Prescriptions move from scrawl to the send button

Nothing starts a rant against the nation’s health-care system like contact with said health-care system.

Last week, I filled a prescription for my daughter’s lingering cold and was again staggered by the inefficiency. The doctor scrawls on a piece of paper, hands me the paper. I go to the pharmacy, hand the pharmacist the paper and wait – 15 minutes in my case – as the pharmacist tracked down a four-day supply of Zithromax.

Now why can’t this be done electronically – the physician emails the pharmacy, and the prescription is waiting for me? Well, it can, and if current trends continue, e-prescriptions will soon become part of everyone’s life.

The number of doctors using e-prescriptions has roughly tripled since 2008, according to Surescripts, the biggest vendor of e-prescription systems, to 200,000 today from roughly 74,000.

The technology isn’t earth-shattering. There’s obviously the classic network problem – no one wants to join until everyone has joined. And you need protections to ensure that the prescription is sent by a doctor and not a drug abuser. But the process needs no more security than, say, a credit-card transaction.

Still, two-thirds of doctors use the paper system, the equivalent of the old credit-card knuckle-buster. When was the last time you saw one of those?

If you aren’t sure what a knuckle-buster is, well,  to describe it would force me to describe carbon-paper, which you’ve probably also never seen. But that’s my point. The humble doctor’s office, like many small businesses (including mine), is slow to embrace new technology. Some offices probably use pneumatic tubes – ask your grandparents about them.

That hesitation hurts the system in small ways, like prescriptions. E-prescription vendors emphasize how they will minimize prescription errors, but as far as I can tell, these are quite rare. The doctor gains because it’s faster to write an e-prescription. The patient spends less time waiting for the prescription to be filled. The system gains because, research indicates, people are more likely to pick up an e-prescription, which reduces the spread of disease.

It took carrots and sticks buried in the 2009 stimulus package to move things along. The feds subsidize the movement to e-prescriptions until 2015. After that they threaten penalties for not having it.

Obamacare is filled with carrots and sticks like this – encouraging electronic medical records is the best-known, and the savings potential for those dwarfs the – in my opinion – puny benefits e-prescriptions promise. But it’s important to remember that in scoring costs, the CBO and Medicare’s Office of the Actuary give no credit to these productivity incentives, since despite the obvious potential there’s no proven basis for scoring them. Scroll down to page 147 of this tome (“Adopting Health Information Technology”) for some light reading on the subject.

So if you read about projections of health-care costs, remember there are additional savings baked in.

(Via Business Insurance.)


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