2015 National Progress Report | Surescripts
 

2015 National Progress Report

It was another transformative but challenging year for the healthcare industry. Thanks to groundbreaking collaboration across our nationwide network, we have a lot of positive stories and fascinating data to share. We expanded our reach, entered new markets and continued to modernize and streamline the healthcare experience for doctors, pharmacists, technology partners and patients.

 
01

The Surescripts Network Continues to Expand and Build Upon E-Prescribing

Fast Fact

In 2015, the Surescripts network grew substantially in transaction volume, secure access to patient health information and connections among doctors, pharmacists, hospitals and health plans.

This expansion made possible our entry into new and underserved markets like Long Term Care, and enabled in-demand functionality like electronic prior authorization and the much-anticipated launch of our National Record Locator Service.

9.7 billion transactions in 2015–a 48% increase over 2014.

Electronic Health Data Exchange Continues to Grow

From transaction volume, to depth and breadth of available data, the nation’s healthcare ecosystem is increasingly digitized.

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E-Prescriptions
 
E-Prescriptions of Controlled Substances

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Medication Histories

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Clinical Messages
 
Patients
 
Healthcare Professionals

Increased Network Usage Means Better Interoperability for Everyone

Industry leaders believe healthcare data exchange will only continue to expand upon the foundation the industry has already built. Health information exchange improves as the network reaches critical mass and connectivity becomes the norm.

Mapping America’s Medicine Cabinet

The Surescripts network provides insights on how and where patients are experiencing the benefits of digital health. Surescripts has its finger on the pulse of medication trends across the country. The map below shows the rate of e-prescribing of medications for the five leading therapeutic classes3 based on a sample of Surescripts transactions in each state. The U.S. rate is represented as a range of +/-1% of the national rate for each therapeutic class

Fast Fact

Fast Fact

Below U.S. Rate
U.S. Rate
Above U.S. Rate
Heart &
Blood Vessel
Antibiotic & Antiviral
Brain &
Spinal Cord
Endocrine/
Hormonal
Respiratory

Connectivity Reaches the Long Term and Post-Acute Care Markets and Makes an Immediate Positive Impact

After many years as a woefully underserved market, long-term and post-acute care facilities are seeing real improvements to workflows and health outcomes as a result of getting connected.

Case study: Improving Long Term Care with Electronic Tools

Janelle Miller, RN, SigmaCare Director of Product Management, Clinical Content and Care Management, and Mike Gelman, SigmaCare VP of Business Development.

Surescripts recently interviewed two leaders from SigmaCare, a healthcare technology company dedicated to serving the long-term and post-acute care (LTPAC) markets. Janelle and Mike talked candidly about the specific challenges these markets face and the exceptionally positive impact electronic tools are having on LTPAC providers and patients.

Read more

02

Controlled Substances: Using the Network to Strike a Healthier Balance

The Surescripts network delivers smart solutions to fight fraud and abuse of controlled substances while effectively serving the patients who need them.

Today, there is no question that the nation is facing a drug abuse epidemic, specifically opioid abuse, which is the number-one cause of preventable death in the U.S., killing 28,000 people in 2014.4 Millions of Americans live with chronic pain and are effectively relieved by opioids when properly prescribed and administered. We must find a healthy balance between making sure that these very effective pain relievers stay available to those who need them and preventing overdose and death.

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In December 2015, opioids made up 32% of all controlled substance e-prescriptions.

State Regulations are Advancing Nationwide Adoption of Electronic Prescribing of Controlled Substances (EPCS)

In 2015, Vermont became the final state to legalize EPCS for all schedules of controlled drugs, and New York enacted legislation to mandate the use of electronic prescribing. These shifting dynamics drove a sharp increase in adoption and utilization of e-prescribing for controlled substances nationwide.

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E-Prescriptions of Controlled Substances


Fast Fact

Pharmacy and Prescriber EPCS Enablement

james_holly

Flipping the Script:
Using EPCS for Customized, Compassionate Care

James (Larry) Holly, M.D.
CEO, Southeast Texas Medical Associates (SETMA)
Clinical Associate Professor, Department of Internal Medicine, School of Medicine Texas A&M Health Science Center, TAMHSC
Adjunct Professor, Family & Community Medicine, University of Texas Health Science Center San Antonio (UTHSCA)

We visited with Dr. James Holly (who prefers to be called Larry), a top physician, professor and industry thought-leader, about the biggest problems facing physicians and the digital tools that are helping to fix them.

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Prescribers Adopt Technology to Fight the Nationwide Opioid Epidemic

According to the Centers for Disease Control and Prevention (CDC), opioids—primarily prescription pain relievers and heroin—were the main causes of overdose deaths between 2000 and 2014. Opioids were involved in 28,647 deaths in 2014, and opioid overdoses quadrupled between 2000 and 2014.4

In 2015, overall adoption and enablement of EPCS grew. However, there is a real disparity between pharmacy and prescriber enablement. All 50 U.S. states and Washington D.C. are ranked below based on the number of pharmacies and prescribers enabled for EPCS, and the percentage of controlled substances prescribed electronically. New York dominates the ranking due to the regulatory mandate that drove a rapid increase in prescriber enablement to meet the March 2016 deadline.

How Does Your State Rank?

Top 10
Bottom 10
State Comparisons

State Rank

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Pharmacy Enablement (%)

 
 

Prescriber Enablement (%)

 

% EPCS Transactions

 
 
 

Opioids were involved in 28,647 deaths in 2014 and opioid overdoses quadrupled between 2000 and 2014.5

Fast Fact

EPCS Transactions by Provider Specialty

32% Family Practice
Family Practice
Psychiatry
Internal Medicine
Pediatric Medicine
Anesthesiology
Interventional Pain Management
Physical Medicine and Rehabilitation
Neurology
Orthopedic Surgery
OB/GYN & Others
03

Using Smart Tools Saves Time, Money and Lives

As the U.S. population ages, the need for healthcare services has increased substantially, resulting in greater healthcare costs. The federal government put reforms in place to improve quality and reduce costs. But in order to realize true value, everyone who touches healthcare needs to work together to change the way we deliver care and employ smart tools to make better use of data.

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Between 28% and 31% of all paper prescriptions either never make it to the pharmacy, or are not picked up once patients see how much it will cost.4

Reducing Medical Errors and Increasing Efficiency with Interoperability

Medical errors have recently been estimated as the number-three cause of death in the United States.6 Real-time access to a patient’s medication history helps providers and their practices, as well as hospitals and health systems, reduce errors during the medication reconciliation process while increasing efficiency. In fact, very large health systems can save more than $1 million per 1,000-bed hospital each year. Go to the Surescripts’ Medication History Hospital Value Calculator to see how much your hospital could save.



Medication Reconciliation Has a Substantial Impact on Total Healthcare Spending

Manually reconciling a patient’s medication history is time consuming and inaccurate, but Surescripts delivers real-time access to medication information to the point of care. This is particularly valuable in an acute care setting like a hospital emergency room, where a more complete, accurate and efficient medication reconciliation process is critical to reducing costly adverse drug events and readmissions. In the case of medication reconciliation, interoperability between different technology platforms, pharmacies and PBMs is essential to getting the full benefits out of a truly connected healthcare system.

In 2015, increased use of Medication History saved hospitals more than $400 million.

Fast Fact

Fast Fact

Access to Patient Medication History Data Has Grown Substantially



Surescripts provides medication history data dispensed from both pharmacy benefit plans as well as pharmacies. The chart above primarily captures medication history data dispensed from pharmacy benefit plans. However, in 2015, an additional 700 million medication histories delivered to the point of care contained data dispensed from retail pharmacies.

Fast Fact

“Before implementing Medication History for Reconciliation, it would take our staff 20 minutes to compile a patient’s medication list by calling pharmacies. Now, we can get a patient’s med list in seven minutes.”
— Megan Davis Hoesly, PharmD, BCPS, Sentara Virginia Beach General Hospital, Clinical Pharmacy Specialist, Emergency Medicine

Optimizing the Value of E-Prescribing with Electronic Prior Authorization

Prior authorization is a critical part of the prescribing process that, until recently, had yet to be digitized. Despite its intended purpose of driving down costs associated with prescribing high-cost medications, it’s a time-consuming, expensive and frustrating step for doctors. And when it’s not part of their existing e-prescribing workflow, it impedes patient care and wastes resources.

Electronic prior authorization delivers real-time responses from health plans, before a patient leaves the doctor’s office. It speeds the processing of prior authorizations and provides quicker access to care that is medically appropriate and cost effective.

A 10-doctor cardiology practice processes 1,680 prior authorizations each year. With electronic prior authorization, this practice could recoup more than 500 hours of administrative work for the doctors, and save the practice more than $16,000 in one year.

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Replacing manual prior authorization with Surescripts CompletEPA can save your practice:

The Surescripts CompletEPA calculator is provided for informational purposes only. Surescripts makes no warranties, concerning the accuracy or completeness of the data and assumes no liability for any damages caused by inaccuracies in this data. Actual results may vary.

“The system routes retrospective prior authorizations back to the provider for approval. A prospective prior authorization solution would further streamline my workflow by eliminating that step.”
— Stacey Swartz, The Neighborhood Pharmacy

Better Data-Sharing for a Brighter Future



Shahid
0:46

Shahid Shah

Co-founder and CEO, Netspective Communications
John
0:28

Dr. John Halamka

CIO, Beth Israel Deaconness Health System and Professor of Medicine, Harvard Medical School
Peter
0:21

Peter De Vault

Director of Interoperability, Epic
Mike
0:28

Mike Gelman

VP, Corporate and Business Development, SigmaCare

During the 0:00 minutes you’ve been reading this report, more than 1,435,000 transactions have crossed the Surescripts network.


  1. Based on National Council for Prescription Drug Programs (NCPDP) total number of prescriptions
  2. Represents patient lives adjusted for multiple coverage
  3. Therapeutic classes defined by First Data Bank, Inc.
  4. CDC/NCHS, National Vital Statistics System, Mortality: http://www.cdc.gov/drugoverdose/data/statedeaths.html
  5. Shrank, W.H., Choudry, N.K., Fischer, M.A., Avorn, J., Powel, M., Schneeweiss, S., Liberman, J., Dollear, T., Brennan, T.A., Brookhart, M.A. (2010). The Epidemiology of Prescriptions Abandoned at the Pharmacy. Annals of Internal Medicine, Vol. 153, No. 10, 633 – 640.
  6. BMJ 2016;353:i2139
  7. Surescripts Hospital Value Calculator: http://surescripts.com/hospitalvalue?val=200
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