Editors' Note

Harry Totonis came to Surescripts in March of 2009 from MasterCard where he was head of Advisors Services. Previously, he had spent 14 years with Booz Allen Hamilton, where he served in several executive positions, including managing partner of the firm’s global banking and insurance practice and member of the firm’s executive leadership team. Before joining MasterCard, he was CEO of Kinexus. He earned an undergraduate degree in computer science from Ohio State University and an M.B.A. in finance from Fisher College. Totonis was featured in the top-selling book The 5 Patterns of Extraordinary Careers.

Company Brief

Surescripts is the result of a 2008 merger between the country’s two leading health information networks, RxHub and SureScripts (www.surescripts.com), and gives health care providers secure electronic access to prescription information that can save patients’ lives, improve efficiency, and reduce health care costs. The Surescripts network is available during both emergencies and routine care and is used every day by hundreds of thousands of physicians, physician assistants, nurse practitioners, and other prescribers across all 50 states. The Surescripts network connects leading payers and pharmacy benefit managers, technology vendors, and prescribers to all of the nation’s major chain pharmacies and independent and mail order pharmacies.

What are the key areas of focus for Surescripts and the services that you provide?

The Surescripts network operates in the health care space, facilitating the sharing of information among a number of key players in that space, namely physicians, pharmacists, health plans, and health payers, including Medicaid and Medicare. We transmit electronic prescriptions, known as e-prescriptions, as well as information that helps physicians choose the right medication for their patients. Instead of doctors writing out prescriptions on paper as they’ve done for centuries, they use a PDA, laptop, or other computing device with a software program that allows them to send the prescription electronically to the pharmacy of the patient’s choice. The pharmacy receives it in its computer system, allowing it to process the prescription in a far more efficient way.

There are all kinds of safety benefits to e-prescribing. The iconic example is the elimination of doctors’ chicken-scratch handwriting, with all the deciphering problems that creates. In addition, doctors are able to look up a patient’s medication history – with the patient’s consent, of course. That means the doctor can write a prescription that will be far less likely to have harmful interactions with other medications the patient may be taking, or to worsen an allergy or cause an allergic reaction.

Where do you foresee your growth coming from?

In 2009, we had a 110 percent increase in the number of active prescribers, and we handled close to one billion prescription messages. We have almost tripled the number of e-prescribers in the country. The demand for e-prescribing has grown tremendously, and it will continue to increase dramatically.

Are there challenges you have faced in bringing physicians on board?

There are challenges. The walls have just come down on one of them, which was that you could not prescribe controlled substances electronically. The Drug Enforcement Administration (DEA), after years of looking into the issue, recently changed that rule. This is a major step in the right direction, but it will require industry-wide collaboration to meet DEA requirements to ensure the safe and secure e-prescribing of controlled substances.

Yet another challenge is that some physicians have trouble using the system because they are not, shall we say, electronically enabled. That is a limited problem, however, because more and more of today’s physicians have grown up using technology as compared with the doctors who graduated years ago.

The last element is that there are about 250 companies offering software to doctors, and figuring out how to automate their offices is one of the largest challenges they face. The good news is that the federal government has created a program to subsidize physicians who adopt electronic health records. They can get as much as $44,000 under Medicare or $60,000 under Medicaid. We are hopeful that large numbers of them will take advantage of that.

In the long run, between the Obama administration’s pushing this issue and a new generation of tech-savvy doctors graduating from medical school, e-prescriptions are going to become part of everyone’s life and that benefits us all.

Do you foresee adding new services that are natural extensions for the brand or will services remain relatively consistent?

We see ourselves in the electronic health records business, not just in electronic prescriptions. Earlier this year, we announced that we were working with a laboratory company to provide lab information electronically. We are also working with urgent-care clinics. We have a system where patients who walk into a clinic can have a summary of their treatment transmitted electronically to their primary care physician at the end of the visit. And this transmission of information is two-way, because patients who go to a clinic for care may not remember 100 percent of their medications, or they might not be able to communicate all the information properly. We make it possible for the clinic to get access to the patients’ medication histories to make sure they don’t have any drug interactions.

When the opportunity presented itself to become CEO of Surescripts, did you know it was the right fit and what excited you about it?

I knew it was the right fit because I came from MasterCard, which was very much about connecting consumers with solutions and providing services.

I also found it exciting to work on improving health care in America. This was an opportunity not just to do a corporate job, but to actually do something with the company that is good for America. I liked the idea that the company could have a big impact on a nationwide problem.•