Imagine if all medications for veterans were prescribed electronically, erasing the need for paperwork and increasing safety and security. That’s the future that California is working towards with its new ePrescribe system. This system went live in December 2021 and, according to officials, has already streamlined the process of prescribing medications for more than 1,700 veteran residents and their spouses at the eight veterans homes in California.
The California Department of Veterans Affairs (CalVet) shined a spotlight on the new system in its nomination for the National Association of State Chief Information Officers (NASCIO) 2022 State IT Recognition Awards.
CalVet said ePrescribe allows veterans to have their regular medication orders sent electronically to CalVet pharmacies. The digital update reduces the paperwork (including traditional handwritten doctor’s notes) and chances for error. It also increases CalVets oversight for drugs like opioids that could be easily misused.
CalVet Secretary Vito Imbasciani praised the ePrescribe development effort, saying the tool exemplified CalVet’s ongoing mission to provide critical services to members.
“I couldn’t be happier with the implementation of CalVet’s new ePrescribe solution,” Imbasciani said. “Our mission is to advocate and care for California’s veterans. Our IT staff, Homes staff, doctors, nurses, and clinicians came together as a team, launched the program efficiently, expertly, and ahead of schedule. I’m very proud of their work and the benefits it brings to the residents in our eight Veterans Homes of California.”
In its NASCIO nomination, CalVet Chief Information Officer Isaiah Mall said the idea for CalVet ePrescribe came as a response to Assembly Bill 2789, signed into law by then Gov. Jerry Brown in 2018. The bill had a two-pronged purpose. Its first goal was to modernize the state’s prescription delivery process between health providers and pharmacists, and its second goal was to fight California’s opioid epidemic and other prescription drug misuse.
This second objective, to combat opioid addiction, was a core driver for the creation of ePrescribe.
Opioid addiction is a critical issue facing veterans in California and across the country. In a study commissioned by the National Institutes of Health, veterans are twice as likely as civilians to die from an opioid overdose. This is due, in part, to the fact that veterans are often prescribed opioids for chronic pain. When they become addicted to these drugs, it can be difficult for them to get help.
In California, opioid addiction continues to rise. The Centers for Disease Control reported that seven percent increase in deaths in the last 12 months, and in the previous year, deaths skyrocketed by nearly 48 percent. When combined, more than 22,000 people died across the state from overdoses in the past two years.
“The [ePrescribe] program uses technology to improve the prescription process, making it safer, more secure, and more efficient. Technology does and must play a major role in serving our veterans,” said Isaiah Mall, CalVet’s chief information officer.
With ePrescribe, state officials hope to reduce, or completely eliminate, fraudulent prescriptions. In the analysis of AB 2789, the legislature referred to a study coordinated by Johns Hopkins Medication outpatient pharmacy showed 89 percent of doctors’ handwritten prescriptions “failed to meet best practice guidelines or were missing information that would otherwise be prompted by an e-prescribing system.” In contrast, the study reported that 100 percent of all electronic prescriptions were error-free.
Outside drug safety and security, Mall said ePrescribe is focused on a larger modernization initiative that will not only digitize the prescription drug process, but also increase efficiency, and improve care through electronic health records.
“There’s much more to come. ePrescribe is the first element of CalVet’s Electronic Health Record Program (CEHR),” Mall said. “Plans are to do a phased, home-by-home rollout of CEHR at CalVet’s eight Veterans Homes this fall, which will provide a single electronic record and enable the measurement of [health] outcomes.”