SureScripts expands its national e-prescribing network to include long-term care

SureScripts (Arlington, VA), a widely used e-prescribing networking platform, has been on a kick for several years to connect with electronic health-record (EHR) systems, so that at least the transmission of prescriptions can flow from the physician to a pharmacy in SureScripts’ network; e-prescribing is one of the relatively few areas where interoperability occurs across providers, dispensers and payers of pharmacy benefits. With the addition of PointClickCare (Mississauga, ON), which says it is in use by 10,000 senior-care facilities in North America, SureScripts can now streamline the flow of prescription data for that part of healthcare.

According to SureScripts, e-prescribing is used by 95% of pharmacies and seven out of 10 office-based physicians, but long-term care has just 3% of prescriptions being handled digitally. In November 2014, the Centers for Medicare and Medicaid Services (CMS) rescinded its e-prescribing exemption for long-term care facilities, and now requires that they adhere to the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for electronic prescribing.

Over the past year or so, SureScripts (which is owned by the National Assn. of Chain Drug Stores, the National Community Pharmacists Assn., CVS Health and Express Scripts) has expanded its service offerings into electronic prior-authorization, the step necessary for many drugs before payers will agree to reimburse the provider and patient. That solution, called CompltEPA, connects five pharmacy benefit managers (PBMs) and 11 technology vendors, reaching 290,000 physicians nationally. In practice, e-PA systems are supposed to reduce the paperwork involved in getting patients on approved therapies; other service providers, including CoverMyMeds and Armada Health, offer their own e-PA solutions.

All this cross-connecting highlights the promise of EHR systems generally, which are supposed to make data exchange across healthcare providers more seamless, and thus reducing redundant testing, gaps in care coordination and the like. Frictionless data exchange, in turn, should improve market conditions for pharma manufacturers, who contend with difficulties such as poor medication adherence by patients, prescription abandonment, and reimbursement obstacles, even when their products have been prescribed by physicians. However, on the eve of next week’s HIMSS meeting (Chicago, Apr 12-16), the topics of “connected health” and interoperability will still be wrangled over by technology providers whose systems are not interoperable.