eRx Bogged Down

I started using electronic prescribing several years ago, and, despite flaws, which have diminished over time, I believe it to carry less risk of error and much greater efficiency. For a while it seemed that most pharmacies were moving toward adoption, but if anything it seems that some have reversed course. Almost all pharmacies accept electronic orders, but fewer seem to send requests for refill authorization electronically. In the past few weeks I have received electronic requests from Top Food Pharmacies and Rite-Aid. I have also received requests from Safeway, but they seem to have stopped. A pharmacist at one store in a chain may tell me the chain has not yet implemented eRx even though I have received such requests from other stores in the same chain. Can a chain really have implemented eRx on a store by store basis? More likely they have simply failed to educate their pharmacists.

The failure of most vendors to implement eRx of controlled substances continues to limit the overall efficiency of the technology despite approval by DEA as long ago as two years. I know of only one vendor having adopted this late last year, but mine, Practice Fusion, has not. This means I still need two separate systems to track and record prescriptions and refills. It also means I still must use paper prescriptions or telephone, both of which I believe to be more vulnerable to fraud and error.

My vendor has only recently implemented (apparently) formulary status check when using eRx. This could help avoid the shock of high copay or required prior authorization, but I have yet to try it.

Speaking of prior authorization, eRx could dramatically increase efficiency. Recently I pursued prior authorization from Medco involving numerous faxes. Ultimately it seems that reimbursement hinged only on whether I prescribed the drug for smoking cessation. Instead of all the faxes and finally a phone call, I should have been able to simply check a box during the initial order.

eRx is not perfect, but with so much potential we should aim for complete conversion in months, not years. Maybe if a large enough number of physicians simply blocked fax requests...

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