Holes in formulary and benefit (F&B) information and medication history of patients have caused some provider skepticism of e-prescribing, a study recently published in the Journal of the American Board of Family Medicine determined.
Although the study was small and limited in scope--only eight practices participated, each consisting of between one and four physicians--the results were alarming. F&B information often was inaccurate because payers weren't required to provide complete information and because software systems "normalized" such data. As a result of the latter, the software systems created unnecessary groupings dubbed "preferred," "on-formulary" and "off-formulary."
What's more, the software systems only included F&B information at a "group-level" rather than a "plan-level," often leading to incorrect coverage information.
With regard to medication history, a number of factors led providers oftentimes to seek out paper-based workarounds, leading to uneven use of electronic information, the study authors noted. "If a person's seeing a cardiologist [who is not using e-prescribing]...is on heart medication, blood pressure medication, those medicines are not in the system," one doctor said. Another doctor pointed out that even with the assistance of an electronic system, "we still have to write [the medication] in the chart...that is the real drawback."
The authors said providers should revisit their reliance on e-prescribing systems on prescription claims data to generate medication history data, and they add that the information communicated by e-prescribing standards be evaluated time and again for quality assurance.
"Until the technical and data quality problems we have identified here are addressed, it is likely that health system-level quality gains and efficiencies expected from e-prescribing use will be realized unevenly as practices struggle to meet the Meaningful Use policy objectives relating to e-prescribing," the authors concluded.
To learn more:
- read the full study