Is IT the answer to reducing the cost of healthcare? My feeling is that it can have a positive influence, since any paper-based system is going to be far more labor intensive and error prone. We have seen the benefits of real-time electronic claims in pharmacy. I can't imagine any pharmacist wanting to go back to paper claims. Yet even electronic systems are not the panacea once thought of as the solution to error reduction. I am hearing about error issues with electronic prescriptions. Keep in mind, however, that e-prescribing is still a learning experience.

There was an editorial in The New York Times in November that was headlined "The High Cost of Health Care." It examined the causes of this and the solutions, and asked the question, "Who picks up the tab?" In the solutions section, information technologies made the list, along with prevention, disease management, and drug prices. The editorial pointed out that healthcare lags well behind other sectors of the economy in the use of information technologies, and that this country lags behind foreign medical systems when it comes to using computers, electronic medical records, and electronic information sharing. The conclusion was that there is a need for "capital infusion" if we are going to see a quick exit from paper-based systems.

Let's go back to electronic prescriptions. These are clearly on the rise, based on a SureScripts report (see Industry Watch). While electronic prescriptions still account for a small percentage of the prescriptions written, they are starting to grow. Also, a study conducted by SureScripts found that there is less "leakage" with electronic prescriptions. That is, not only are these prescriptions being filled, they are being picked up. Suddenly, large numbers of physicians are beginning to e-prescribe. And our cover story survey found that virtually every pharmacy in the country is now ready to handle these.

Disease management benefits are a byproduct of electronic prescriptions. Zix Corporation has announced that it is beginning a pilot program with Blue Cross Blue Shield of Massachusetts for disease management enrollment at the point of care. Physicians will now know that the patient is eligible for enrollment in a BCBSMA disease management program. BCBSMA has also found that e-prescribing is reducing pharmacy costs associated with high prescribers, saving its members $20 to $25 for each electronic prescription changed to a preferred brand or generic. Another benefit is that prescribers at the point of care will receive drug-to-drug interactions and drug-allergy alerts. These are reasons IT is viewed as a solution for reducing healthcare costs in this country. I would have to say e-prescribing is the role model.

However, e-connectivity will move what was the domain of pharmacists, such as interaction and formulary alerts, to the point of care. Will medication therapy management programs take up the slack? A lot depends on how responsive pharmacy is in enrolling in MTM programs and then responding to Part D patients presented as candidates for MTM.

Clearly, information technology is center stage in pharmacy. It is helping to keep operating costs down, while yielding a slew of patient benefits. This is why our survey found such an optimistic outlook for 2008. CT

Bill Lockwood is the publisher of ComputerTalk. He can be reached at wal@computertalk.com.