2014 National Progress Report

2014 National Progress Report
More Connected Than Ever Before.
900,000 healthcare professionals
45 immunization registries
3,300 hospitals
230 million
patients
71%
of US population1
The Surescripts network is

more connected than ever.
Day in and day out, massive amounts of private and secure healthcare data are exchanged across the country.
By connecting to the Surescripts network, doctors, pharmacists, and others can fill electronic prescriptions,
review patient medication histories, report immunization records and exchange patient records. Each day,
providers nationwide exchange valuable information through a single point of connectivity using our vendor
neutral technology.
In 2014, the Surescripts network continued to grow, connecting more providers and exchanging more
information than ever before.
32 state and regional networks
700
EHR software
applications
40,000 | 98%
chain pharmacies2
21,000 | 88%
independent pharmacies2
Walgreens is committed to enabling

a connected patient experience. This
means creating a connected health
ecosystem that supports good clinical
care collaboration. Our focus on
connected health includes clinical
interoperability, clinical portals and
apps, care management, and connected
devices for clinical care, to bridge gaps in
care and provide vital information to
care providers at the point of care and
beyond. We utilize Surescripts clinical
messaging and HISP services that
are seamlessly integrated into
this infrastructure.
Venk Reddy, Senior Director,
Connected Health, Walgreens
Massive amounts of private and

secure health data crossed
the Surescripts network in 2014.
1.2 billion
764 million
7.4 million
19%
9%
1,300%
67%
44%
E-prescriptions
growth y/y
of all new prescriptions
More than
6.5 billion
transactions
Medication histories
growth y/y
hospital adoption3
Clinical messages
growth y/y
Improving Data Quality

One Prescription at a Time.
A connected network is only as good as the information exchanged, so the quality and accuracy of the data on the
Surescripts network, particularly prescription data, is critically important. Given the progress we have made driving
adoption and utilization of e-prescribing, we are now uniquely positioned to optimize the process. Were doing this
by adding new functionality, like electronic prior authorization, and by improving the quality of the data that flows
over the network, to increase customer satisfaction and drive growth.
1.2 billion
1 billion
800 million
600 million
400 million
200 million
Number of E-Prescriptions
0
2005
2006
2007
Adoption
2008
2009
2010
2011
2012
2013
Utilization
Increased connectivity in healthcare means providers have

access to exponentially more clinical data. But to fulfill the
promise of improved patient care through safer prescribing,
reduced medication errors, and improved medication adherence,
clinical data must be accurately and reliably captured.
Shane Stenner, MD, MS, Program Director,
RxStar,Vanderbilt University Medical Center
2014
Optimization
Interoperability
Reduces Costs, Saves
Time and Improves Care.
A seamless, connected healthcare experience is an increasing expectation for patients and providers.
Interoperability between providers is a critical step in creating a more efficient and quality-driven healthcare
system. Surescripts has been working on interoperability for more than a decade. With more than half of all
prescriptions routed electronically, were moving from adoption to optimization. W
ere expanding our network
to enable integrated electronic solutions for prior authorization, controlled s ubstances, clinical messaging,
and medication adherence. By increasing access to accurate and complete medication information, we can
add more value for providers and improve the patient experience.
What is medication
history worth to a hospital?
The process of reconciling a patients medication history has traditionally been very time consuming and
inaccurate. The growth in electronic prescribing has made real-time access to medication information at the
point-of-care possible. This is particularly true in acute settings, such as a hospital emergency room, where
a patient may be unconscious or unable to tell the doctor what medications they are on. In the case of
medication reconciliation, interoperability between different technology systems is critical to realizing the
true value of a connected healthcare system.
SMALL
100 Bed Hospital
MEDIUM
200 Bed Hospital
LARGE
500 Bed Hospital
VERY LARGE
1,000 Bed Hospital4
Less Patient

Less Patient

Less Patient

Less Patient
3Adverse
26
Drug Events
5Adverse Drug Events
13 Adverse Drug Events

Adverse Drug Events

Prevented Patient

Prevented Patient

Prevented Patient
4 Prevented Patient
9
22
43
Readmissions
Readmissions
Readmissions
Readmissions

Unnecessary
3,331 Unnecessary
Hours Cut
6
,663 Unnecessary
Hours Cut
1
6,657 Unnecessary
3
3,315 Staff Hours Cut

Staff

Staff
Staff Hours Cut

SAVINGS
$110,704 per year
SAVINGS
$221,409 per year
SAVINGS
$553,522 per year
SAVINGS
$1,107,045 per year
80-85% nationwide
data coverage
Hospitals are increasingly dependent
upon Surescripts for patient medication
history data in acute settings.
2.15 billion
medication records
7.5% growth y/y
84.7 million
medication history transactions by hospitals

75% growth y/y
Medication claims data for
230 million patients
Adopted in approximately
44% of U.S. hospitals5
Approx.
Approx.
2,500 Hospitals 370,000 Beds
Industry standards and legislation are driving demand for

electronic prior authorization. In 2014, Surescripts nationwide
network continued to expand to enable electronic prior
authorization through more pharmacy benefit managers and
EHR software vendors than ever before.
EHRs representing 40% of providers

Claims data for
230 million patients
PBMs reaching
75% of patients
Reaching
330,000
doctors
Electronic prior authorization

saves time & money while increasing
medication adherence.
Prior authorization is an important yet inefficient administrative task that costs providers precious time and money
while increasing wait time for patients to receive their much needed medication. In fact, 20 30% of patients
abandon their prescribed medications at the pharmacy due to prior authorizations6.
Surescripts CompletEPA connects physicians with patients health plans to help them realize the benefits of prior
authorization without enduring the pain of using outdated and slow phone, fax and portal systems. Surescripts
simplifies the prior authorization process by using the software systems providers are already familiar with and
leveraging the existing e-prescribing process. The single point of contact through the Surescripts network
allows providers to complete the prior authorization process accurately and efficiently, in many cases before
the patient leaves the office.
Manual prior authorization is costly and time-consuming.
4 hours
$11k
5-8 hours
$14k
Per pharmacist
each week
Per pharmacist
each year
Per physician
each week
Per physician
each year7
Clinical messaging increases

workflow efficiency and connects
providers nationwide.
Exchanging clinical data, such as discharge and visit summaries, patient charts, and referral orders, is not just
a regulatory requirement to improve care coordination, but it makes good business sense. Surescripts Clinical
Messaging can help meetMeaningful Use requirements for transitions of care and helps hospitals and other
healthcare organizations improve patient outcomes.
In the past three years, Surescripts has built the nations largest physician directory, connecting more than
160,000 providers, so they can exchange patient-specific clinical information electronically.
Prior authorization has been a pain point for providers and patients alike. Through our collaborative efforts with Surescripts, we are providing the industry with the tools necessary to
alleviate this frustration while saving time and resources. Integrating CompletEPA into our
application will provide our clients with automated, real-time electronic prior authorization
processes enabling them to focus less on administrative functions and more on providing
better patient care.
Michael Lovett, Executive Vice President
& General Manager NextGen
Clinical messaging, while still in the

adoption phase, is beginning to take off.
2,000
rovider
p
organizations
160,000
providers connected
400% growth y/y
974
hospitals
7.3 million
clinical messages
18%
of all staffed beds
in the country
1,300%
growth y/y
HITECH led directly to our Epic project and to participation in the Meaningful Use
Program. All of our eligible providers and hospitals have successfully participated
in Stage 1, and in 2014 98% of our 500 Stage 2 providers and one Stage 2 hospital
successfully attested. Surescripts was critical to that success, providing infrastructure
that supported our Transitions of Care strategy.
Dr. Lynn Witherspoon, SVP & CMIO,
Ochsner Health System
Improving Public
Health By Combating
Prescription Fraud
and Abuse.
In 2013, more than two million Americans abused prescription painkillers such as hydrocodone, oxycodone
and methadone.8 Since 1999, overdose deaths involving prescription painkillers have quadrupled, and by 2007
they outnumbered heroin and cocaine overdoses.9
The rescheduling of hydrocodone to a Schedule II drug has made the need for safe and secure electronic
prescriptions for controlled substances even greater. By eliminating the paper prescription and connecting
physicians and pharmacists electronically, there is an opportunity to improve care, reduce fraud, and identify
potential instances of abuse.
The ability to communicate easily and efficiently ensures that all of our physicians and
health care providers will be armed with the right information at the right time to make the
right decisions for our patients. To advance healthcare interoperability we need to move
faster as an industry, and the changes in the delivery model that are being thrust upon us
are going to necessitate that we do it quicker.
Chuck Fennell, CIO, St. Josephs - Syracuse
E-prescribing of controlled substances

increased by 400% in 2014, but adoption
among providers is still low.
73%
pharmacies
enabled
1.4%
providers
enabled10
Legal in 49 states
and D.C.
1.67 million
controlled substance
e-prescriptions
Almost
400% y/y growth
State
Top 10 States
E-Prescribing
Controlled
Substances11
1 Nebraska
2 California
3 Michigan
4 Massachusetts
5 Delaware
6 Illinois
7 Iowa
8 Rhode Island
9 Arizona
10 Minnesota
% Prescribers
Enabled
% Pharmacies
Enabled
% EPCS
Transactions
NE 8.11% 75.90% 6.81%

CA 8.58% 71.20% 4.26%
MI 9.07% 65.90% 2.57%
MA 4.91% 80.60% 2.72%
DE 1.39% 87.90% 3.37%
IL 2.76% 78.80% 2.19%
IA 3.31% 75.30% 1.99%
RI 2.30% 91.40% 1.15%
AZ 2.24% 87.20% 1.03%
MN 2.99% 64.10% 1.63%
OR 1.74% 81.80% 1.15%
TX 1.59% 81.30% 1.21%
NH 0.90% 89.10% 1.07%
MD 1.61% 77.20% 1.28%
WY 1.92% 72.90% 0.78%
CO 1.47% 82.40% 0.38%
OK 1.18% 84.20% 0.44%
DC 1.39% 75.70% 0.87%
IN 0.99% 85.70% 0.29%
OH 1.01% 77.70% 0.87%
NY 1.84% 70.30% 0.77%
VA 0.81% 78.80% 0.75%
NV 1.29% 80.30% 0.12%
NC 1.04% 78.30% 0.44%
CT 0.74% 81.10% 0.46%
NM 0.81% 78.70% 0.43%
ME 0.53% 79.60% 0.53%
ID 1.18% 68.10% 0.82%
WA 0.98% 71.70% 0.55%
NJ 0.61% 77.40% 0.36%
FL 1.57% 68.40% 0.17%
AK 0.73% 75.80% 0.22%
TN 1.19% 67.60% 0.33%
PA 0.51% 71.90% 0.52%
LA 0.49% 74.60% 0.20%
WI 0.33% 70.70% 0.56%
WV 0.48% 69.00% 0.39%
SC 0.20% 73.90% 0.04%
KS 0.45% 71.30% 0.03%
GA 0.55% 69.40% 0.08%
KY 0.51% 60.80% 0.54%
AL 0.79% 63.00% 0.15%
MS 0.61% 62.80% 0.14%
AR 0.86% 60.80% 0.04%
UT 0.61% 57.80% 0.09%
VT 0.34% 56.20% 0.10%
HI 0.05% 56.00% 0.00%
MO 0.47% 42.40% 0.09%
SD 0.20% 45.30% 0.02%
MT 1.68% 25.50% 0.00%
ND 0.00% 26.50% 0.00%
EPCS is one example of how our customers can achieve

interoperability, resulting in increased practice efficiency and
patient convenience, not to mention improved patient safety
and medication adherence.
George Cuthbert, Vice President, MEDENT
I see the physical and emotional toll that opioid abuse takes on patients and their families
every day in the emergency room. EPCS can be an effective tool in fighting that abuse.
Physicians are eager to embrace technology as long as it is good technology that speeds
our workflows and allows us to make better informed decisions that increase patient safety.
What we dont want is bad technology that slows us down, costing us minutes that impact
the health and well-being of our patients.As a healthcare community, we need to work
together to deliver integrated, usable systems; good technology that prescribers want to
use. EPCS can help with that.
Dr. Sean Kelly, FACEP, CMO, Imprivata and an emergency physician
at Beth Israel Deaconess Medical Center
National Progress Report

Data Set
2014
2013
Healthcare professionals
900,000
700,000
Health data transactions
6,500,000,000
6,000,000,000
Hospitals
3,300
n/a
Patients
230,000,000
210,000,000
EHR Applications
700
600
Chain pharmacies
40,000
40,000
Independent pharmacies
21,000
21,000
Number of state and regional networks (HIEs)
23
21
Electronic prescriptions
1,200,000,000
1,040,000,000
Percentage of new e-prescriptions
67%
58%
Prescribers utilizing
56%
55%
Clinical messages
7,400,000
509,000
Hospitals utilizing
974
400
Provider addresses
160,000
32,000
Medication history transactions
764,000,000
699,000,000
Medication history transactions by hospitals
84,700,000
48,000,000
Hospitals utilizing
2,500
1,200
Patient data coverage
80-85%
66%
Network Connections & Transactions
Electronic Prescribing
Clinical Messaging
Medication History
Electronic Prescribing of Controlled Substances (EPCS)

EPCS transactions
1,670,000
340,000
Percentage of pharmacies enabled
73%
40%
Percentage of providers enabled
1.40%
n/a
Virginia
2800 Crystal Drive
Arlington, VA 22202
Fax: 1-703-921-2191
Minnesota
920 2nd Avenue South
Minneapolis, MN 55402
Fax: 1-651-855-3001
1. U.S. Census Bureau, 2014

2. NCPDP
3. AHA, http://www.aha.org/research/rc/stat-studies/fast-facts.shtml
4. http://surescripts.com/hospitalvalue
5. AHA, http://www.aha.org/research/rc/stat-studies/fast-facts.shtml
6. http://content.healthaairs.org/content/28/4/w533.full
7. Health Aairs July/August 2009 vol. 28 no. 4 w533-w543 http://content.healthaairs.org/content/28/4/w533.abstract?ijkey=0ea98293a5c04485a869a0310555efbdfc387258&keytype2=tf_ipsecsha
8. Centers for Disease Control and Prevention, http://www.cdc.gov/drugoverdose/data/index.html
9. National Institute on Drug Abuse
10. Total prescribers in both acute and ambulatory settings based on Enclarity data.
11. Based on pharmacy and provider enablement, and prescription volume on the Surescripts network.

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2014 National Progress Report

More Connected Than Ever Before.

900,000 healthcare professionals

The Surescripts network is

32 state and regional networks

Walgreens is committed to enabling

Massive amounts of private and

Improving Data Quality

Increased connectivity in healthcare means providers have

100 Bed Hospital

200 Bed Hospital

500 Bed Hospital

1,000 Bed Hospital4

$110,704 per year

$221,409 per year

$553,522 per year

$1,107,045 per year

medication history transactions by hospitals

Medication claims data for

230 million patients

2,500 Hospitals 370,000 Beds

Industry standards and legislation are driving demand for

EHRs representing 40% of providers

Electronic prior authorization

Manual prior authorization is costly and time-consuming.

Clinical messaging increases

Clinical messaging, while still in the

E-prescribing of controlled substances

400% y/y growth

NE 8.11% 75.90% 6.81%

EPCS is one example of how our customers can achieve

National Progress Report

Health data transactions

Number of state and regional networks (HIEs)

Percentage of new e-prescriptions

Medication history transactions

Medication history transactions by hospitals

Patient data coverage

Network Connections & Transactions

Electronic Prescribing of Controlled Substances (EPCS)

Percentage of pharmacies enabled

Percentage of providers enabled

1. U.S. Census Bureau, 2014

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