In a post earlier this month I explored the question of who has the largest B2B integration network in the world. The competition is primarily between the top vendors in the financial services, health care and supply chain segments, each of which have been using B2B technologies for over 20 years now. But another equally interesting question is who has the fastest growing B2B network? One of the candidates must surely be in the US Electronic Health Records (EHR) market. The topic of Electronic Health Records has been receiving a great deal of publicity in the past year since the American Recovery and Reinvestment Act (ARRA) was passed. ARRA stipulates that the Federal Government will provide financial incentives for health care providers which can demonstrate “meaningful use” of EHRs. EHRs can include a variety of information about a specific patient including demographics, medications, immunizations, allergies, laboratory data, radiology reports and past medical history. In my last post I described one of the fastest growing segments of EHR, the sharing of medication data between providers, pharmacies, and payers via e-prescription networks. In this post I will outline who are these e-prescription networks and how fast are they growing?
Historically, there were two dominant e-prescription networks in the US – one which represented the pharmacies and the other which represented the PBMs. Surescripts was formed in 2001 by the National Association of Chain Drug Stores and National Community Pharmacists Association as a privately held company. The second was RxHub, founded by CVS Caremark, Express Scripts and Medco. However, in 2008 Surescripts and RxHub merged. The merged company, which uses the Surescripts name, maintains a vast network of connections to pharmacies, providers and insurers for the purpose of e-prescription routing. In addition to providing an e-prescription network, Surescripts also provides services such as certification, education and standards development.
What is Meaningful Use – One of the Biggest Questions in Today’s Health Care Industry
Every year Surescripts publishes a report of the activity on their network, which serves as a gauge of the growth in adoption of e-prescription technology. The most recent report has some very interesting data about transaction volume growth of these specialized B2B integration networks:
- Benefits Requests – Doctor’s asking insurance companies or pharmacy benefit managers for a patient’s eligibility and formulary increased 284% from 2008 to 2009. Whereas only 8% of patient visits involved an electronic benefits request in 2008, over 30% were digitized in 2009.
- Prescription History – Doctor’s requesting a list of current and past medications from the patient’s pharmacy and insurance carrier increased five-fold in 2009. Only 1.7% of patient visits in 2008 involved an electronic history request. The percentage jumped to 8.2% in 2009.
- Electronic Routing – 18% of doctors were submitting prescriptions electronically to a pharmacy versus a handwritten or phone based request. Only 4% of eligible prescriptions were sent electronically in 2008. Note that certain “controlled substances” as defined by the DEA are not eligible for electronic routing.
Walgreens in North Dakota – Electronic Routing – Maybe?
Surescripts also include data about the percentage of health care providers, payers and pharmacies adopting e-prescription technology:
- Provider Adoption – By the end of 2009, there were 156,000 “prescribers” (typically providers) routing prescriptions electronically, which represents 25% of all office-based.
- Insurer Adoption – By the end of 2009, Surescripts had access to 65% of US patient’s prescription benefit and history information. There were only two states – North Dakota and Mississippi in which Surescripts had access to less than 40% of the population.
- Pharmacy Adoption – 97% of chain pharmacies such as Rite Aid, CVS and Walgreens were connected to e-prescription networks along with 6 of the largest mail-order pharmacies. Additionally, 85% of community pharmacies in the US were wired for prescription routing.
Are e-prescription services the fastest growing B2B integration networks? It would not be fair to draw conclusions without examining some of the other emerging B2B networks first. More thoughts on this topic in a future post…
