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APHA Scientific Session and Event Listing

Kate L. Lapane, PhD, Community Health, Brown Medical School, Box GH105, Providence, RI 02874, (401) 863-9648, Kate_Lapane@brown.edu and Catherine Dube, EdD, Institute for Community Health Promotion, Brown Medical School, 1 Hoppin Street, 4 West, Providence, RI 02912.

Implementation of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) has spurred research in the e-prescribing arena. For Part D eligible individuals, prescriptions transmitted electronically must comply with final uniform standards adopted by the Secretary. The extent to which the proposed standards meet the needs of the users needs to be evaluated in several projects funded by the Agency for Healthcare Research and Quality. Our research represents a unique partnership between academia and industry that takes advantage of the strengths of each organization to maximize the value of the information derived from the intensive year-long study. We developed a protocol that enables the evaluation of the extent to which the proposed MMA e-prescribing standards work effectively and efficiently and are adopted within a variety of practice, technology, and geographic settings around the country. In addition, our proposal seeks to understand what health care providers want (e.g. what information, at what time, and in what format) to make full use of the information that can be provided with compliance to e-prescribing standards. We have identified six physician software vendors, twelve major retail pharmacy chains, and have recruited ~180 physicians in NJ, MA, RI, TN, FL and NV to participate in the pilot testing. The research team will discuss strategies to successful recruiting, approaches used to optimize relationships with partners who are competitors in industry, methods to implement “smart” sampling to maximize variability observed, coordination of sub-studies to work-around issues related to patient confidentiality, preservation of relationships between industry partners, and physician practices.

Our approach is a mixed-method design using qualitative and quantitative methods. We will conduct performance analyses in the context of site-visits of physician practices. The performance analyses will seek to describe the extent of implementation, current state of skills, values, behaviors and challenges around the use of technology in the pharmaceutical care processes in physician offices. The approach uses information obtained by direct observation and interviews with key personnel, supervisors and managers and consumers. The work performance is examined from the perspective of what is happening, and what should be happening. Multiple perspectives on the performance, potential problems and opportunities, and barriers and facilitators for successful performance are investigated. We will discuss the viability of this approach for informing the adoption of standards for eprescribing.

Learning Objectives:

• To assist researchers in implementing large-scale non-experimental studies in evaluating the impact of technology on medication use
• To understand methods to increase participation of pharmacy practices in research
• To learn about methods to increase synergies across multiple industry research partners
• To discuss the successes and challenges of implementing mixed-methods (qualitative/quantitative) research protocols

Keywords: Medicare, Drug Use

Presenting author's disclosure statement:

Any relevant financial relationships? No