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Annals of Family Medicine 2:494-498 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.233
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Impact of an Evidence-Based Computerized Decision Support System on Primary Care Prescription Costs

S. Troy McMullin, PharmD1, Thomas P. Lonergan, PharmD, MBA1, Charles S. Rynearson, RPh, MS2, Thomas D. Doerr, MD1, Paul A. Veregge, MD, MS2 and Edward S. Scanlan, MD2

1 Department of Clinical Decision Support, WELLINX, St. Louis, Mo
2 Affinity Health System, Menasha, Wis

CORRESPONDING AUTHOR: S. Troy McMullin, PharmD, 10426 Baur Blvd, St. Louis, MO 63132, tmcmullin{at}wellinx.com

PURPOSE Although newer, heavily promoted medications are commonly prescribed, published evidence and consensus guidelines often support the use of less expensive alternatives. This study was designed to evaluate the impact on prescription costs of a computerized decision support system (CDSS) that provides evidence-based recommendations to clinicians during the electronic prescribing process.

METHODS A retrospective cohort study was performed using a pharmacy claims database. Clinicians using the CDSS were matched with a control group by pharmacy billed amount, number of patients treated, and number of new prescriptions filled during a 6-month baseline period in which neither group used the system. The primary outcome measure was the difference in prescription costs between the 2 groups after implementation of the CDSS in the intervention group.

RESULTS Clinicians who received evidence-based messages had significantly lower prescription costs than those in the control group. The average cost per new prescription was $4.16 lower (P = .02) in the intervention group, and the average cost for new and refilled prescriptions was $4.99 lower (P = .01). The 6-month savings from new prescriptions and their refills are estimated to be $3,450 (95% CI, $1,030-$5,863) per clinician.

CONCLUSIONS Providing electronic, evidence-based decision support during the prescribing process can shift prescribing decisions toward more evidence-based care and significantly decrease primary care prescription costs.

Key Words: Decision support systems, clinical • medical records systems, computerized • ambulatory care information systems • clinical pharmacy information systems • medical decision making, computer assisted • medical informatics applications • drug utilization • drug therapy, computer assisted




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TRACK Comments:

Read all TRACK Comments

Interventions for Rising Prescription Expenditures
Kenneth S. Fink
Annals of Family Medicine, 6 Oct 2004 [Full text]
Important attributes of a successful decision support system
S. Troy McMullin
Annals of Family Medicine, 7 Oct 2004 [Full text]
Integration into workflow
Lee A. Green
Annals of Family Medicine, 23 Oct 2004 [Full text]
Waiting for a National Health Information Infrastructure?
Mark Frisse
Annals of Family Medicine, 21 Nov 2004 [Full text]

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