E-prescribing soars among doctors with EHRs

More and more are moving away from stand-alone systems. Nearly half write prescriptions electronically through an EHR.

By — Posted Dec. 18, 2012

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Government incentives and better education on the benefits of e-prescribing are being credited for a dramatic increase in the number of physicians who use electronic health record systems to e-prescribe.

The Office of the National Coordinator for Health Information Technology in the Dept. of Health and Human Services published a report in November that looked at e-prescribing trends in the U.S. As of June, 48% of physicians are e-prescribing with an EHR. That is up from 7% in December 2008 (link).

Physicians sending prescriptions electronically can do so using stand-alone systems or EHRs with an e-prescribing component.

Although e-prescribing adoption rates among states vary, each state has seen growth since 2008. In 23 states, more than half of physicians e-prescribe through an EHR. The highest growth rates are in New Hampshire, which saw an increase of 70 percentage points from 2008, and North Dakota, which had an increase of 65 percentage points.

“What we are really seeing is that it’s going to take time, but we are well into the adoption story,” said Seth Joseph, director of strategy and innovation for Surescripts, an e-prescribing network used by more than 95% of pharmacies and the source of the data used by the ONC in its report.

Joseph said the increase can be attributed not only to government programs, such as the EHR meaningful use and the Medicare e-prescribing incentive programs, but also to the promotion of e-prescribing that came because of those programs. The government did a good job of explaining the benefits and advantages of e-prescribing during promotion of the incentive programs, he said.

The ONC report examined only physicians who e-prescribe through an EHR system. But Surescripts data show that the number of physicians e-prescribing is a little higher if physicians who use stand-alone e-prescribing systems are included.

Surescripts found that 58% of office-based physicians were e-prescribing, either through an EHR or a stand-alone system, by the end of 2011. The number of those e-prescribing through an EHR has increased, which is important, because many of the benefits of electronic prescribing come only when the system is integrated with a full EHR that gives the prescriber more information about the patient who will receive the prescribed medications.

The Health Information Technology for Economic and Clinical Health Act, which created the EHR meaningful use incentive program, was enacted in 2009 as part of the economic stimulus package. But the percentage of e-prescribers using an EHR already had reached 63% in 2008, Joseph said. That represented a flip from 2004, when about 80% of e-prescribers used stand-alone systems. Many physicians adopted stand-alone e-prescribing systems as a steppingstone to adopting full EHRs, Joseph said.

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Doctors with EHRs lead online prescribing trend

Nationally, the percentage of physicians who e-prescribe using an EHR grew 41 percentage points from December 2008 to June 2012. Alaska had the lowest growth rate, and New Hampshire the highest.

State % in December 2008 % in June 2012
Alabama 4% 44%
Alaska 4% 32%
Arizona 7% 46%
Arkansas 6% 54%
California 4% 37%
Colorado 7% 43%
Connecticut 7% 43%
Delaware 8% 55%
District of Columbia 2% 52%
Florida 5% 45%
Georgia 5% 45%
Hawaii 2% 38%
Idaho 7% 41%
Illinois 6% 57%
Indiana 8% 49%
Iowa 7% 73%
Kansas 6% 52%
Kentucky 5% 40%
Louisiana 3% 39%
Maine 7% 56%
Maryland 4% 39%
Massachusetts 27% 77%
Michigan 8% 44%
Minnesota 4% 72%
Mississippi 3% 42%
Missouri 9% 62%
Montana 3% 43%
Nebraska 3% 53%
Nevada 6% 37%
New Hampshire 5% 74%
New Jersey 4% 38%
New Mexico 3% 43%
New York 6% 44%
North Carolina 12% 58%
North Dakota 1% 67%
Ohio 8% 53%
Oklahoma 4% 47%
Oregon 11% 63%
Pennsylvania 9% 57%
Rhode Island 20% 59%
South Carolina 3% 44%
South Dakota 7% 64%
Tennessee 7% 46%
Texas 6% 48%
Utah 3% 36%
Vermont 8% 61%
Virginia 6% 54%
Washington 7% 48%
West Virginia 9% 52%
Wisconsin 5% 68%
Wyoming 4% 38%

Source: “State Variation in E-Prescribing Trends in the United States,” Office of the National Coordinator for Health Information Technology, November (link)

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