Tufts, BCBSMA Offer Docs Wireless Prescription

Seeking to boost generic drug utilization and increase quality of service, Tufts Health Plan (Waltham, Mass.) and Blue Cross Blue Shield Massachusetts (BCBSMA, Boston) are joining in a $3 million initiative to offer physicians a comprehensive e-prescribing program. The companies will provide approximately 3,400 physicians hand-held devices equipped with Zix Corp.'s PocketScript e-prescribing software.

Both of the health insurers executed pilots of Zix Corp.'s (Dallas) PocketScript between 2001 and 2002 and decided to expand their commitment to the e-prescribing solution. Given that in Massachusetts' healthcare market almost every physician is a member of the top HMOs' networks, Tufts and BCBSMA pursued a collaborative approach. "It didn't seem to make sense for both of us to be banging on physicians' doors to see if they wanted to participate or enroll in a prescribing program," says Robert Mandel, BCBSMA's vice president of provider enrollment and services. "We thought we'd create less confusion in the market and increase the likelihood of having the physicians adopt the technology."

The PocketScript e-prescription program enables physicians to create both new and refill medication prescriptions electronically instead of through the traditional pen-and-paper method and allows physicians real-time access to patients' prescription history and real-time formulary information, according to Mandel.

Through the Tufts/BCBSMA program, physicians identified as high-volume prescribers will be provided with RIM (Waterloo, Ontario) BlackBerry 7200 color PDAs or Dell (Round Rock, Texas) Axim X5 pocket PCs. The doctors get the hardware to keep, and are given an introductory period of software licensing benefits and data service. When prescriptions are written at the point of care, the devices will dial up Zix Corp.'s central server to check eligibility and formulary information. Upon approval, the prescription will then be faxed through the device to the appropriate pharmacy. Zix accesses the necessary patient information from the carriers' pharmacy benefit manager (PBM) contractors, via RXHub, a joint venture of three large PBMs that routes up-to-date medication history and benefit information to healthcare providers.

Mandel claims that the experience of both BCBSMA and Tufts indicates that the PocketScript program will increase the utilization of generic drugs, among other benefits. A study conducted by Tufts as a result of its PocketScript pilot found that rejected prescriptions due to illegibility and interaction with other prescribed drugs decreased under the program, as evidenced by a 30 percent reduction in calls between physicians and pharmacists; 35 percent of prescribers reported patient care benefits due to the ability to check drug interactions and prescription accuracy; 50 percent of study respondents reported changing patient drug therapies to Tufts Health Plan preferred drugs, which, if the technology were widely deployed, could mitigate rising pharmaceutical costs by two percent or more.

Tufts also found an improvement in the efficiency of prescribing, with participating medical group practices reporting a decrease in total time spent on prescriptions of up to two hours per prescriber and affiliated staff; and a savings of nearly one hour per pharmacist in a typical day.

"From our book of business, we know that every point increase in generic utilization saves about $10 million yearly," Mandel notes. "Our investment is justified by what we se in the reduced costs related to generic utilization and the reduction of medical errors"savings that get passed on to our members."

While Tufts and BCBSMA are inviting other Massachusetts carriers to invest in the program, roll-out has already begun, according to Mandel. "Once we get in full-swing, which we expect will be in early to mid-December, we hope to be rolling out between 500 and 800 of [the hand-held devices] per month," he says. Within six months, the carriers expect to have the entire 3,400 program physicians enrolled. "We have 15,000 physicians in our managed care network, so we shouldn't have trouble getting participation," adds Mandel.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio