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.
The Surescripts Network Continues to Expand and Build Upon E-Prescribing
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.
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.
Increased Network Usage Means Better Interoperability
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
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.
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.
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.
E-Prescriptions of Controlled Substances
Pharmacy and Prescriber EPCS Enablement
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
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?
Pharmacy Enablement (%)
Prescriber Enablement (%)
% EPCS Transactions
Opioids were involved in 28,647 deaths in 2014 and opioid overdoses quadrupled between 2000 and 2014.5
EPCS Transactions by Provider Specialty
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.
Reducing Medical Errors and Increasing Efficiency
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,
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
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.
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.
Better Data-Sharing for a Brighter Future
Shahid ShahCo-founder and CEO, Netspective Communications
Dr. John HalamkaCIO, Beth Israel Deaconness Health System and Professor of Medicine, Harvard Medical School
Peter De VaultDirector of Interoperability, Epic
Mike GelmanVP, 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.
- Based on National Council for Prescription Drug Programs (NCPDP) total number of prescriptions
- Represents patient lives adjusted for multiple coverage
- Therapeutic classes defined by First Data Bank, Inc.
- CDC/NCHS, National Vital Statistics System, Mortality: http://www.cdc.gov/drugoverdose/data/statedeaths.html
- 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.
- BMJ 2016;353:i2139
- Surescripts Hospital Value Calculator: http://surescripts.com/hospitalvalue?val=200