Big trends can sometimes take centuries or even millennia to develop. Think about how long it took between the dawn of anatomically modern humans and the adoption of agriculture. Health care is no different, having come a long way since the days of bloodletting and the assorted quackeries that were once considered acceptable medical practices.
But there’s one trend in health care that has happened with astonishing speed, particularly in the United States: the adoption of electronic prescribing. According to the latest numbers from e-prescribing network Surescripts, there were 16,000 office-based prescribers who had adopted e-prescribing in 2006. Within two years, that number climbed to 74,000, but that still represented only 12% of the total. By 2011, however, that number had reached 390,000 — 54% of all prescribers in the country. The numbers from the pharmacy side have increased even faster. In 2008, 46,000 pharmacy retailers, or 76%, were set up for e-prescribing; in 2011, it was 56,900, or 91%. Of those, chains have adopted the technology to the greatest degree, with 98% of chain pharmacies using it, compared with 79% of independents. According to Surescripts, of the 62,461 community pharmacies in the United States, 64% are part of a chain, while 36% are independents.
One case in particular is Walgreens, which in March announced a program with Surescripts whereby it would send immunization records directly from Walgreens and Duane Reade stores, and Take Care Clinics, to primary care providers using Surescripts’ Clinical Interoperability services, with plans to share immunization data with public health authorities starting later this year.
Currently, the percentage of prescriptions transmitted electronically remains relatively small: In 2011, 570 million prescriptions, or 36%, were sent electronically — but compare that with 2008, when that figure was 68 million, or 5%. The reason for the discrepancy, according to Surescripts, is that actual use of e-prescribing tends to lag adoption, with the most recent adopters among prescribers using it less than those who adopted it in earlier years.
At the same time, adoption has been somewhat uneven when examined on a state-by-state level. So far, according to Surescripts, Massachusetts has seen the most comprehensive use of e-prescribing, while such states as Minnesota and Oregon have seen widespread use as well. On the other hand, adoption has been relatively light across Nevada and California, and appears almost nonexistent in all but a few portions of Alaska. Also, while e-prescribing is common in Dallas and Houston, it’s extremely rare, if not absent, in many other Texan counties, with Kansas, Nebraska and South Dakota showing similar patterns.
One major reason why e-prescribing has seen such dramatic growth is government incentives under the Medicare Improvements for Patients and Providers Act of 2008. According to a report released in February by the Centers for Medicare and Medicaid Services, nearly $271 million was paid to physicians as part of the eRx Incentive Program in 2010, an 83% increase over 2009, the first year of the program, when the program paid out $148 million. The payments went to 65,857 individual professionals and 18,713 practices. The CMS report also found that almost 700,000 professionals were qualified to participate in the eRx Incentive Program in 2010, compared with close to 669,700 in 2009.
At press time, CMS didn’t have complete data for 2011, but it found that by 2011, 160,959 eligible professionals, or 26.3% of those eligible, had submitted data for the eRx measure through claims.