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Dr. Bill A. Bridgforth Jr. of Johnson City Pediatrics discusses medication options with a young patient's mother.

BlueCross BlueShield of Tennessee (BCBST) has announced enhancements to the Caremark® Rx, Inc. iScribe® electronic prescribing program. The goal is to enroll 250 new BCBS network physicians who write more than 1,000 prescriptions per year.

Since the iScribe program first offered the free software to physicians in 2004, 60 Tennessee physicians have come on board and are prescribing meds with handheld devices. Features being offered now for docs signing up include not only free iScribe software but also a printer, related hardware, installation and follow-up, and field support.

Dr. Bill A. Bridgforth Jr. of Johnson City Pediatrics has been using iScribe on a Palm LifeDrive PDA about two years and said he couldn't be happier.

"It makes prescription writing faster," he said. "It allows me to do refills faster. It allows me to give patients a generic substitute if they wish, saving them lots of money and insurance companies a lot of money. It's compacted record-keeping because it takes up less room in the charts. With a touch of the stylus, I can click on a letter of a person's name and then find their name and click on it. Then, I type in the first letter or two of the drug I want and it gives me a list. I hit on it and then the form I want it in — whether tablet or liquid, the number of milligrams, and touch on the number of refills. Then, it gives me a list of pharmacies and with a touch of a button I send it to the pharmacy of their choice or can print it. I can pull up pharmacies in California if I want. It prints on a special paper that's harder to forge, if we print it. It saves a lot of time, it's great."

Terry Shea, director of pharmacy services for BCBST, said the iScribe program has been redesigned to remove barriers frequently cited, such as the cost of the tools themselves, as a reason for its slow adoption across the board.

"BlueCross is constantly seeking innovative ways to work with our network doctors and our members on quality and cost issues," said Shea. "The iScribe program allows us to address both."

According to the Institute of Medicine, medication errors harm at least 1.5 million people every year. Studies associate paper-based prescribing with high error rates. The report calls for all prescriptions to be written electronically by 2010.

IScribe is fully compliant with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, which governs the management and use of confidential patient information. Benefits of the program include being able to generate prescriptions with a handheld PDA or desktop computer and transmitting them directly to the patients' pharmacy without all the script pads, phone calls and faxes usually necessary. It also serves as a valuable resource tool researching drugs and interactions at the point of prescribing and can be used as long as the physician is a participant in BCBS regardless of whether or not the patient is covered by BCBS or any other health plan.

Dr. Jan Berger, Caremark senior vice president and chief clinical officer, said electronic prescribing represents a significant advance in the delivery of healthcare, and they are pleased to be working with BCBST in leading the introduction of this technology.

"The iScribe service promotes not only drug safety, but also convenience and time savings for patient and physician alike," Berger said.

Dr. Bennie Whitehead of Alcoa said iScribe saves him between 30 to 60 minutes a day.

"I've changed how I've scheduled patients," Whitehead said. "With iScribe, I see four to five more patients a day. You multiply that over a year and that's significant."

To take advantage of the iScribe program, clinicians must have high-speed Internet access and be enrolled in the BCBST network. The program can be used to write prescriptions for patients regardless of whether the patient is covered by BCBST or some other health plan.


November 2006

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