We are excited to present this article, reprinted with permission from Andrew Mellin, MD, Vice President, Chief Medical Information Officer at Surescripts®.
For prescribers, choosing the right medication is only half the battle. Even the optimal therapeutic decision falls flat when a patient can’t access and adhere to it because of the cost. Personally, there are few things more frustrating and disheartening for my colleagues than when they thought their patient was well on their way to a good outcome, only to find out later that the patient never began treatment because of financial constraints they weren’t aware of.
More than half of patients struggle to adhere to their medication because it’s too expensive. And of those who skipped a medication because of its cost, 94% said they would have been willing to take a lower-cost alternative if a doctor or nurse had suggested one.
Today, prescribing medications requires both clinical and financial decisions. Electronic health records (EHRs) can now empower clinicians with in-workflow solutions so they can have meaningful cost conversations and make medication decisions that work for patients on both fronts.
Prescribers want to do the right thing for patients. But they face serious barriers without the right information about the exact cost of a medication—and therapeutic options that might be more affordable.
EHR-integrated prescription price transparency tools can help keep adherence on track throughout the care journey. For prescribers, this means no more guesswork and far less rework. In a matter of seconds, they have the cost of the selected treatment, an indication of whether or not it needs a prior authorization, the cost for a 30- or a 90-day supply, and the cost at the patient’s preferred pharmacy or with a mail-order option associated with their benefit plan. They don’t have to search for the information—it’s right there in their workflow. They can turn the screen to the patient and say, “I have this medication in mind, but I want to go over the costs with you to make sure we’re choosing one you’re comfortable with.”
Imagine the trust this builds between physician and patient. It preserves that interaction as a sacred space, but facilitates a whole new level of awareness, consideration and collaboration in a shared decision-making process that simply wasn’t possible before.
Demand for a real-time prescription benefit tool continues to grow given recent regulations designed to promote price transparency and medication affordability. At the end of 2020, Congress passed legislation intended to drive greater price transparency for prescription medication. Part D Medicare plans are now required to implement at least one real-time benefit tool (RTBT) integrated with prescribers’ e-prescribing and EHR systems. And, starting January 1, 2022, qualified EHR systems under the ONC Health IT Certification Program must include an RTBT that conveys patient-specific cost and coverage information.
With tools available today, EHRs like Quanum EHR can help prescribers start seeing a meaningful cost conversation as a fundamental component to each and every patient interaction—and to empower them to make medication decisions that work both clinically and financially.
Once prescribers see how they can impact adherence and reduce calls for rework with a workflow that helps them get it right for their patients the first time, they won’t want to go back to the old way—ever.
Andrew Mellin, MD, MBA, is Vice President of Medical Informatics at Surescripts and has more than 20 years of experience in health information technology, patient quality and safety, consumer health and EHR implementation and adoption.
Disclaimer: The views expressed in this blog post do not necessarily reflect the views of Quest Diagnostics® or any of its employees.