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Independence Blue Cross Launches E-Prescribing

In an effort to reduce prescription errors, Independence Blue Cross is sponsoring an electronic prescription pilot based on hand-held technology for physicians.

By providing hand-held computers, software and training to 500 participating southeastern Pennsylvania and New Jersey physicians as part of a pilot initiative called e-Prescribing, Independence Blue Cross (IBC; $9.7 billion gross 2004 premium) aims to offer a more convenient and cost effective way of filling and refilling prescriptions while reducing the risk of adverse drug interactions or allergies, according to Steven Udvarhelyi, chief medical officer at IBC.

"Prescription errors are an unnecessary cost, and we benefit by eliminating errors," Udvarhelyi explains. "Helping the physician understand what they are prescribing should also help moderate the cost increase of prescription coverage."

According to Udvarhelyi, the e-Prescribing initiative, which has been in development for five years, fits within IBC's commitment to help build a statewide electronic patient data network throughout Pennsylvania, as a participant in the Pennsylvania eHealth Initiative, a collaboration of over 40 healthcare-related organizations in the state. The program also fits within the effort to establish a nationwide electronic medical record system, adds Udvarhelyi.

The 500 physicians participating in the program use Dell (Round Rock, Texas) Axims to prescribe medications. The pocket PCs work on a Microsoft (Redmond, Wash.) Windows platform and interface with a secure Web-based server at either Zixcorp (Dallas, Texas) or Allscripts (Chicago). The information from the prescription is then transferred to RxHub (St. Paul Minn.), an electronic card catalog. "RxHub indexes patients by their name, date of birth, gender and zip code, and then finds the insurer that handles the prescription coverage," says Ninette Swanson, systems analyst and manager of e-Prescribing at IBC.

RxHub locks into IBC's system and then, based on claims history, supplies the doctor with a list of medications the patient has been taking. With all the information about the patient at his fingertips, the physician can prescribe a medication to fit the patient's needs. "This system will also give physicians information about formularies and generics that are known to be as effective as brand drugs at a much-reduced cost," says Udvarhelyi. RxHub is also designed to alert the doctor to allergy or drug interactions. The program also relieves the pharmacist of any handwriting discrepancies. "When the doctor hits the send button, the prescription is electronically sent to the patient's pharmacy," says Swanson. "Physicians can also do prescription refills easily with this program." IBC invested one million dollars into the program, hoping to steer physicians toward using technology as part of their daily routine. IBC will collect data from the pilot to see if such an endeavor will be successful at a statewide use. "The key pieces of information that we are getting about the doctors behaviors with the system will provide us with data to enhance the process," says Swanson.

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