Paper-only prescribers become a vanishing breed

The physician who is not writing at least some prescriptions electronically is quickly becoming rare.

Sixty-nine percent of U.S. office-based physicians prescribed electronically in 2012, up from 58% in 2011, according to a May 6 report by Surescripts, an e-prescribing network used by more than 95% of pharmacies. Not that long ago, in 2008, only 10% of office-based physicians were prescribing electronically (link).

Small practices led the way in e-prescribing, with 65% of those between six and 10 physicians and 64% of those between two and five physicians doing so. Internists, at 93%, were the most likely to e-prescribe. In 2012, office-based doctors sent 788 million prescriptions electronically, up 38% from 2011, and up more than tenfold from 2008, the first year Surescripts tracked e-prescribing data.

Surescripts did not say why the rates have gone up so quickly. But the numbers track with federal initiatives, such as the Medicaid and Medicare programs for meaningful use of electronic health records and Medicare e-prescribing program, which provide financial bonuses for adopting and employing technology and Medicare penalties for those doctors who do not. For example, an Accenture survey of 500 U.S. physicians, released May 9, finds 93% using EHRs, with 65% of those users employing them for e-prescribing purposes (link).

The Surescripts report said 87% of e-prescriptions were sent through an EHR, with 13% coming through a stand-alone prescribing device. Those numbers have gone up every year from the 63-37 ratio of EHRs to e-prescribing systems Surescripts found in 2008.

Drugstores embrace e-prescriptions

Also making it easier to e-prescribe is the fact that Surescripts found nearly universal acceptance at the nation's pharmacies. Surescripts said 93% of drugstores accept e-prescriptions — 98% of chain pharmacies and 85% of independents.

But although a large majority of office-based physicians are e-prescribing, only 44% of prescriptions dispensed were routed electronically, according to Surescripts. That is up from 36% in 2011. Surescripts noted without comment that electronic refills were down from 2011 to 2012 — from 96 million to 82 million.

However, other analysts have said that one barrier to increased e-prescribing is regulatory restrictions on sending Class II controlled substances electronically. Until recently, federal rules allowed only paper prescriptions for such drugs. Those rules have been modified so pharmacies can be certified and audited to allow them to fill electronic prescriptions, but many states still require paper prescriptions.