Dispatch from the non-HITECH-incented Health IT world: electronic medication history adoption and utilization

Abstract

Objective: To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems.

Materials and methods: The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013.

Results: Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for <5 years had a lower likelihood of requests than those on the network for 5 or more years. Although descriptive analyses showed that prescribers in rural areas were alongside e-prescribing, and requesting medication histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively.

Discussion: Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories.

Conclusion: Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks.

Keywords: e-prescribing; electronic health records; health information technology; medication history.

Figure 1.

Methodology: e-prescribers using medication history, December 2013. Source: author’s analysis of data from the 2013 Surescripts medication history data.

Figure 2.

Trends in e-prescribers using medication history 2007–2013. Source: author’s analysis of data from the 2013 Surescripts medication history data.

Figure 3:

Descriptive results: average medication history use by average e-prescribing volume for provider specialty, network persistence, physician practice size, and area characteristics. Source: author’s analysis of data from the 2013 Surescripts medication history data. Notes: These results are based upon unadjusted descriptive analyses; bubble size indicates relative number of physicians.

Figure 4:

Logistic regression results: likelihood of sending more than the average number of medication history requests and electronic prescriptions by network persistence, practice size, area characteristics, and specialties. Source: author’s analysis of data from the 2013 Surescripts medication history data. Notes: Dependent variables were recoded into binary indicators such that the multiple logistic regression evaluated characteristics of prescribers requesting more medication history transactions than the average (>260), and the second model measured the likelihood of routing more e-prescribing transactions than the average (>205) during the analysis period.