RAND to Lead Research Team Probing Adequacy of Standards for Electronic Drug Prescriptions

A coalition led by the RAND Corporation has been selected by federal officials to conduct pilot tests of electronic drug prescribing technology designed to help eliminate paper prescriptions and improve patient care.

The $1.85 million project will evaluate standards for electronic prescribing proposed by the U.S. Department of Health and Human Services (HHS) for transmitting prescriptions and related information electronically between doctors, pharmacies and prescription drug plans.

The RAND-led effort will evaluate experiences with electronic prescribing among 1,000 physicians who are participating in an e-prescribing an initiative created by Horizon Blue Cross Blue Shield of New Jersey.

“We will be evaluating a number of standards designed to safeguard patients' health and to improve the efficiency of the prescribing process,” said Dr. Douglas Bell, a RAND researcher and principal investigator of the project. “By testing whether the proposed standards deliver on this promise, we will help HHS and Congress decide whether these standards should be required for e-prescribing under the new Medicare prescription drug benefit.”

The evaluation will take place within the New Jersey E-Prescribing Action Coalition. The industry-academic partnership involves RAND Health, Horizon Blue Cross Blue Shield of New Jersey and the e-prescribing vendors AllScripts, Caremark iScribe, and InstantDx. Other partners are: the electronic prescribing information exchange companies RxHub and SureScripts; Caremark's mail-order pharmacy; Walgreen's retail pharmacies; the University of Medicine and Dentistry of New Jersey; and Point of Care Partners, a consulting group that has led standards development efforts for electronic prescribing.

Standards that the project will evaluate include those for transmitting patient medication histories, lists of drugs covered by insurance companies, and benefit information. In addition, the effort will evaluate standards for informing prescribers when a prescription is filled, obtaining prior authorization for certain medications from insurance plans, standardizing patient instructions and other technical issues.

The standards may improve patient care and reduce medication errors by simplifying the review of patient drug histories and by standardizing patient instructions, among other things.

The project is supported by a cooperative agreement with the U.S. Agency for Healthcare Research and Quality as part of an effort to test e-prescribing standards proposed for Medicare. The new Medicare Part D drug plan for seniors encourages physicians to transmit new prescription and refill requests electronically.

RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care quality, costs and delivery, among other topics.