NewMaker Interview: Harry Totonis, president and CEO of Surescripts

Do you consider 140,000 physicians, or 23 percent,  who are now e-prescribing to be good progress?

When you consider that 74,000 physicians were using e-prescribing at the end of 2008 and 36,000 at the end of 2007, then yes – that is pretty impressive growth no matter how you slice it. However, the mission is far from over. While the growth among physicians in medium to large practices has been impressive, there has not been enough progress with small and solo practitioners. This is critical as they tend to be specialists that write a very large share of prescriptions. If our goal is to use e-prescribing to improve the safety, cost and quality of every prescription dispensed in the U.S., it is clear that we must all work together to bring e-prescribing to more small and solo practitioners.

What is the top barrier to physician uptake of e-prescribing?

There are two: The DEA’s policy prohibiting e-prescribing of controlled substances; and the challenges faced by physicians – especially small and solo practitioners with no dedicated IT staff – when adopting any form of information technology. We are hopeful that the DEA will soon address their e-prescribing policy in a way that works for physicians, pharmacists and their patients. We are encouraged by Dr. Blumenthal and ONC’s proposal around health information technology regional extension centers. We believe they can play an important role in helping physicians get the technical help they need with e-prescribing and, more broadly, electronic health records.

Is there consumer pressure on physicians and pharmacies to adopt e-prescribing?

About 84 percent of retail pharmacies and six of the major mail order pharmacies in the U.S. use e-prescribing vs. about 23 percent of physicians and other prescribers. So the question probably applies more to physicians. In any case, we believe the answer is “yes.”

What is the top physician incentive for e-prescribing?

I don’t think there’s any question that what initially gets their attention are the gains in safety. Physicians obviously care deeply about patient safety. Therefore, the opportunity to improve the safety of a process they repeat most hours of every day is truly compelling.

These safety improvements come in two forms: the elimination of illegible handwriting; and access to a more comprehensive prescription history. That said, the major focus in healthcare these days is clearly on cost. The feedback we are receiving suggests that the ability of e-prescribing to reduce everyone’s costs is what will ensure its long-term viability.

What’s next for Surescripts over the next year?

Surescripts’ commitment to maintaining a neutral platform has been a largely uncelebrated but critical component of its success. It has been central to securing an extraordinary level of participation on the Surescripts network among pharmacies, payers, software vendors and physicians.

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