Use of Technology
Where We Stand:
The Academy of Managed Care Pharmacy (AMCP) supports the implementation and expanded use of health information technology (HIT), including electronic health records, electronic prescribing, electronic prior authorization, real time benefit check, telehealth, remote patient monitoring, digital therapeutics and other technology advancements that promote efficient use of healthcare resources, improve quality and patient and provider satisfaction. AMCP also supports the use of technology in the dispensing and delivery of prescription drugs to patients.
Managed care pharmacy has developed a broad range of innovative and integrated strategies using state‐of‐the‐art technology to effectively manage prescription benefits for given patient populations. Industry standards have been developed and adopted for electronic prescribing, electronic prior authorization, and other transactions and processes. These standards allow for access to and use of patients’ health records in a productive and efficient manner while protecting patient information. Technology for accurate dispensing has been adopted in most pharmacy settings.
The further implementation of standards for interoperability of electronic health records, electronic prescribing and electronic prior authorizations offers opportunities not only to improve patient care, but also to combat fraud, waste and abuse within the health care system. Integrated HIT systems can encourage the use of evidence‐based clinical guidelines. Interoperable electronic interchange of healthcare information can also help health plans and law enforcement monitor and share information regarding potentially fraudulent activity, or suspected abuse or drug diversion activities. At a time when some estimate that inappropriate or unnecessary care, fraud, and abuse account for almost one‐third of overall health spending, HIT offers opportunities to reduce health care costs without reducing the quality of care.
Electronic Health Records (EHRs)
The Centers for Medicare & Medicaid Services (CMS) has recognized the value of technology in the provision of medical care via its adoption of standards and its promotion of the use of electronic health records. EHRs have been shown to reduce errors through computerized prescriber order entry (CPOE) systems and lower costs due to reduced paperwork and fewer duplicate treatments and tests. Patient safety is improved as such systems facilitate the management of chronic conditions.
Electronic transmission of prescription information offers benefits over written and oral prescriptions in terms of accuracy, storage capacity, accessibility, security, and productivity. Benefits of electronic prescriptions include the reduction of errors due to misinterpretation of handwritten prescriptions, confusion between similarly sounding drug names during oral transmission of prescription orders, and order‐entry errors.
Electronic prescribing systems alert prescribers to potentially harmful drug interactions, patient drug allergies, and duplicate or overlapping drug therapy, enabling the prescriber to adjust the prescription before the pharmacy dispenses the drug. Electronic prescribing systems can also allow prescribers to access the formulary for a patient’s prescription drug benefit, ensuring that they select a therapy for which the patient has coverage, in addition to any clinical edits that may be present.
Electronic Prior Authorization
Electronic transmission of prior authorization requests from pharmacies and prescribers improves the quality of the request, reduces the time for review and improves the patient and prescriber experience. Prescribers often are not aware that a PA is needed until the prescription claim is rejected at the pharmacy. Pharmacists are often in the middle between the payer and the patient, contacting the prescriber for additional information.
Electronic prior authorization can proactively identify the need for a prior authorization, minimizes the information required to make a determination and presents questions in a logical fashion reducing the processing time. This can lead to improved access to needed medications.
Real-Time Prescription Benefit Check
A Real-time Prescription Benefit Check solution allows prescribers to see prescription benefit details at the point of prescription, such as patient out-of-pocket cost and coverage, formulary alternatives, and PA requirements. This capability enables providers to make informed medication choices for their patients and prevent a bad experience at the pharmacy counter.
Technological advances have led to the development of innovative systems for automated drug counting, labeling, filling and delivery of prescription orders. The use of these systems is accepted as standard practice in community, hospital, and mail order pharmacies. Automated systems for dispensing allow the pharmacist to participate in appropriate medication selection and management of positive patient outcomes.
AMCP supports the adoption and use of national standards that promote system interoperability among providers and payers, and the use of requisite sets of functional elements necessary for optimizing medication access, safety, and cost‐effective utilization. Such standards have been developed to protect patient confidentiality and assure the accuracy and completeness of every transmission and record and improve the exchange of healthcare information to improve quality in a cost-efficient manner . The use of information systems and technology advance productivity, improve customer satisfaction, and allow pharmacists to concentrate on clinical outcomes. Patients are the ultimate beneficiaries of these technological advances.
AMCP Where We Stand series: https://www.amcp.org/policy-advocacy/policy-advocacy-focus-areas/where-we-stand-position-statements
Revised by the AMCP Board of Directors, December 2020
Approved by the AMCP Board of Directors, June 2013