Electronic Prescribing (eRx) Initiative
Electronic Prescribing (eRx) Overview | PCIP's eRx Pilot | Future Expansion
Electronic Prescribing (eRx) Overview
Electronic prescribing (eRx) refers to the use of computing devices to enable real time access to patient medication histories and send prescriptions directly to pharmacies electronically.
Research has shown that adverse drug events (ADE) are extremely common in ambulatory settings and have serious consequences. According to the Center for Information Technology Leadership (CITL), more than 8.8 million ADEs occur each year in ambulatory care, of which over 3 million are preventable i. Medication errors account for 1 out of 131 ambulatory care deaths ii.
eRx is point of care technology that provides decision support tools that can help increase patient safety by reducing preventable medical errors. This includes reducing medication transcription errors, drug to drug interactions, drug to allergy reactions, dosage errors and drug to indication errors.
PCIP's eRx Pilot
PCIP has launched a pilot project to gain insights into the workflow change, as well as efficiency and safety gains from eRx implementation. Clinical Director's Network (CDN) is the subcontractor in the project.
Four Federally Qualified Community Health Centers (FQHCs) are participating in the pilot: Morris Heights Health Center (Bronx), Joseph P. Addabbo Family Health Center (Arverne), Brownsville Multi-Service Center for Family Health (Brooklyn), and Community Health Network (Manhattan). AllScripts® was selected by CDN through a competitive process to provide the eRx system and technical support based on their product, market share, and experience working with FQHC.
All physicians participating in the pilot are provided PDAs (see www.eClinician.org) preloaded with the eRx software free of charge. Prior to scheduled go-live dates, participants will also receive in-person instructions on general PDA use, and a 3-day onsite training on eRx software use.
During the pilot phase, Allscripts® will provide monthly summaries of eRx usage to DOHMH and CDN. Pre- and post-usage survey tools, developed by Columbia University Dept of Biomedical Informatics, will measure provider satisfaction and identify barriers to eRx adoption in pilot sites. The pilot will be rolled out in a stepwise fashion to the four sites.
Future Expansion
Using lessons learned from this pilot project, PCIP plans to expand eRx use to 2,100 primary care clinicians over the next 3 years. PCIP will:
- • Select an eRx software vender through competitive RFP (Request For Proposal) process
- • Generate awareness through detailing at small practices and community health centers (PCHIC process)
- • Conduct pharmacy outreach to ensure adoptability for eRx receipt
- • Engage in state and national processes to overcome regulatory challenges
- • Focus on formulary and medication history of Medicaid and the uninsured population
- • Engage insurers and other stakeholders (e.g. Agency for Healthcare Research and Quality, IPRO), and demonstrate value to ensure sustainability
i Center for Information Technology Leadership. The value of computerized provider order entry in ambulatory settings. 2003.
ii Institute of Medicine, Committee on Quality in Healthcare in America. To err is human: building a safer health system, Washington, DC, National Academy Press; 1999.
