Practice Rounds: Explosive Growth for Electronic Scripts

Welcome to Practice Rounds, our new weekly column exploring what's being covered in the larger world of healthcare.

Electronic Scripts for Narcotics Grow 600 Percent

Surescripts, a leading health information network, has released its annual National Progress Report. The company processed 9.7 billion secure data transactions in 2015, according to Surescripts' press release. That breaks down into 1.4 billion electronic prescriptions, 1.05 billion medication histories, and 15.3 million clinical messages. The company says 77 percent of all prescriptions were submitted electronically in 2015, a nearly 17 percent increase over 2014. There was also significant growth in the number of physicians who were able to electronically prescribe controlled substances - an increase of 359 percent in 2015 - resulting in a 600 percent increase in the number of electronic scripts written for controlled drugs.

NY Doctors Say Quality Goals Unrealistic

Physicians who are employed by New York City public hospitals are locked in a battle with their employer, NYC Health & Hospitals, over ambitious quality metrics, reports Modern Healthcare. As part of new performance improvement measures, the hospital system negotiated a contract with physicians that tied 5 percent of their wages to quality metrics. The system itself received $1.1 billion in value-based payment arrangements, according to the city's administration. But physicians are taking umbrage with specific quality targets - like patient satisfaction and the length of time between treatment and admission to the hospital - saying they are unobtainable.   

Cost for Lifesaving Medication out of Reach

An unfortunate twist with newer high-deductible (HD) health plans is that patients must often shoulder the full burden of cost for prescription medications until they meet their deductible, which can be $4,000 or more. That can present a shock when patients must purchase costly medication. That's the case with the EpiPen which is used to treat life-threatening allergic reactions, according to Mother Nature Network. A common medication, the EpiPen was much more affordable in 2008, at $100, but now it can cost roughly $600 for one EpiPen - a six-fold increase. Mylan pharmaceutical, which holds a near monopoly on EpiPen, said in a statement to CBS News "[The cost] has changed over time to better reflect important product features and the value the product provides."

Female Physicians Still Face Harassment

Nearly one-third of high-achieving, female physician-scientists have experienced sexual harassment on the job, according to a study at the University of Michigan. While the study focused on an academic environment, parallels can be drawn with physicians in practice-based medicine, according to an article in Medical Economics. Even though gender-based discrimination exists in the general workplace, physicians and their employers must also be sensitive to the use of inappropriate language and overt sexual references in the workplace. "Physicians, in their relations with each other, with staff, and with patients, must be increasingly sensitive to how their actions or comments may be perceived by others, or later judged by the media, an agency bureaucrat, or a jury in our current highly sensitized and highly politicized culture," said attorney Mark Van Brussel.

Quote of the Week:

"Zika can clearly enter the brain of adults and can wreak havoc. But it's a complex disease - it's catastrophic for early brain development, yet the majority of adults who are infected with Zika rarely show detectable symptoms. Its effect on the adult brain may be more subtle, and now we know what to look for."

Sujan Shresta, professor at the La Jolla Institute of Allergy and Immunology, as quoted in the Washington Post.