Governor Donald L. Carcieri announced Monday that Rhode Island is the first state in the country with 100 percent of its pharmacies e-prescribing.

“Rhode Island is leading the way again in all-around health care and health care technology,” Carcieri said in a morning press conference in the parking lot of Oxnard Pharmacy in Buttonwoods.

The system also enables the state to track diseases using prescription data from pharmacies.

“Rhode Island becomes the first state in the nation to work with Surescripts to use prescription data in the aggregate for disease surveillance, specifically monitoring and tracking the use of antiviral data during this H1N1 pandemic,” said Director of Health David R. Gifford, MD MPH.

Rhode Island is also providing the department with weekly updates of prescription data from pharmacies across the state.

This electronic integration is enabling health officials to assure the prescribing within a community is matching with the diseases that are being reported. If these statistics do not match, HEALTH can immediately go into these communities and better educate them on treatments and diagnoses.

The state had three goals when the e-prescription program began in 2003: have 100 percent of pharmacies equipped with the necessary electronic capabilities, get two-thirds of physicians to e-prescribe and have over 50 percent of prescriptions be e-transmitted. Today 100 percent of pharmacies are capable, 63 percent of physicians are e-prescribing and 31 percent of prescriptions are being e-transmitted.

“Rhode Island is once again demonstrating to the rest of the nation how to do something and do it well,” said Carcieri.

Dave Feeney, owner of Oxnard Pharmacy is seeing firsthand the time saving measures that accompany the e-prescribing system. Oxnard was the first independent pharmacy in the country to have e-prescribing, he said.

“E-prescribing allows you more time with patients, improves prescriber relationships and improves patient relationships,” said Feeney.

Surescripts, the nation’s leading e-prescription network, selected Rhode Island as the national beta test site and birthplace of electronic prescriptions in 2003.

“We were created by the pharmaceutical industry as a way to save costs by building one network that everyone can use,” said Surescripts spokesman Rob Cronin.

Surescripts headquarters are located in Alexandria, Va. and St. Paul, Minn.

When the beta testing started, the state was operating at a 3 percent pharmacy involvement, now all 181 are involved.

“When was the last time in Rhode Island that we had 100 percent agreement on anything,” said Mayor Scott Avedisian.

The cost for a year of e-prescription data is estimated at $15,000 to $20,000 and Rhode Island is using federal grant money to fund these costs. According to Dr. Gifford, the state has also received four different $1 million to $2 million allocations for H1N1 treatment since the spring.

In 2006, Child Magazine ranked Rhode Island as the safest place in the nation to raise a child, listing its e-prescribing initiative as one of the reasons why.

Laura Adams, president of the Rhode Island Quality Initiative, believes that the establishment of a complete electronic infrastructure will be invaluable to patients and health care workers alike.

“A patient in Rhode Island was treated at a local hospital using all of the information the doctor had available at the time, but was forced to extend their hospital stay because the correct diagnosis was not made,” said Adams.

Through the use of electronic health records the doctor would have had access to the patient’s complete medical history and may have been able to prevent the extension of their stay.

The level of patient participation in the program is assessed on an individual basis and only with the patient’s permission.

“No one will be placed into the system if they feel uncomfortable with it,” said Adams.

The Quality Initiative spent 18 months working with the ACLU, the coalition against domestic violence and other organizations in order to build a consent model and develop privacy standards for patients involved.

The e-prescription program will implement timesaving measures, while improving the safety of patients.

“If I try to prescribe a drug with a component that the patient is allergic to, a red flag will alert me to the problem,” said Dr. David Gorelick. Gorelick is an internist with Aquidneck Medical Associates in Newport.

One major roadblock to the e-prescribing program is the inability of doctors to send Schedule II drugs through the system. Schedule II drugs are drugs with a high abuse risk such as morphine, cocaine and Ritalin. The Justice Department fears that a computerized format may allow for hacking and easy access into that infrastructure, according to Adams.

“With this system if a Schedule II drug is misdiagnosed or prescribed, the system will provide an electronic flag for doctors and pharmacists,” said Adams.

Adams also noted that if a person were to try and hack into the system they would leave an electronic footprint at several different levels.

The transformation from paper to digital health care in Rhode Island began with the Quality Initiative founded by U.S. Senator Sheldon Whitehouse in 2001.

In a statement Whitehouse said, “Today’s announcement is another impressive milestone in a long line of health care innovations in Rhode Island.”

President of Surescripts, Harry Totonis, said that while Rhode Island is the only state that is fully operational to date, the hope is that the rest of the country will not be far behind.