New initiative aims to bring e-Rxs to the masses

For years, industry experts have touted the advantages of e-prescriptions, hoping to reduce medical errors and increase efficiency, while at the same time auger in a new era of electronic medical records. Still adoption of e-prescription technology has lagged in the United States. While more than 90% of pharmacies have the ability to receive e-prescriptions, fewer than 5% of doctors have ordered a prescription electronically.

Now a new organization, the National ePrescribing Patient Safety Initiative (NEPSI), is hoping to change all that. Bringing together health insurance payers, major employers, and health technology companies, NEPSI has created the first nationwide system for e-Rxs, which it hopes will jump-start the process.

"This is good news for the pharmacies that have spent millions to upgrade their systems to be ready for e-prescriptions," commented Kevin D. Hutchinson, president and CEO of SureScripts, which is a member of NEPSI. SureScripts was formed by the National Association of Chain Drug Stores and the National Community Pharmacists Association and operates the largest e-prescription network in this country.

NEPSI brings together a large coalition of healthcare and technology companies interested in spurring e-prescriptions. In addition to SureScripts, the group includes other key e-prescription stakeholders, such as Allscripts, which provides clinical software to physicians, and Wolters Kluwer Health, which will provide black box warnings and other health information to the system.

What's more, NEPSI also includes WellPoint and Aetna, marking the first time that major insurance providers have backed a nationwide program. A number of other technology companies, such as Dell, Cisco Systems, Fujitsu Computer Systems, Google, Microsoft, and Sprint Nextel, have also joined the group as much for their concerns over employee health as for the technologies they can bring to the table.

Even companies with competing e-prescription platforms seemed to see NEPSI as a positive move. "We have seen proven results firsthand on how e-prescribing has positively impacted patient safety and the efficient delivery of care in the United States," noted Rick Spurr, CEO of ZixCorp, in a written statement. "We believe this announcement helps to raise awareness about the value of e-prescribing and its ability to dramatically improve patient safety. All who are involved with e-prescribing realize the true benefits for healthcare providers and certainly for patients."

In January, ZixCorp announced yet another e-prescription pilot program it was launching in conjunction with Independence Blue Cross of southeastern Pennsylvania. According to the company, it processed 5.3 million e-Rxs in 2006. The company derives its profits from transaction fees. "We can now see a clear path to achieving the $1,200 per-prescriber per-year revenue target that we have indicated is necessary to achieve our goals for contribution to fixed costs and profitability," Spurr stated. "We believe that the willingness to pay transaction fees on top of the base subscription cost is a significant statement regarding the value of this technology."

How states differ on e-prescribing

All states are not created equal when it comes to e-prescribing. Many state pharmacy boards have rules that complicate the process or prohibit it altogether. The National Association of Boards of Pharmacy has drafted model regulations for e-prescriptions and many state boards are adopting its provisions. Here are a few hurdles that e-prescriptions face: