Healthcare Technology Featured Article

September 19, 2014

Four PBMs and Six Health Technology Vendors Adopt the Surescripts EPA Platform


The U.S. healthcare budget, which currently stands at almost $3 trillion at the moment, can only be appreciated when data points about small segments of the whole are highlighted. For example: The Institute of Medicine, an independent adviser to the government and the public, and part of the National Academy of Sciences, revealed an incredible $190 billion is spent on paperwork and unnecessary administrative costs annually. This is a glaring example of how the industry needs to make a more of an effort to digitize all of its paperwork. Electronic health record (EHR) is now making this possible, and more organizations are implementing this technology because government mandates are requiring the practice.

Surescripts, a health information network, has expanded its electronic prior authorization (EPA) solution for e-prescribing with four nationwide pharmacy benefit managers (PBMs), including CVS/caremark and Express Scripts, as well as six health technology vendors, Aprima Medical Software, DAW SYSTEMS - SCRIPTSURE, digiChart, First Databank, Inc.’s FDB MedsTracker, OA Systems, and Stratus EMR.

By integrating EHR, healthcare providers can replace outdated and inefficient manual processes in order to drive measurable time and cost savings for everyone in the values chain. The CompletEPA simplifies the process of writing prescriptions so patients, pharmacists and prescribers are on the same page with a single, efficient electronic workflow that automates a time- and resource-intensive medication prior authorization (PA) process.

According to the company this is the first solution for sending verified, standardized messages from EHRs to PBMs with no phone calls or faxes. The EHR workflow lets providers know instantly if a medication requires prior authorization, and if it is approved or denied with real-time processing so medication approval is made before prescriptions are routed to pharmacies.

The platform:

  • Leverages eligibility and formulary data to notify providers of (prior authorization) PA requirements before e-prescribing
  • Helps eliminate forms with electronic exchange of clean, standardized messages
  • Dynamically delivers PA questions customized to patient, plan and medication
  • Pre-populates required PA information, increasing efficiency and accuracy
  • Enables real-time transactions to accelerate time to fill and increase member satisfaction

This process will be able to expedite the prescription process to 70 percent of patients in the U.S., representing 210 million lives covered by the nation’s largest PBMs.

“There is so much opportunity for clinicians to leverage data to improve healthcare, but more often than not, critical information exists on paper and in silos,” said Tom Skelton, CEO of Surescripts. “By connecting our healthcare system with solutions like ePA, we can make healthcare more efficient and easier to manage and ensure that care providers have a more complete picture of a patient’s health.”




Edited by Maurice Nagle





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