2016 National Progress Report | Surescripts
2016 National Progress Report

Actionable Patient Intelligence is Taking Hold Across American Healthcare

As the nation’s single most trusted and capable health information network, our purpose is to increase patient safety, lower costs and ensure quality care. To do so, we must ask one critical question: Are we delivering the actionable intelligence that providers need to make the best-informed care decisions for each and every patient?

Today, digital information is available “on demand.” We use apps to track our daily steps, check ER wait times online and pay doctor bills with our smartphones. Despite these advances and our more active roles as healthcare consumers, many healthcare decisions still suffer from a lack of critical information. Care providers are asking important questions like, “What medication is my patient taking? Is my patient adhering to their medication? What will a particular medication cost and are there alternatives? What other providers have seen my patient, and can I communicate with them for deeper understanding of what’s going on?” This is where Surescripts comes in. This report charts our progress made delivering the answers to these questions and more.

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Better Patient Data, Better Decisions—
Better Healthcare for All
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INTELLIGENT APPROACHES TO FIGHTING OPIOID ABUSE
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It’s What’s Inside That Counts: On the Road to Perfect E-Prescriptions
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Better Patient Data, Better Decisions—
Better Healthcare for All

We were founded on the premise that a truly interoperable network is required to provide actionable patient intelligence that leads to better healthcare decisions, wherever they are made. We started with e-prescribing, but we didn’t stop there. We extended our network to facilitate the prescription decision-making process, to help providers work with patients to achieve the best treatment outcomes, and to connect providers when their patients transition between various points of care.

Today, Surescripts continues to bring together data from disparate entities and systems with solutions that deliver a cohesive picture of a patient at any point in time-and effectively answer some of healthcare’s most critical questions.

Network Transactions

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82% more transactions
since 2013.
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ENABLING THE BEST PRESCRIPTION DECISIONS

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HELPING PROVIDERS OPTIMIZE PATIENT ADHERENCE TO MEDICATION

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DELIVERING ACTIONABLE PATIENT INTELLIGENCE ACROSS TRANSITIONS OF CARE

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ENABLING THE BEST PRESCRIPTION DECISIONS

Our mature network’s massive scale fuels industry-leading technologies and insights that answer critical questions that help healthcare professionals make the best prescription decisions and use data to increase patient safety and quality at a lower cost.

What benefits apply to this patient and this medication?

Electronic prescribing allows healthcare providers in all care settings to manage prescriptions electronically, making prescribing safe, convenient and fast. Electronic prescribing drives a 10% increase in patient first-fill medication adherence, which reduces hospital readmissions and improves patient care.

E-Prescriptions

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73% of prescriptions were electronic
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Is it medically appropriate for this patient to be prescribed a controlled substance?

With critical patient data at their fingertips, providers can use a single e-prescribing workflow to manage all prescriptions, including controlled substances. E-Prescribing of Controlled Substances (EPCS) ensures medications safely and securely reach the patients who need them.

E-Prescriptions for Controlled Substances

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256% increase
since 2015.
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Does this prescription require prior authorization?

Manual prior authorization is one of the biggest pain points for healthcare professionals, with 91% of physicians describing the process as primitive, time consuming, expensive and frustrating. Electronic prior authorization automates and streamlines the historically tedious and wasteful manual prior authorization workflow.

60% of approvals
returned within one minute.
85% of PBMs
connected.
EHRs representing 75% of all physicians
100 EPIC Health systems

Which medications are covered by insurance and how much will they cost?

Putting real-time actionable patient intelligence in the hands of providers at the point of care is critical to ensuring the best prescription decisions are made and that treatment plans are followed. With the right information, prescribers can optimize the quantity of the medication prescribed, encourage the use of generics and affordable brands, reduce waste and improve adherence, and better manage high-cost specialty medications.

6000+ Prescribers
checking patient medication benefits
Over 1.75 Million
patient medication benefits transactions

Increased Network Reach Means Actionable Intelligence for All

In 2016, even more healthcare professionals and organizations joined the network, improving healthcare quality and safety for virtually every American.

Who's connected?

1.3 Million Healthcare Professionals
+22% since 2015.
98% of retail pharmacies
64% of prescribers
+7% since 2015.
230 Million patients
71% of U.S. population.

Industry Commentary

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HELPING PROVIDERS OPTIMIZE PATIENT ADHERENCE TO MEDICATION

HELPING PROVIDERS OPTIMIZE PATIENT ADHERENCE TO MEDICATION

Actionable patient intelligence answers key questions to help optimize compliance and outcomes once treatment has been initiated.

What medications is my patient taking?

We believe the most complete medication history leads to the most informed care decisions. Surescripts provides access to complete and up-to-date medication history data to limit errors and adverse drug events (ADEs). Medication history data is particularly valuable to hospitals and health systems managing large patient populations, particularly those who are critically ill. People with chronic conditions account for 81% of hospital readmissions and 91% of prescriptions filled.

Patient Medication Histories

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*Surescripts provides medication history data supplied by both pharmacy benefit managers and pharmacies. This chart primarily captures medication history data supplied by pharmacy benefit managers. However, in 2016, an additional 870 million medication histories delivered to the point of care contained data supplied by retail pharmacies.
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“This technology adds more value—the Surescripts technology—to the quality of care, the safety of care, and the cost of care, than almost any other single solitary thing that we do. I've been using electronic records for 20 years and writing about it, discussing it, teaching about it, speaking about it … Surescripts has added tremendously. I can’t say enough because I’m just amazed that you all have done what you've done.”
holly-headshotJames "Larry" Holly, M.D. CEO, Southeast Texas Medical Associates (SETMA)

How can I cancel or change a prescription?

Expanded e-prescribing functionality gives prescribers the flexibility to cancel or change prescriptions that have already been sent to pharmacies, vastly improving physician and patient satisfaction and safety. Expanding the use of these capabilities will improve efficiency and patient safety by preventing adverse drug events due to duplicate or unnecessary therapy.

100,000 cancel requests
sent to pharmacies in just one month.
“We’re really excited about CVS being one of the early adopters of the cancel message, and we hope that more pharmacies support it so that the providers have a single experience. It's clear that CancelRx is one of those things that we want to do. We don’t want to be limited by just being able to submit and receive information, but make sure we're all on the same page. And anything that drives toward that mission is the right thing to do.”
joel-headshot Joel Jones, Pharm.D., Clinical Informatics & Population Health, Epic

Industry Commentary

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DELIVERING ACTIONABLE PATIENT INTELLIGENCE ACROSS TRANSITIONS OF CARE

DELIVERING ACTIONABLE PATIENT INTELLIGENCE ACROSS TRANSITIONS OF CARE

Surescripts connects healthcare providers across care settings to answer critical questions and deliver actionable intelligence that stays with the patient as they move from one care setting to the next.

How can I communicate with other providers to ensure quality care?

Surescripts connects healthcare providers nationwide to deliver convenient and secure clinical communications and data for improved care coordination and increased workflow efficiency.

Clinical Messages

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38 times more clinical messaging
than in 2013.
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Where has my patient received care?

Our national record locator service puts care summaries directly into physicians’ EHR workflows, regardless of where in the country care was received or which EHR was used. This allows healthcare providers to quickly locate and exchange patient information, ultimately improving overall care and efficiency and reducing the burden on patients to “connect the dots” of their healthcare experience.

43 million visits and 4.38 billion interactions
Clinicians from 10 health systems
in 7 states.
2.2 Million+ care location summaries
including patient visits with more than 165,000 clinicians.

Industry Commentary

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INTELLIGENT APPROACHES TO FIGHTING OPIOID ABUSE

INTELLIGENT APPROACHES TO FIGHTING OPIOID ABUSE

Our nation is in the midst of an unprecedented opioid abuse epidemic. In 2015, opioid overdose killed more than 33,000 Americans. We're mapping the utilization of electronic prescribing of controlled substances (EPCS) to better understand the scale of the problem, where technology adoption is lagging behind, and what e-prescribing trends can tell us about the impact of technology on this nationwide epidemic.

State by State: EPCS Enablement and Transaction Volume

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Saving Lives with Naloxone: Prescribing Volume, Availability and Awareness

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Controlling Pill Volume as a First Line of Defense

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State by State: EPCS Enablement and Transaction Volume

EPCS READINESS: WHICH STATES LEAD THE CHARGE?

Facing a public health crisis, state governments are taking action through a combination of public policy, technology adoption and education.

As in previous years, we ranked states based on three criteria: the rate of EPCS enablement among prescribers, the rate of EPCS enablement among pharmacies and the percent of controlled substance prescriptions sent electronically.

E-prescribing data from 2016 points to where the most dramatic progress took place—New York and Minnesota—the only two states where e-prescribing was mandated as one tool for fighting the opioid epidemic. A number of other states are now following their lead and considering mandates of their own.

HOW DOES YOUR STATE RANK?

Use the map to explore the nation's enablement.
Top 10
Bottom 10
State Rank
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Prescriber Enablement (%)
 
Pharmacy Enablement (%)
 
% of Controlled Substances Prescribed Electronically
 
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4 new states moved into the top 10

North Dakota, South Dakota, Minnesota and North Carolina.

4 states fell from the top ten

Oregon, California, Massachusetts and Wisconsin.

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North Dakota went from #48 to #2 in the ranking.

S2-F1-SS-4

Minnesota saw double-digit growth across all three metrics, moving up from #24 in the ranking to #7.

an increase of 72% of prescribers were enabled (in New York)

in New York.

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Saving Lives with Naloxone: Prescribing Volume, Availability and Awareness

Saving Lives with Naloxone: Prescribing Volume, Availability and Awareness

THE LIFESAVING EMERGENCY TREATMENT IS MORE PREVALENT AND ACCESSIBLE THAN EVER BEFORE.

Opioids are potent respiratory depressants and overdose is a leading cause of death among people who use them. According to the Centers for Disease Control and Prevention (CDC), each day in the U.S., 78 people die from an opioid–related overdose on average. The opioid abuse epidemic is also economically disastrous, with $55 billion a year in health and social-related costs.

Naloxone (Narcan) is an injectable treatment that quickly reverses the effects of opioid overdose, and saves thousands of lives each year. Since its introduction in 1971, naloxone has been available and administered primarily in healthcare settings, with 25,143 e-prescriptions in 2016. The Food and Drug Administration (FDA) recently approved new dosage formulations like a nasal spray and an auto-injector—both designed to be more accessible and convenient to administer outside of a healthcare setting. Numerous jurisdictions across the country now provide naloxone to first responders in communities with high rates of overdose, and many pharmacies now offer it without a prescription.

Naloxone Dosage Formulations

25,143 naloxone e-prescriptions
50% auto-injector
33% nasal spray

In August 2016, there was a significant increase in the volume of e-prescriptions for naloxone across all three dosage formulations (including traditional syringe injection). This was likely driven by major media attention around the opioid epidemic stemming from an education campaign by the federal government following President Obama’s signing of the Comprehensive Addiction and Recovery Act in July. Surescripts conducted the analysis utilizing data from the World Health Organization (WHO) and First Databank.

80% more prescriptions
In August, there were 3,779 naloxone e-prescriptions, well above the monthly average of 2,095.

Industry Commentary

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Controlling Pill Volume as a First Line of Defense

Controlling Pill Volume as a First Line of Defense

IN THE CONTINUED BATTLE AGAINST OPIOID ABUSE, ASSESSING E-PRESCRIBING PATTERNS TO UNDERSTAND THE NUMBER OF PILLS E-PRESCRIBED IS CRITICAL.

Two of the most commonly abused opioid prescription medications are oxycodone and hydrocodone. In March 2015, the Obama administration announced an initiative targeting three priority areas to tackle the opioid epidemic and help save lives. One priority focused on reducing the sheer number of pills prescribed, an impossible task without understanding when and where e-prescribing is being used.

OPIOID PRESCRIBING TRENDS

3.71 Million E-presctiptions
for oxycodone and hyrdocodone
307 Million pills

THE AVERAGE PILL QUANTITY PER PRESCRIPTION REMAINED RELATIVELY CONSTANT WITH A SLIGHT DOWNWARD TREND.

1.8% Fewer pills
per e-prescription for oxycodone and hyrdocodone.
The largest decrease in pill quantity occurred from February (85.27) to April (82.43), when the e-prescribing mandate went into effect in New York.
“We feel that the benefits of being able to do the electronic prescribing of controlled substances are vast … Everything from patient safety, quality, efficiency, total cost of care. I don’t have my DEA number hanging out there. It decreases fraud, diversion—all these things that keep doctors up at night worrying about controlled substances … as well as keeping patients up at night worrying about if they’re going to be able to get them in a timely way—EPCS really helps alleviate all of those concerns.”
smith-headshot Todd Smith, CMIO, HealthEast Care System

Industry Commentary

“If a patient is appropriately on a controlled substance, it ought to be as easy to get as aspirin … What we want to do is make it as easy as possible for our patients to be on the medications they need to be on … They appreciate the convenience, they appreciate the quality and the safety and the security of knowing that they can get medications when they need it.”
holly-headshotJames “Larry” Holly, M.D., CEO, Southeast Texas Medical Associates (SETMA)
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It’s What’s Inside That Counts: On the Road to Perfect E-Prescriptions

It’s What’s Inside That Counts: On the Road to Perfect E-Prescriptions

SURESCRIPTS CONTINUES TO CONVENE THE INDUSTRY AND LEAD THE MOVEMENT TO PERFECT E-PRESCRIBING QUALITY, SAFETY AND COST WITH AN ULTIMATE GOAL OF ZERO ERRORS.

The incredible group effort that resulted in replacing paper prescriptions with electronic—sparked by the industry recognizing the need for a leap forward, and competing organizations coming together for the greater good—has been a major interoperability success story with a significant impact on healthcare. Yet, e-prescribing is only as good as the quality of the data that goes in. So while the "pipes" of our network are unmatched by any other in the country, it’s what’s inside that counts.

E-PRESCRIBING IS ONLY AS GOOD AS WHAT GOES IN

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Delivering Value and Ensuring Quality with Surescripts Sentinel™

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E-PRESCRIBING IS ONLY AS GOOD AS WHAT GOES IN

Network-Wide Collaboration for the Win

E-prescribing is robbed of its power when pharmacists or prescribers are forced to stop what they’re doing and intervene manually via phone or fax. So, we’re pushing e-prescribing to realize its full potential by continuing to drive broader adoption and better data quality for the benefit of every pharmacist, prescriber and patient.

In 2016, Surescripts convened the network—nearly 200 representatives from pharmacies, PBMs, EHR software vendors and drug compendia among others—to understand e-prescribing’s current pitfalls, establish network-wide best practices and collaboratively identify opportunities for continuous improvement and growth.

POTENTIAL IMPACT ON E-PRESCRIBING ACCURACY

Two-thirds of e-prescription data is unstructured
10% of e-prescriptions require manual handling
“Surescripts is a really great organization. They’ve put in a lot of effort into assuring that we go through the state Boards of Pharmacy process, that we promote the use of standards, that we promote that exchange between the physician and the pharmacist.”
spiro-headshotShelly Spiro, PharmD, Executive Director, Pharmacy HIT Collaborative

Delivering Value and Ensuring Quality with Surescripts Sentinel™

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Delivering Value and Ensuring Quality with Surescripts Sentinel™

The Future of E-Prescribing: Meaningful Insights and Emerging Health Trends

Poor e-prescribing quality can cause a whole slew of inefficiencies and errors that negatively impact patients, prescribers and pharmacists in a number of ways. From forcing pharmacists to manually follow up with prescribers via wasteful back-and-forth faxes and phone calls, to increased patient wait times, prescription abandonment, potential fraud and abuse and risks to patient safety—the stakes are high.

Sentinel is our automated system that monitors network-wide e-prescribing quality and accuracy. By analyzing all of the more than 1.6 billion e-prescriptions processed each year, Sentinel produces accurate, timely, detailed and scalable data to help raise the bar for industry-wide quality metrics.

GOAL

22% improvement in e-prescribing accuracy Metrics include clear prescriber intent, patient directions and standard drug descriptions.

Industry Commentary

VIDEO_NEIL

Neil Simon

Chief Operating Officer, Aprima Medical Software

VIDEO_PETER

Peter Basch, MD, MACP

Senior Director, IT Quality and Safety, Research and National Health IT Policy, MedStar Health

VIDEO_SHELLY

Shelly Spiro, RPh

Executive Director, Pharmacy HIT Collaborative

“Safety with electronic prescribing is incredibly valuable. I think we’re going to see over the next ten years the incidence of medication-related deaths go down dramatically—maybe even to approaching zero because of the legibility, the availability and the ease of reconciliation of those medications.”
holly-headshotJames “Larry” Holly, M.D., CEO, Southeast Texas Medical Associates

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