Cloud-based on-demand formulary service powers the next generation of ePrescribing

Validation of formulary status at the point of prescribing, powered by distributed Formulary and Benefit (F&B) files, has been a mainstay of ePrescribing for more than 20 years. The traditional distribution process consisting of multiple steps across multiple stakeholders including creating, processing, and uploading/downloading files has not changed significantly over the past two decades. Due to the multiple hand-offs of files and different distribution schedules of formulary data by EHR vendors, information may be out-of-date by the time the prescriber views it in the electronic health record (EHR). In addition, the amount of data and size of the formulary files have led to an increase in the time and resources it takes for an EHR vendor or practice to update the files on a regular basis. This has put a greater burden on EHR vendors, health systems, and physician practices who are the ultimate “consumers” of this information.  

Recently, Surescripts developed a cloud-based formulary service, On-Demand Formulary, that eliminates the need for EHRs to process and download formulary files in the traditional manner.  On-Demand Formulary is an enhancement built to replace legacy downloading of massive formulary files and helps to ensure that EHRs, and ultimately providers, have the latest formulary information at the point of care.

On-Demand Formulary is a real-time request and response transaction that enables the EHR to electronically query for formulary information directly from Surescripts during the prescribing workflow, versus relying on static files that are stored in the EHR. 

This cloud-based formulary service eliminates the need for the EHR to download the most recent formulary files and process and publish downloaded files to their customers. The real-time request and response transaction uses National Council of Prescription Drug Programs (NCPDP) Formulary and Benefit Standard, Version 3, and will be upgradable to the new Formulary Standard 5 in the future.

To better understand the potential cost savings for stakeholders using On-Demand Formulary, Surescripts developed a cost model template that can be used to inform a broader return on investment (ROI) analysis for vendors who are considering switching from the traditional F&B download process to On-Demand Formulary.

For health systems and practices that are using an EHR that has implemented On-Demand Formulary, not only can they expect to see more timely and accurate formulary data, but they can also save money and resources in several categories including processing capacity and bandwidth, data storage, quality assurance, and technical support. EHR vendors who make the switch will have similar costs savings.  Below is a sample cost savings model for a decentralized EHR vendor who distributes files to each practice. The model assumes the vendor supports 100 practices.

Decentralized EHR vendor who distributes formulary files to each practice.

Assumption: Vendor supports 100 active practices.

To create the cost savings model, Surescripts has surveyed several EHR vendors who have transitioned to On-Demand Formulary. These vendors agree that cost savings is accrued in the transition from traditional F&B file download to On-Demand Formulary, because many existing processes can be reduced or eliminated.  

“We decided to replace the distributed F&B file with Surescripts’ new On-Demand Formulary service as a way to enhance the Aprima formulary process, and at the same time reduce our development costs, network, bandwidth, and people costs.  It’s been a smooth process – the service is reliable, response time is good, and our customers are benefiting from having up-to-date information.”   
– Neil Simon, COO, eMDs. 

EHR vendors, health systems, and practices should consider a cloud-based formulary and benefit solution such as Surescripts On-Demand formulary service. Through administrative efficiencies, cost savings can be realized today.  
 

Michael Burger is a senior healthcare information technology consultant specializing in both clinical and administrative systems and processes with specific expertise in EHR implementation & optimization.
 

Surescripts’ purpose is to serve the nation with the single most trusted and capable health information network, built to increase patient safety, lower costs and ensure quality care. Since 2001, Surescripts has led the movement to turn data into actionable intelligence.