Digital Prescriptions Could Save Lives, But Most States Say No

Digital prescriptions could save lives, but most states say no
Provided by MarketWatch

Paper prescriptions will soon go the way of subway tokens in New York.

All prescriptions in the state, including prescription pain medications, must be legally issued electronically after late March. It’s part of a new mandate aiming to curb the decades-long opioid crisis that’s ravaged America for years, in which prescription painkillers can sometimes be a gateway to heroin.

Moving paper prescriptions online is supposed to cut down on forged prescriptions, and reinforce online prescription drug monitoring databases, which let doctors see if a patient has been given drugs for pain by other doctors, said Jim Owen, vice president of practice and science at the American Pharmacists Association.

The law has helped move New York doctors’ ability to e-prescribe painkillers leaps and bounds ahead of other states, or five times the national average, according to data from electronic prescription network Surescripts LLC.

But most states in the country barely have the ability to e-prescribe substances such as prescription painkillers.

While doctors’ ability to e-prescribe has swelled in the U.S. over the last decade, controlled substances are a different story: states topped out at about 7% of such transactions in 2014, with the bulk of states at 1% or even less, according to Surescripts, which handles a majority of such business in the U.S.

Why such dismal numbers?

For one, controlled substances are involved so the standards for electronic software and requirements for physician authentication are high per Drug Enforcement Administration rules.

Nearly three-quarters of pharmacies have met those standards. The discrepancy is on the white coat end: Only 1.40% of providers were equipped to e-prescribe controlled substances in 2014, according to Surescripts.

Why are doctors lagging behind? Doctors say it’s not that they don’t want to e-prescribe but that implementation is more extensive and expensive a prospect.

“E-prescribing in the right circumstances is fast, efficient and liked by patients and pharmacists and physicians. But there are many circumstances where there are challenges,” said Dr. Steven Stack, president of the American Medical Association.Stack said he and others oppose a mandate, such as New York’s, because the newness of the technology means there are still kinks in the system and challenges to access. For example, the software can be challenging for small doctors’ offices to obtain, he said, and there are problems of doctor-pharmacy coordination.

Surescripts acknowledges that there’s no easy way to get an e-prescription transferred to another pharmacy if a patient’s choice of store is closed.

“With any technology, things improve the longer it’s used,” said Surescripts senior vice president Ken Whittemore, Jr. “There are some things we’ll have to work through.”

For controlled substances, where intense pain must be treated, that issue turns urgent, Stack said, which is why he believes e-prescribing currently works best for non-emergency medications, such as blood pressure or diabetes pills.

Some experts believe that the opioid epidemic was fueled by wider cultural acceptance of pain medications, so a change requires targeting those societal factors alongside improved treatment options and supporting prescription drug monitoring programs, Stack said.

“Electronic prescribing is just one piece of a much more complicated issue of the opioid epidemic,” he said.

New York and Minnesota both require e-prescribing, but it’s a voluntary process in most other states. (Minnesota’s mandate went into effect in 2011).

But with Massachusetts and Maine legislatures considering their own state requirements, New York’s move will be one worth watching.

“We obviously won’t know the true impact until we see what happens in New York,” said Owen.

Written by Emma Court of MarketWatch

(Source: MSN)

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