Study supports MU Stage 2 threshold for e-prescribing

While adverse drug events (ADEs) are less likely in patients with diabetes when their doctors practice higher levels of e-prescribing, not all groups of patients are equally served by the practice, according to a study published Wednesday in the Journal of the American Medical Informatics Association.

The researchers, who include former National Coordinator for Health IT Farzad Mostashari, examined diabetic patients covered by Medicare Part D, and studied adverse drug events among doctors who use e-prescribing for less than 50 percent of their orders, as well as those who use it for more than 50 percent of prescriptions. The 50 percent cutoff point corresponds to the Meaningful Use Stage 2 electronic health record incentive program's core requirement. The study furthered previous research by including patients in ambulatory settings, not just hospitals.

At its most basic level, e-prescribing presents legible prescriptions to pharmacies, reducing the risk of error. These systems also provide varying degrees of decision support and drug interaction alerts as well, the authors pointed out.

The study determined there to be a statistically significant, albeit small association of e-prescribing in the ambulatory setting with lower risk of ADEs significant enough to result in a visit to the hospital or emergency department. Other physician and patient panel characteristics were independently associated with risk of diabetes-related ADE.

Providers who were women, younger, or practiced in rural areas were less likely to have an ADE among their patients, while providers with a sicker panel of patients or more low-income patients had greater risk of ADEs. The risk was higher among black patients, while lower for Hispanics.

The authors say the study supports previous hospital-based findings that MU measures are associated with a reduction of ADEs. At the same time, the report finds that many traditionally disadvantaged populations are less likely to receive prescriptions from a clinician who frequently e-prescribes.

CMS recently reported that the number of eligible professionals who qualified for the eRx incentive program increased every year of the five-year program, reaching 259,401 eligible professionals within 54,854 practices.

New York, the first state to mandate e-prescribing, recently delayed the start date for its mandate by a year.

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