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Improving e-prescribing with integrated clinical decision support

The Allscripts Application Store helps instantly connect Allscripts clients with approved third-party applications and devices designed to improve productivity, deliver higher-quality care, engage patients in their own care and more.  Our goal is to help our clients make the most of their electronic health record (EHR) investment.

We currently have more than 60 solutions built for various Allscripts applications that tackle a wide range of healthcare challenges. One area where we’re seeing innovation growth is clinical decision support for electronic prescriptions.

The benefits of electronic prescriptions

According to the Office of the National Coordinator for Health Information Technology, electronic-prescribing (“e-prescribing”) adoption is growing in the United States. Between December 2008 and June 2012, the number of physicians e-prescribing with an electronic health record (EHR) increased by 41 percentage points. About half of U.S. physicians are now e-prescribing.

One of the biggest drivers of this trend is that e-prescribing is part of several core objectives of Meaningful Use. According to Stage 2 Meaningful Use criteria, clinicians should now enter most prescriptions electronically. This requirement recognizes that medication management is one of the key steps to reducing readmissions and adverse drug events, which are costly and potentially dangerous.

6 ways clinical decision support tools can improve e-prescribing

EHRs are a critical component to help clinicians manage prescriptions across the continuum of care. But to further improve patient safety, some prescribers are doing more than simple electronic medication management. They are integrating clinical decision support tools into the EHR’s medication management plan to help catch potential problems and reduce readmissions.

YouScript® Personalized Prescribing software, from ADP partner Genelex, is one of the tools available in the Allscripts Application Store. It enhances the EHR’s prescribing capabilities in six ways:

1. Improves risk assessment – Caregivers can assess the risk of side effects, drug-drug interactions and even how a patient’s genetics and medical conditions may interact with medications, also known as pharmacogenetics*. These factors can seriously impact the effectiveness of treatments and can help providers select the right medication for a situation.

2. Helps avoid readmissions – Reducing risk of adverse drug reactions can help reduce the number of readmissions, days in the hospital and unnecessary procedures. It’s estimated that 20% of all hospital readmissions are due to adverse drug reactions.

3. Reduces costs – A retrospective analysis performed by Genelex and the University of Kentucky’s Gill Heart Institute on a group of 400 patients showed that integrated clinical decision support could  save $230,000, prevent 20 adverse drug events and avoid eight potentially fatal incidents per year.

4. Saves time – By integrating medication management into an existing EHR, the software can automatically compile the patient’s medical information and run it through the clinical decision support tools. Caregivers don’t need to manually reconcile medication lists or memorize clinical information, such as drug-drug interactions.

5. Engages patient in medication managementStudies have shown that mutual collaboration helps increase patient satisfaction and improve adherence. Mobile apps can help remind patients about their medication, help them recognize side effects or advocate for changes in their medication regimen.

6. Manages population risks – Instead of analyzing each patient one by one, highlighting trends in a population can help flag patients who need a closer look. One risk analysis using the YouScript system showed that over 50% of patients could have unknown significant drug interaction risks and 40% have known risks that deserve extra review.

Real world implementation

Stone Run Family Medicine (Rising Sun, Md., U.S.A.) has been using Allscripts for more than seven years and is already seeing benefits from integrating YouScript.

“What’s exciting about YouScript integration,” said Dr. Joseph Weidner, a Stone Run provider, “is that we’re able to identify patients who would have a potential drug interaction at the point of care. Identifying whether a medication is going to put the patient at risk, or whether it’s going to be as effective as I would want, is important and useful information.”

Stone Run has also improved medication management beyond the point of care by monitoring its patient population and proactively contacting high-risk patients. To see a video of Dr. Weidner and learn more, visit YouScript at the Allscripts App Store.


* Editor’s Note: YouScript can help ambulatory practices integrate pharmacogenetics into its clinical decision making. Acute caregivers on Allscripts SunriseTM are also using pharmacogenetics for safer drug orders.

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