E-Prescribing Impact on Patient Safety, Use, and Cost (Massachusetts)
The purpose of this project was to evaluate the effects of a natural experiment in e-prescribing on uptake, and the impact on cost, safety, and quality. Approximately 7.4 million filled prescriptions, over 212,000 of which were e-prescriptions, were included in the study. Over 35,000 clinicians and over 1.5 million patients were identified with a filled prescription claim. Of these 1,198 clinicians wrote one or more e-prescription that was filled by 64,749 patients. To conduct the study, a pre-post with concurrent controls method was used, utilizing data from the deployment of an e-prescribing program by two large insurers in a northeastern state. Data on paid medical was used and pharmacy claims data coupled with data from the e-prescribing vendor to identify filled prescriptions written / not written during our study period (2003 through the first quarter of 2005). These data were used to evaluate prescribing for each physician in our sample before and after they began e-prescribing. Evaluation of e-prescribing uptake showed steadily increasing use of e-prescribing over the study period. E-prescribing with formulary decision support led to the use of lower-priced medications. Early results also indicated that patients getting e-prescriptions had less severe potential drug-drug interactions among their dispensed medications.