Electronic prescribing: the way of pharmacy's future

Drug Store News, March 6, 2000 by Liz Parks

Because of the consumer healthcare benefits and the efficiencies that can be realized by streamlining prescription transmissions, industry sources are estimating that about 10 percent of all prescriptions will be transmitted electronically by the year 2001.

"The estimates range from 8 [percent] to 10 percent," said a source at a leading online pharmacy, "but I think the higher range is more likely because there is so much work being done on this now and the benefits are so real and so great."

Kurt Proctor, senior vice president of pharmacy services at the National Association of Chain Drug Stores, said it would be great if more prescriptions could be sent electronically within the next few years. "They're clean, there's less data entry, and it allows the pharmacists to focus on patient care rather than processing scripts," he said.

The latest advancement came in January when PlanetRx.com, using the @Rx service from Tarrytown, N.Y.-based AHT Corp., became the first online pharmacy to fill via the Internet an electronic prescription that was compliant with the National Council for Prescription Drug Program's script standards.

In that instance, a physician in Chicago sent a prescription to PlanetRx.com over the Internet where it was then dispensed by PlanetRx.com's Memphis, Tenn., pharmacy and distribution center. (The NCPDP standard sets the codes and data for electronic prescribing, thus ensuring that when physicians send electronic prescriptions to pharmacies, the transmissions will be standardized so that everyone is using the same fields and the same data elements.)

PlanetRx.com's successful implementation of an NCPDP script-compliant electronic prescription service, which was partly integrated with its TechRx pharmacy management system, follows up on the success that brick and mortar chains such as Walgreens, Wal-Mart and Eckerd have had in integrating electronic prescriptions into their pharmacy management data bases.

Merck-Medco has also successfully integrated e-prescriptions in its mail order pharmacies as has healthcare provider Kaiser Permanente.

eMD.com, a consumer healthcare information, pharmacy and online medical management Web site, has been fulfilling prescriptions transmitted via its Internet-based chronic care and medication management system since Dec. 1.

Early last month, CVS.com and Rx.com, two other leading online pharmacies, were beta testing the NCPDP script-compliant interfaces that integrate electronic prescriptions with their pharmacy management systems. These companies noted that they expected to go from beta tests to fully integrated implementation most likely before the end of this quarter.

At PlanetRx.com, Kerr Holbrook, manager of business development, declined to elaborate on what currently is manual and what is automated in the electronic prescriptions the online drug store is receiving now over the Internet.

Holbrook said: "Full automation is still to come. We did, however, take some of the manual labor out of the process, and in the next several months, we will be working to automate the entire process."

Online health, beauty and wellness storemore.com, which has a strategic store pickup partnership with drug wholesaler Bergen Brunswing, has been working with Newport, Calif. based med-i-nets.com, a national provider of e-commerce and mobile point-of-care productivity tools for the medical community, to establish a nationwide electronic distribution network, pharm-i-net, that also will automate electronic prescription fulfillments.

Med-i-nets.com recently tested the service in a pilot that involved several hundred physicians in hospital practices.

Another leading online pharmacy, drugstore.com, was in the process of designing an online prescription certification program that could be used by all e-prescription connectivity application providers and all pharmacies. Marc Lilly, director of health services for drugstore.com, said that standard, which is NGPDP compliant, would be beta tested in the next few months, and the details of the enhanced standard will be published so that all e-prescribing companies and all online pharmacies can benefit in general.

Online pharmacy retailer Rx.com already has achieved one unique milestone: fully integrating prescription refills sent directly from consumers into its NextRx pharmacy management system, which is made by Southampton, Pa.-based Flux Technology. According to chief executive Joe Rosson, the Rx.com online pharmacy is the only one with a Web browser interface where one can enter refill prescription information automatically without any manual intervention.

Rx.com also is working on integrating its pharmacy management software with a physician connectivity software application called PocketScript created by Cincinnati-based Way Over the Line Co. Rosson said integration may be in place by the end of this quarter.

Click-and-mortar activity

CVS.com is working on integrating electronic prescriptions from three connectivity application providers: San Francisco-based Healtheon/WebMD, Fort Lauderdale, Fla.-based ProxyMed and Hillsboro, Ore.-based MedicaLogic. CVS.com also is in the midst of getting approval from the various state boards of pharmacy for the technology it has developed for its connectivity providers.