G. Cameron DeemerHealthcare industry finance leaders face challenges today ranging from navigating an ever-evolving regulatory environment and risk-based payments to responding to the increased focus on America’s opioid epidemic. These factors are affecting how hospitals operate and how physicians care for patients, making it increasingly difficult for finance leaders to determine which initiatives to prioritize. Many of these issues are closely connected to digital technology, and this is especially true of electronic medication management. Until recently, mobile medication management was lagging, which also has had an influence on adoption and utilization of e-prescribing technology. 

A major pharmacy chain recently reported still receiving 40 percent of its prescriptions on paper or via the phone. Although the vast majority of clinicians are now e-prescribing, prescriptions continue to be issued non-electronically in part because of situations that make it difficult or inconvenient to access providers’ primary health information or electronic health record (EHR) systems. Eliminating this remaining 40 percent is important not just because it will enable electronic prescribing to deliver on its promise of reducing errors and adverse events, but also because it dramatically improves provider and pharmacy workflows. 

The cost-saving advantages of e-prescribing are well documented. One study found that new e-prescriptions took 26.6 percent less staff time to process than manual prescriptions, leading to an estimated cost savings of 97 cents per prescription. Separately, a study published in Perspectives in Health Information Management reported that e-prescribing had a positive effect on patient safety: medication error rates decreased from 42.5 to 6.6 per 100 prescriptions. 

Fighting Opioids

For a mobile system to be effective, it must not only provide effortless prescribing of legend drugs; it must also ensure that controlled substances can be carefully managed. Hospitals and providers currently have an acute focus on fighting America's surge of opiate addictions and deaths. A mobile medication management system connected with a state prescription drug monitoring program (PDMP) can be an important tool for providers. Before prescribing opioids to patients, providers can use the tool directly within their prescribing workflows to access data from a state’s registry, disclosing whether the patients have histories of opioid use. The convenience of not needing to take extra steps to use a separate PDMP website increases the likelihood that clinicians will check the registry, avoiding penalties in states where such a check is mandated

A single e-prescribing process for legend drugs and controlled substances with PDMP access also improves efficiency. Studies have shown that the combined workflow makes the prescribing process up to three times faster than separate workflows for controlled and noncontrolled drugs. As more states require e-prescribing of controlled substances (EPCS) and PDMP queries, this kind of mobile medication management can streamline the process of regulatory compliance.

Mobile Advantage

In addition to helping clinicians identify potential addiction issues and prevent fraudulent opioid scripts, a robust mobile solution delivers the well-known benefits of electronic prescribing: improved legibility and reduced prescription abandonment. It also gives clinicians better insights into a patient’s medication therapy. When this kind of app is integrated with an ambulatory care or hospital EHR, it can be used to automatically update patients’ medication histories. The EHR can deliver demographic information to populates the mobile app, reducing the amount of work that a physician must do in prescribing. Mobile medication management also can improve drug adherence, which has a significant effect on patient outcomes, and it can reduce first-fill abandonment. Today, in part because of rising drug costs, patients do not fill about 25 percent of new prescriptions, which has a serious impact on their health and wellness. 

If a mobile medication management solution is closely integrated with health plans and pharmacy benefit managers (PBMs), providers can view medication costs during the e-prescribing process. This drug price transparency can form the basis for a dialog between the provider and patient. As a result, the physician may prescribe a lower-priced but equally effective medication that the patient is more likely to pick up at the pharmacy.

In short, mobile medication management gives clinicians the convenience and immediacy of a paper prescription pad and greater efficiency than the phone along with features that can improve organizational performance and patient outcomes. Drug price transparency improves medication adherence. A built-in link to state PDMP registries makes it less likely that doctors will prescribe opioids to those already addicted. And a single workflow for the prescribing of legend drugs and controlled substances saves time—a commodity that doctors can always use. 

Finance leaders play a critical role in these initiatives. They can help to pave the way for embracing mobile medication management by better understanding the cost and efficiency benefits and rallying the leadership team with return on investment guidance. This in turn can be the impetus in organizational adoption and utilization with the end goal of improving patient safety, promoting provider satisfaction, and enabling a more informed and efficient clinical team. 


G. Cameron Deemer is president of DrFirst, Rockville, Md. 

Publication Date: Monday, December 10, 2018