EHR Interoperability for Prescription Management

October 1st, 2012 /
Vikram Maindan
/ 3 Min Read

Interoperability has long been a cornerstone of health information technology. The goal of digital healthcare systems such as electronic health records, telemedicine, and e-Prescriptions, is ultimately to develop a cohesive structure to provide patient care. The first step is to take into account the biggest issues healthcare is currently facing, for example, medication adherence.

Last week, reported on the state of e-Prescribing across the United States. Many states are beginning to mandate use of e-Prescription technology. Minnesota has had a mandate in place since 2011, New York’s mandate has been effective for almost a year, and Maine’s law will become effective in 4 months. Pennsylvania, Connecticut, and Virginia have all followed the example and proposed similar legislation in the past two months.

One of the biggest issues e-Prescribing technology can help with is medication non-adherence. A lack of medication adherence can negatively impact the entire healthcare industry. A report from the New England Healthcare Institute states that non-adherence “could result in as much as $290 billion per year in avoidable medical spending or 13 percent of total health care expenditures.” The interoperability between electronic health record (EHR) software and electronic prescriptions gives providers the ability to track and monitor patient prescription fills, usage, and adherence conveniently with various features in their EHR.

EHR Interoperability Tracks Prescription Usage

The accidental overdose of prescribed and over-the-counter acetaminophen ranks as the number one culprit of chemical-driven liver damage. Acute liver failure due to acetaminophen might most frequently begin in the place where people go to get well: the hospital. The integration of e-Prescriptions with EHR software allows for tighter medication tracking, which could contribute towards preventing the problem of acetaminophen-related liver failure occurrences from hospital stays.

To determine the frequency of liver toxicity occurrence, a study was conducted in two Boston hospitals by the Partners HealthCare System, Inc. that examined the EHRs of 23,750 adults treated by the hospitals to see how much aggregated acetaminophen they took during their stay.  The calculations from the EHRs revealed that 955 patients were given more than the recommended maximum daily dose (4 grams) in a 24 hour period, including over 20 percent of elderly patients, and sometimes on more than one occasion. Luckily, none of the patients in the study experienced liver failure from the overdose.

The eye-opening results of the study triggered the researchers to call for the need to enforce the use of electronic medical record software to monitor aggregate dosages of acetaminophen given to patients by healthcare providers. Through the advancement of health information technology, physicians and nurses can enter the dosage, the name of medication and the time administered; when the patient is about to exceed the maximum recommended daily amount of acetaminophen, the healthcare provider will be alerted to avoid an overdose.

EHR Prescription Management Features

The features offered by PrognoCIS EHR to simplify prescribing and medication management include:

e-Prescriptions: e-Prescription systems allow providers to send prescriptions directly to a patient’s pharmacy electronically. This is much easier than writing out a paper prescription that may be difficult to read or that the patient might forget to fill. Electronic prescribing also enables quicker refill requests, which can be done easily through a Patient Portal.

Electronic Prescribing of Controlled Substances (EPCS): A common problem with prescriptions is misuse of controlled substances, which providers were unable to prescribe electronically. That is, until the advent of e-Prescription of Controlled Substances, which is now allowed in all 50 states. This allows providers to safely send prescriptions for DEA-class drugs.

Medication Management for Adherence: The Medication Management for Adherence feature from Surescripts is now integrated with PrognoCIS EHR to simplify prescription management for both patients and providers. Medication Management for Adherence uses data directly from Pharmacy Benefit Managers and sends them to the EHR so providers can track prescriptions, side effects, and non-adherence.

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