Phil Walls, RPh
Chief Clinical Officer
Electronic prescribing, or e-prescribing, is the practice of using computers to generate, transmit and process a prescription. This rapidly evolving technology, replacing traditional paper and fax prescriptions, has received extra attention in the wake of the pandemic and is expected to continue gaining market share. myMatrixx has integrated e-prescribing and digital provider engagement technology into our workers’ compensation pharmacy program and it is an integral part of our online adjudication system. E-prescribing, along with point-of-care actionable data, represents technology that is positioned to change the practice of both medicine and pharmacy and myMatrixx is well prepared as an organization for this transition.
As part owner of Surescripts, the nation’s most trusted and capable health information network that facilitates prescribing and clinical messaging through electronic health records (EHR), myMatrixx, an Express Scripts company is uniquely positioned to maximize the use of electronic prescribing, increasing efficiency, accuracy and patient safety for injured workers. According to a fact sheet published by the Office of the National Coordinator for Health Information Technology, e-prescribing improves workflow, increases patient safety and facilitates drug price transparency. It is also an essential component to accelerating the adoption of electronic health records and building a national IT infrastructure. We also firmly believe e-prescribing will play a key role in the ongoing battle against the opioid misuse epidemic.
Challenges and opportunities for e-prescribing in workers’ compensation pharmacy
As reported in our 2020 Drug Trend Report, 55.9% of all myMatrixx prescriptions were transmitted to the pharmacy utilizing electronic prescribing. Although that number represents a 7.6% increase over 2019, it indicates that workers’ compensation lags behind the 80 to 86% rates typically reported for group health. This is primarily due to the high percentage of controlled substances seen in workers’ compensation, a category of drugs which has lagged behind adoption of e-prescribing. However, we predict that will change in 2021 with the implementation of the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, which requires e-prescribing for all opioids and controlled substances dispensed to Medicare Part D recipients, and regulations by over half of all states requiring similar adoption. As workers’ compensation follows suit, this gap will narrow substantially.
Increased adoption of e-prescribing will also pave the way for the transfer of clinical interventions from the point of dispensing to the point of prescribing. In fact, myMatrixx has already moved many formulary decisions to the point of prescribing for many of our clients, improving the injured patient experience at the pharmacy counter by eliminating prior authorization delays. It is important to note that myMatrixx clients may utilize multiple formularies, including state-specific, phase of care, and client-specific formularies. Therefore, there will be instances where prior authorization may still be required at the pharmacy. If prior authorization is necessary, our technology supports an automated prior authorization process that follows our intelligent routing algorithm to immediately send an email to the claims professional or other designated party.
Increasing prescriber awareness of programs that promote patient safety and better outcomes
Through our e-prescribing program, myMatrixx is poised to move even more clinical decisions to the prescriber, enhancing patient safety and streamlining the dispensing process. This can ensure that prescribers are aware of key information and clinical interventions while they are still with the patient. For example, prescribers may be alerted to step therapy opportunities, dangerous drug interactions like opioids and benzodiazepines, duplicative prescriptions among multiple prescribers and many other concerns.
Perhaps the single biggest advantage of e-prescribing to workers’ compensation pharmacy is eliminating dangerous drugs at the point of service — before they are prescribed — and expediting care to the injured worker. This is particularly effective for curbing the practice of prescribing combinations of opioids and benzodiazepines. Both drug classes carry the risk of abuse, and concomitant use can result in increased risk of overdose resulting from additive respiratory depression. With enhancements to e-prescribing, we will essentially be augmenting the intent of the state prescription drug monitoring programs and physicians will be able to quickly identify potentially life-threatening combinations like these and avoid sending the prescription to the pharmacy.
As we continue to implement and expand our e-prescribing program, the myMatrixx clinical pharmacy team will be working to ensure that it maximizes the benefits for both the injured workers and clients we serve.