check the drug formularies of Blue Cross Blue Shield of South Carolina and its competitors to ensure she is prescribing "approved" drugs that have the lowest co-pays for her patients.
Beam me up
After she has written a prescription, she beams the order via an infrared scanner to a fax machine. The order is then handed to a patient or faxed to a pharmacy. Carter also has loaded the medication history of her patients onto the PDA to speed the process of refills and ensure she has an accurate account of her patients' drug therapies.
"Being on my own and in a fairly new start-up practice, I was thrilled that Blue Cross Blue Shield of South Carolina was offering the software for free," Carter says. "I don't have any other technology in my practice, and this has eliminated a lot of work for my staff and me."
In the public mind, "managed care" is not a term typically synonymous with generosity. But when it comes to e-prescribing, some payers are assuming the role of Santa Claus.
In the past few years a number of managed care organizations have launched initiatives to provide physicians with free hand-held devices, e-prescribing software and network connectivity. Many are combining these mobile initiatives with a rollout of online e-prescription tools that enable physicians and their staffs to use a Web site to electronically prescribe drugs.
The payers say their motivation for the most part is altruistic. They hope that by spurring practices to begin e-prescribing, they can increase patient safety and satisfaction.
"The No. 1 reason we are promoting this, pure and simple, is patient safety," says Robert Mandel, M.D., vice president for e-health at Blue Cross Blue Shield of Massachusetts, Boston. The Blues plans, along with Tufts Health Plan, Neighborhood Health Plan and Dallas-based Zix Corp., is offering free mobile hardware, a one-year license for Zix's e-prescribing software and six months of free connectivity to physicians through its eRx Collaborative. Rockville, Md.-based DrFirst joined the collaborative last month.
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