Changing Behavior through Electronic Prescribing
One of the greatest challenges facing the health care system is how best to influence and change both individuals’ and clinicians’ behaviors. Over the past 50 years, whole industries have sprouted up around exercise, nutrition, obesity control, and smoking-cessation programs. Despite notable set-backs — especially with obesity — tobacco use has declined by 55% over the last 50 years (sidenote: did 42 percent (!) of American adults really smoke in 1965?) and greater attention is now paid to health and wellness than ever before. While progress has been incremental, the trend lines are encouraging.
In a similar way, health insurance plans, large employers, and public programs have spent the past several decades working hard to align incentives in benefit design, including pharmacy benefit design. This work has taken many forms, including expanded use of generic alternatives; new pharmacy options, such as the mail-service pharmacy option; and the expanded use of electronic prescribing.
With that in mind, a recent article about a new e-prescribing study caught our eye. The study found that most doctors surveyed [close to 75% ] indicated that e-prescribing makes them pay more attention to patient costs when they prescribe. While the sample of physicians surveyed was small, the implications are tremendous. For too long, many patients and their prescribing physicians have been disconnected from one another about the cost side of the equation. If e-prescribing can help introduce cost-effectiveness discussions into the examination room, that is important progress and one more reason for cash-strapped state and federal governments, along with private payers, to embrace e-prescribing. E-prescribing systems also often will alert the physician if a less-expensive generic version of a prescribed drug is available.
Last year, we wrote about e-prescribing and the benefits that sophisticated e-prescribing models can provide. History shows that to change behaviors, especially in health care, requires a comprehensive and tenacious approach that spans the spectrum. Since e-prescribing allows a physician to see a patient’s complete prescription drug history, better decisions can be made, especially for patients with multiple conditions. The good news is that e-prescribing is taking us in the right direction by reducing costs, improve adherence, and allowing for better medical outcomes.