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Why drug stores are high on electronic prescriptions

Although the vast majority of U.S. pharmacies can handle “e-prescribing” of medication, most doctors still scribble them and hand them off to patients for dispensing. Drug-store chain CVS Health and healthcare technology company Surescripts are pushing to close that gap, and a new law in New York could help their cause.

The legislation, which takes effect March 27, requires electronic prescriptions for controlled substances—like codeine, hydrocodone, oxycodone or valium. No, faxed copies of handwritten orders don’t count.

E-prescribing of these drugs is legally allowed in almost every state (except for Montana and Missouri), but New York is the first to make it mandatory. The motivation is pretty simple: rampant abuse that makes these substances deadlier on an annual basis than cocaine and heroine, combined. “This is the part of the system that faces the most challenges in terms of fraud,” said Surescripts CEO Tom Skelton, when I spoke with him in late December.

Today’s Surescripts was formed when it merged in 2008 with RxHub, a rival e-prescribing network created by CVS Caremark, Express Scripts, and Medco Health Solutions. It processes approximately 7 billion “transactions” per year, including messages sent between member healthcare organizations, searches of medication histories, and e-prescriptions.

Notes CVS Health Senior Vice President Josh Flum: “Our retail pharmacies were early adopters of electronic prescribing and all of our 7,800 are enabled to receive electronic prescriptions, which is an important tool for reducing incidences of fraudulent controlled substances being presented at the pharmacy.”

Surescripts links more than 93% of all U.S. pharmacies, including CVS, Walgreens, and the departments found in many large retailers and grocery stories such as Walmart. It also has relationships with benefits companies like Aetna and Anthem. During 2015, the company figures it will communicate at least 5 million prescriptions for controlled substances—a 400% increase over 2014. Electronic health records software companies like Practice Fusion and athenahealth offer this feature as part of their systems.

The potential side effects of e-prescriptions? Surescripts cites figures suggesting that they can help reduce adverse drug reactions by more than 60%, by flagging pharmacists when a new medication may contraindicate another drug. Physicians stand to reduce paperwork filing costs, while pharmacies can expect a reduction in abandoned prescriptions.

“We are the intelligence within the network,” Skelton said. “We have made substantial progress, now the goal is to go broader.”

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