Electronic Prescribing A Pathway to Advanced HIT

1. Electronic Prescribing A Pathway to Advanced HIT? Douglas S. Bell, MD, PhDRAND HealthDavid Geffen School of Medicine at UCLA Thank you, _____. It�s really an honor to be here and to share with you the work we�ve done and that we�re now doing on electronic prescribing systems. Thank you, _____. It�s really an honor to be here and to share with you the work we�ve done and that we�re now doing on electronic prescribing systems.

2. What Is �Electronic Prescribing?� Providers� use of computer systems to generate or renew prescriptions A type of computerized physician order-entry (CPOE) May be part of an electronic health record (EHR) vs. stand-alone e-prescribing system �e-prescribing� is a synonym doesn�t necessarily imply online (internet) systems First, let�s DEFINE what we mean by electronic prescribing. It�s: Providers� use of computer systems to generate or renew prescriptions. So these are systems that providers use, which means we�re not talking about back-end systems, like the point of sale systems, that pharmacies run. I�ll be using �E-prescribing� often as a synonym for this concept. So when you see the �e� don�t think that I mean anything more specific, than just any use of computers to actually generate prescriptions. First, let�s DEFINE what we mean by electronic prescribing. It�s: Providers� use of computer systems to generate or renew prescriptions. So these are systems that providers use, which means we�re not talking about back-end systems, like the point of sale systems, that pharmacies run. I�ll be using �E-prescribing� often as a synonym for this concept. So when you see the �e� don�t think that I mean anything more specific, than just any use of computers to actually generate prescriptions.

3. E-Rx: A Focus for Transformation Safety: Medication errors are prevalent Costs: Pharmaceuticals a growing component of health care costs Office efficiency Rx management inefficient for most MD offices e-Rx may be easier to implement than full EHR A step toward EHRs So eRx can improve errs But beyond medication errors, an entry point, like a start drug that hooks them in on hit Leads ultimately to the hard stuff So eRx can improve errs But beyond medication errors, an entry point, like a start drug that hooks them in on hit Leads ultimately to the hard stuff

4. Risks of Harm from Outpatient Prescribing This is the potential payoff. (was seen as low-hanging fruit )This is the potential payoff. (was seen as low-hanging fruit )

5. Talk Overview Design theory: How does it work? Review RAND�s expert consensus recommendations for e-prescribing Variance in implementation among systems MMA-mandated pilot studies Testing 6 �initial� standards that support advanced e-prescribing features

6. Design Theory E-prescribing Featurese.g. DDI alerts, formulary info, electronic transmission enable Change in prescriber work processes produce Changes in drug use Appropriateness Costs (patients�, payors�) Patient adherence produce Health outcomes