New report: Upstate Is Ripe with Opportunities to Save Lives, Time and Money with E-prescribing

Upstate New Yorkers could potentially avoid more than 2 million adverse drug events if all physicians in the region started using e-prescribing systems, according to a new report issued today by Excellus BlueCross BlueShield.

“Based on numerous national studies, our analysis of upstate data shows that e-prescribing holds the potential to annually prevent 35 deaths, 160 permanent disabilities, 400 hospitalizations and 3,000 physician office visits,” said Arthur Vercillo, M.D., regional president, Excellus BCBS. “Right now, about 17 percent of prescriptions are sent electronically, but we’re on the verge of seeing explosive growth that will save lives, time and money.”

In 2009, the number of prescriptions sent electronically in the United States exceeded 190 million, an increase of 181 percent over the previous year. Nationally, 85 percent of pharmacies, including many of the largest mail-order pharmacies, were able to receive e-prescriptions in 2009.

In the first quarter of 2010, according to the Excellus BCBS report, 65 percent of prescriptions were still handwritten or printed on paper, while 18 percent were telephoned or faxed to the pharmacy. Rapid change is under way, as e-prescribing systems become more affordable and government incentives for providers to adopt the technology are more readily available.

The federal government’s economic stimulus package included $20 billion to encourage doctors and hospitals to invest in health information technology infrastructure. New York state’s Medicaid program and the federal government’s Centers for Medicare & Medicaid Services also offer financial incentives for providers to adopt health information technology.

“In the case of CMS, it’s first a carrot and then a stick,” said Vercillo. “The CMS incentive for providers to use e-prescribing will gradually be reduced. Beginning in 2012, there will be a penalty for providers who don’t successfully e-prescribe.”

The Excellus BCBS study, “Trends and benefits of electronic prescribing in upstate New York,” notes that nationally at the end of 2009, about 25 percent of prescribers routed prescriptions electronically, which is more than double the percentage from the previous year. In Central New York, an estimated 22 percent of physicians e-prescribe and 17 percent of physician assistants and nurse practitioners e-prescribe.

For patients, e-prescribing offers convenience on top of safety. During an office visit, a prescriber can direct a prescription to any pharmacy the patient chooses with just a click.

“Handwritten prescriptions can lead to errors that can potentially put patients at risk and also waste time and precious health care dollars,” said Vercillo.

Instructions are clear with e-prescriptions, which reduce the number of callbacks from the pharmacy to doctors’ offices. An estimated 30 percent of prescriptions that are not e-prescribed require a callback, including for clarity and missing information.

Handwritten prescriptions can also be forged. In a statement submitted to a U.S. Senate hearing on the e-prescribing of controlled substances, the American Pharmacists Association wrote that e-prescribing could advance the Drug Enforcement Administration’s goals of preventing illicit prescribing, doctor shopping and drug diversion.

E-prescribing technology can include a clinical decision support function that issues alerts about dosing recommendations and checks for drug allergies, drug-drug interactions and duplicate therapies. It also can alert prescribers to money-saving opportunities with generic or other lower-cost alternatives to prescription drugs.

“If e-prescribing alerts raised the generic fill rate by just 1 percent, health care spending in upstate New York could be reduced by more than $64 million a year,” said Vercillo. “That includes $14.2 million saved just in Central New York.”

There are millions of opportunities to save because in 2009 in upstate New York:

• 21.1 million new and renewal prescriptions were filled.
• Two-thirds of the population used at least one prescription drug.
• 25 percent used six or more different drugs.
• 5 percent used 13 or more different drugs.
• 25 percent had three or more different prescribers.
• 5 percent had six or more different prescribers.

A 2008 survey of upstate New York providers conducted by Excellus BCBS had 88 percent of respondents who e-prescribe report positive feelings about e-prescribing’s ability to provide patient care.

“The sooner all physicians convert to e-prescribing, the better for all health care stakeholders,” concluded Vercillo. “That’s why it’s a good idea for everyone to ask his or her doctor, ‘Do you e-prescribe?’”

To view the complete report on e-prescribing, go to