The need to increase efficiencies, cut costs and decrease the potential for drug errors has motivated the nation's largest health-plan-owned manager of pharmacy benefits to provide SureScripts-RxHub connectivity to health professionals in Rhode Island.
The connectivity will allow physicians access both to a formulary and, with patients' consent, to patient medical information to determine at the point of care whether the patient's health plan will cover the cost of medications, said Marion Hague, assistant vice president of ancillary contracting for Blue Cross and Blue Shield of Rhode Island (BCBSRI), which covers more than 680,000 members.
"We want to make sure our physician community is sharing information in the most efficient way possible," Hague said. "One of the things we had heard anecdotally is that they wanted easier access to our formulary. We wanted to make sure that we weren't creating any barriers to e-prescribing, and this seemed to be a good way of eliminating any barriers."
Hague noted BCBSRI and WellPoint Rx have experienced a healthy partnership on other initiatives, such as the OTC [Over-the-Counter] Options Program, which enables prescribers to access the drug formulary, review the claims history, and see patients' existing medication regimens to determine whether an over-the-counter drug is an appropriate choice for the patient.
"When the pilot projects work well and the collaboration is successful, we are able to move onto another level," Hague said. "There was a good effort on OTC Options Programs, and now we have moved onto something more ambitious, the SureScripts-Rx Hub connectivity. Everyone at the Rhode Island Quality Institute agreed that legible prescriptions and eliminating medication safety errors would be the way to go."
The Rhode Island Quality Institute, an organization that involves senior health-care professionals such as hospital administrators, physicians, consumers, university educators, and leaders in public health, business and insurance, examines through various strategies the potential for improving health care.
The uptake of electronic prescribing requires facilitating prescriber access to information, Hague said. "Our own physicians told us that a lack of access to the drug formulary represents a barrier to e-prescribing. Having decision support tools further permits e-prescribing."
The new connectivity will see physicians equipped with handheld devices that allow them to contact a patient, obtain consent to review the medication history, determine whether the patient is eligible for a drug, and access the formulary to obtain a less expensive, generic, or alternative drug with a lower co-payment.
BCBSRI is tracking the use of electronic prescribing and will survey physicians to evaluate whether they are electronically prescribing and how comfortable they are with the practice, Hague said.
"It represents a change in their workflow and a financial investment on the part of physicians," Hague said, noting that physicians need to purchase software packages that facilitate electronic prescribing.
BCBSRI is also providing support for the development of electronic health records and offering financial incentive programs aimed at physicians to encourage prescription of generic drugs, Hague said.
Kristi Meyer, vice president of marketing and product development for Well Point NextRx, said that it is a common objective for WellPoint NextRx and BCBSRI to reduce safety errors in drug prescribing.
A study released in 2006 by the National Institute for Medicine found that medication errors injure 1.5 million Americans annually, and the cost of treatment in hospital for drug-related injuries was estimated to be $3.5 billion annually.
"This capability allows physicians to evaluate if a member is taking multiple prescriptions, and what the risks are for prescribing a new medication, such as interaction with another medication," Meyer said. "The safety is not just about miscommunication from errors," such as pharmacists not being able to read prescribers' handwriting, "but providing better information as the physician is working through the next step of therapy."
Meyer said WellPoint NextRx's relationship with BCBSRI has expanded over time to manage clinical programs with a mutual goal of cost containment.
Meyer described Rhode Island as being on the "leading edge" in the area of electronic prescribing. In 2006, Rhode Island ranked first in the nation as part of a nationwide ranking of electronic prescribing activity.
Currently, more than a quarter of physician-prescribers in Rhode Island use electronic prescribing, Meyer said, noting that uptake will accelerate rapidly.