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Archived ePrescribing News

News relevant to the scope of Florida's ePrescribe Clearinghouse mandate are shown below.
Click on the source to read entire articles.

A new analysis by a Washington health care consultancy suggests that despite the incentives for adopting e-health records in the stimulus legislation, some doctors may be better off financially sticking with pen and paper.

The stimulus law calls for giving Medicare providers up to $44,000 apiece for adopting EHRs and reducing their payments by up to 5 percent if they fail to use them by 2015.

But the Avalere Health analysis concludes that a doctor still will have to shell out $70,000 over five years for an EHR system, or about $14,000 a year, beyond the incentive payments. The maximum penalty for nonadopters would amount to $8,500, Avalere officials said.

“These are incentives” in the stimulus bill, “not 100 percent subsidies,” said Jon Glaudemans, a senior vice president of Avalere.

Source:  http://govhealthit.com/articles/2009/03/10/docs-to-pay-substantial-sums-for-ehrs.aspx?s=GHIT_170309

Health Care Stakeholders Release “How-To” Guide to Help Clinicians Switch from Paper to E-Prescribing Systems

The eHealth Initiative (eHI), in collaboration with the American Medical Association, the American Academy of Family Physicians, the American College of Physicians, the Medical Group Management Association, and the Center for Improving Medication Management (Center), issued the first comprehensive, multi-stakeholder-informed “how-to” guide to help clinicians make informed decisions about how and when to transition from paper to electronic prescribing systems.  A Clinician’s Guide to Electronic Prescribing was released at the Centers for Medicare and Medicaid Services (CMS) National e-Prescribing Conference in Boston today and follows the agency’s decision earlier this year to offer financial incentives--beginning in 2009--to providers who adopt e-prescribing.

“We know e-prescribing is an efficient way to improve health care delivery, decrease medication errors, and prevent potentially dangerous drug interactions,” said eHI Chief Executive Officer Janet Marchibroda. “However, the transition from a paper to electronic system is quite challenging. This guide is meant to remove some of the mystery around e-prescribing and help physicians begin to realize some of the many benefits e-prescribing can bring to their patients and their practices.”

Developed with the strategic guidance of a multi-stakeholder Steering Group comprised of clinicians, consumers, employers, health plans, and pharmacies, and in partnership with four major medical associations, the guide is designed to meet the needs of two target audiences: The first section of the guide targets office-based clinicians who are new to the concept of e-prescribing, and who seek a basic understanding of what e-prescribing is, how it works, what its benefits and challenges are, and the current environment impacting its widespread adoption.  The second section of the guide targets office-based clinicians who are ready to move forward and bring e-prescribing into their practices.  It presents fundamental questions and steps to follow in planning for, selecting and implementing an e-prescribing system.  The guide also provides a list of key references and resources readers may consult to help make the transition to e-prescribing as smooth as possible.

“E-prescribing holds great promise for improvements in patient safety and advances in care coordination, and the AMA is committed to helping physicians adopt this technology,” said American Medical Association Board Member, Steven J. Stack, M.D. “This guide is an important resource for physicians and can aid in the adoption and implementation of e-prescribing.”

“With all the momentum toward e-prescribing and its accelerated growth, it is important to assist physicians and other prescribers to ensure that e-prescribing is implemented well in order for the full range of benefits can be achieved,” said Steven E. Waldren, MD, MS, Director, Center for Health-IT at the American Academy of Family Physicians and Center for Improving Medication Management Board member. “This Guide provides substantial detail not only on how to get started but what challenges to expect and how to overcome them.”...

"A Clinician's Guide to Electronic Prescribing"
http://www.ehealthinitiative.org/assets/Documents/e-Prescribing_Clinicians_Guide_Final.pdf

Source:  http://www.ehealthinitiative.org/news/2008-10-07.mspx

September 25, 2008

Hospital Group Throws Support Behind ERx of Controlled Substances

On Wednesday, the American Hospital Association said it supports the use of electronic prescribing for controlled substances, AHA News  reports.

However, AHA called on the Drug Enforcement Administration to ensure that its proposed e-prescribing rule aligns with other private and public health care sector efforts to avoid conflicts and redundancy.

The hospital group also urged DEA to:

• Gain a strong understanding of the security-related functionality of electronic health record systems;
• Identify the financial and legal risks associated with e-prescribing of controlled substances; and
• Conduct pilot testing of its proposed e-prescribing rule (AHA News, 9/24).

AHA publishes AHA News.

September 24, 2008

FL doctors offered free electronic prescribing service

Doctors who've resisted moving to electronic prescribing because they fear start-up costs can now do so for free. Availity of Jacksonville has teamed with an IT company in Virginia to offer Florida doctors up-to-date patient information in a protected system called CarePrescribe. 
 
The free connections are available  to all doctors in Florida who participate in the Availity network, according to Laura Ahlbin, a spokeswoman for Prematics of Vienna, Va. More than 90 percent of Florida doctors have access to that network, she said, and all Florida hospitals are enrolled.

Doctors in Tampa and Miami who participate can even get free handheld devices with a high-speed connection to Prematics, she said.

The federal government is offering doctors an extra incentive for signing up. A provision in the Medicare Improvements for Patients and Providers Act that passed earlier this year offers a 2 percent increase in payments beginning next year to physicians who use e-prescribing technology. After two years, that incentive payment drops, but doctors who balk at adopting e-prescribing could actually have payments cut starting in 2012.

Tampa doctors familiar with the project say it's a great help to all concerned -- doctors, pharmacies and patients. Jose Burgos of Prime Care Medical Group said he's enjoying the convenience and the greater safety that's provided by not relying on messy handwriting.

"The prescriptions are clean and neat," he said. "I've longed for this technology."

SureScripts-Rxhub, which is handling the pharmacy sign-up, has certified more than 95% of retail pharmacies nationwide for electronic prescribing, Ahlbin said. CarePrescribe users can send prescriptions to any of these pharmacies, in or out of Florida.

Availity and Prematics receive support from Humana and Blue Cross and Blue Shield of Florida. More information is available at Availity's Web site.

Source:  Florida Health News - http://www.floridahealthnews.org/index.cfm/go/public.articleView/article/9140

July 31, 2008

HHS Takes New Steps to Accelerate Adoption of Electronic Prescribing
Medicare Payments for Successful Electronic Prescribers, Reporting Quality Data are Important Steps Toward a Value-Driven Health Care System

Medicare is starting a new program to encourage physicians to adopt e-prescribing systems.  Incentive payments will be available beginning in 2009 for physicians who meet the requirements of the program.  The initiative is part of the Administration’s broader efforts to accelerate the adoption of health IT and the establishment of a health care system based on value. 

Beginning in 2009, and during the next four years, Medicare will provide incentive payments to eligible professionals who are successful electronic prescribers.  Eligible professionals will receive a 2 percent incentive payment in 2009 and 2010; a 1 percent incentive payment in 2011 and 2012; and a one half percent incentive payment in 2013. 

Beginning in 2012, eligible professionals who are not successful electronic prescribers will receive a reduction in payment. Eligible professionals may be exempted from the reduction in payment, on a case-by-case basis if it is determined that compliance with requirement for being a successful prescriber would result in significant hardship.

To read more, see the entire HHS Fact Sheet at http://www.hhs.gov/news/facts/eprescribing.html

July 10, 2008

Senate OKs Medicare Bill With E-Rx Incentives for Physicians

On Wednesday, the Senate approved by a veto-proof margin a bill that would halt a scheduled 10.6% Medicare physician pay cut and provide financial incentives to physicians for using electronic prescriptions, Healthcare IT News reports.

The House passed the bill, called the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331), by a veto-proof margin in June (Manos, Healthcare IT News, 7/10).

Under the bill, Medicare physicians who use e-prescribing technology would be eligible for incentive payments of 2% in fiscal year 2009 and 2010, 1% in FY 2011 and 2012 and 0.5% in 2013 (Health Data Management, 7/10). Physicians participating in Medicare who do not e-prescribe by 2012 would see a 2% payment cut (Healthcare IT News, 7/10).

According to the Wall Street Journal, the increase in payments for adopting e-prescribing for Medicare physicians is the "most significant long-term effect" of the bill (Mathews/Lueck, Wall Street Journal, 7/10).

The bill also includes a measure to expand Medicare payments for telehealth in hospital-based renal dialysis centers, skilled nursing facilities and community mental health centers (Healthcare IT News, 7/10).

The bill now goes to President Bush (Health Data Management, 7/10).

Reaction

"E-prescribing is a fundamental step toward modernizing our health care system," Sen. John Kerry (D-Mass.) said in a written statement, adding, "It will save lives by reducing medical errors and save billions of dollars."

Kerry authored much of the bill's health IT language, which was based partly on health IT legislation he introduced last year (DoBias, Modern Healthcare, 7/10).

In a joint statement, the co-CEOs of SureScripts-RxHub, J.P. Little and Rick Ratliff, said, "The potential impact of this legislation on the everyday lives of patients in the U.S. health care system cannot be overstated."

They added that lawmakers "are wisely applying the federal government's leverage as the nation's largest health care insurer to accelerate the adoption of e-prescribing" (SureScripts-RxHub press release, 7/9).

In a statement, the Pharmaceutical Care Management Association said, "From a patient's perspective, e-prescribing is the most important issue in the Medicare bill because it saves lives and saves money." The group added, "This is a historic step forward for e-prescribing, as the new requirement in Medicare will now lead to broader adoption of overall health care IT" (PCMA press release, 7/9).

Source:  http://www.ihealthbeat.org/articles/2008/7/10/Senate-OKs-Medicare-Bill-With-ERx-Incentives-for-Physicians.aspx?topicID=56

Physician Adoption of E-Prescribing Technology Increasing

The hand-written prescription is "on its way to becoming a historical curiosity," as physicians and pharmacies increasingly adopt electronic prescribing systems, according to a New England Journal of Medicine article by Richard Steinbrook, a physician and the national correspondent for NEJM, the Newark Star-Ledger reports.

Physicians and pharmacies are being motivated to adopt the technology by the promise of fewer prescribing errors and the possibility of e-prescribing mandates.

As of March, about 7% of the 560,400 office-based physicians were regularly writing e-prescriptions and about 73% of the 57,500 retail pharmacies in the U.S. were regularly receiving them, according to the article. Nationwide, about 2% of all prescriptions are sent electronically, the Star-Ledger reports.

Steinbrook said, "With any new technology, it takes a period of time for it to be adopted, and some people would rather let others work out the bugs."

He added that there still are barriers to the adoption of e-prescribing technology, including high start-up costs and Drug Enforcement Agency restrictions on e-prescribing of controlled substances.

DEA is considering lifting the ban. However, Steinbrook said that some physicians "aren't moving until they can do everything electronically" (Stewart, Newark Star-Ledger, 7/10).

Source:  http://www.ihealthbeat.org/articles/2008/7/10/Physician-Adoption-of-EPrescribing-Technology-Increasing.aspx?topicID=57

July 8, 2008

New CMS Proposal To Allow Some Computer Faxes for Prescriptions

A proposed CMS rule establishing Medicare physician payment policies for 2009 includes an exemption to the planned elimination of computer-generated faxes for prescriptions and refills, Health Data Management reports.

As of Jan. 1, 2009, CMS was scheduled to prohibit the use of computer-generated faxes to transmit prescriptions and refill requests, except during temporary network transmission failures. The policy did not mandate electronic prescribing but would have eliminated computer-generated faxes to encourage vendors to build and physicians to use "true" e-prescribing systems.

However, comments on the proposal indicated that the industry is not yet ready to transition from computerized faxes to true electronic transmissions for prescription and refill requests, according to policymakers.

The new CMS proposal would allow computer-generated faxes "when the prescriber is incapable of receiving electronic transmissions using the NCPDP SCRIPT standard."

CMS periodically will revisit the topic and is seeking comments on an acceptable timeframe to transition to the electronic standards (Health Data Management, 7/7).

Source:  http://www.ihealthbeat.org/articles/2008/7/8/New-CMS-Proposal-To-Allow-Some-Computer-Faxes-for-Prescriptions.aspx?topicID=56#

July 1, 2008

One nationwide network will support e-prescribing

The nation’s two major e-prescribing networks are merging and will form a single, comprehensive network for the exchange of prescriptions and related information.

RxHub and SureScripts will each bring different expertise to the newly merged organization, which will be known for now as SureScripts-RxHub.

RxHub was founded by companies that manage pharmacy benefits and has focused on delivering medication histories and eligibility and benefits information to doctors, other prescribers and pharmacies. SureScripts was founded by two associations of drug stores and has focused on linking doctor’s offices and pharmacies for the routing of prescriptions.

In 2008, SureScripts-RxHub expects to handle 100 million electronic prescription transactions and respond to more than 70 million requests from doctors for benefits information and medication histories, according to a news release.

The merger comes at a time when momentum for e-prescribing is increasing. Congress is considering whether to mandate that doctors who treat Medicare patients must use the technology, and other recent developments in Washington are helping to drive the trend.

“This merger represents a collaboration between industries that are equally committed to improving health care,” said Bruce Roberts, executive vice president and chief executive officer of the National Community Pharmacists Association, in a statement. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency and quality of one of the largest segments in health care.”

The merger will streamline development of technical interfaces with e-prescribing software and electronic health record systems, officials of the new organization said. Software vendors can now use a single process for testing their interfaces and becoming certified as compatible with the e-prescribing network.

Each organization will retain half ownership of the private network. No cash changed hands in the merger, according to the news release. The CEOs of the two former organizations are jointly managing the new company while the board of directors undertakes a search and selection process for a new CEO.

SureScripts-RxHub will have more than 75 employees and will maintain offices in St. Paul, Minn., and Alexandria, Va.

Source:  http://www.govhealthit.com/online/news/350453-1.html

June 27, 2008

DEA proposes rules to allow e-prescribing of controlled substances

The Drug Enforcement Administration has proposed rules to allow e-prescribing of controlled substances, such as painkillers and stimulants, and will accept public comments until Sept. 25.

The proposed rules, as explained in a 62-page Federal Register notice today, require doctors to use two forms of identification for each transmission of e-prescriptions for controlled substances in addition to an annual audit of each system by a certified public accountancy.

Under current rules, doctors may use e-prescribing for most prescriptions but must sign a written prescription for Schedule II controlled substances, such as Nembutal, OxyContin and opium. The DEA rule, if it becomes final, would allow doctors to use the same system for generating and transmitting all prescriptions.

The rules call for doctors and other prescribers to have their identity verified in person at a DEA-registered hospital that has granted the doctor privileges to practice at the hospital, a state professional or licensing board, or a state or local law enforcement agency...

E-prescribing systems in use by doctors, pharmacies and intermediaries would have to support two-factor authentication and implement strong security so there would be virtually no possibility that the e-prescription could be diverted or altered. If a diversion occurred, it would have to be possible to identify the perpetrator and exonerate the doctor who wrote a legitimate prescription.

“In the absence of appropriate controls, allowing electronic prescriptions for controlled substances could exacerbate the already increasing problem of…controlled substance abuse,” the draft rules state.

“The publication of this proposed rule is an important step toward making electronic prescribing an option for practitioners who prescribe controlled substances,” said Joseph Rannazzisi, deputy assistant DEA administrator of the Office of Diversion Control. “Our goal is to put in place an electronic prescribing system that is efficient, medically beneficial to patients and prescribers, and provides security from hackers and others who might seek to engage in fraudulent prescribing activities.”...

Source:  http://www.govhealthit.com/online/news/350451-1.html?GHITNL=yes

DEA proposed rule:  http://edocket.access.gpo.gov/2008/pdf/E8-14405.pdf

June 26, 2008

House Passes Bill To Create Incentives for Using E-Prescribing

On Tuesday, the House approved a bill (HR 6331) that would delay Medicare physician fee cuts and authorize incentive payments for physicians who use electronic prescriptions, Health Data Management reports.

The incentive payments would be 2% in fiscal years 2009 and 2010, 1% in 2011 and 2012, and 0.5% in 2013.

The bill also would require physicians to report any e-prescribing quality measures established under Medicare's physician reporting system (Health Data Management, 6/25).

Senate Majority Leader Harry Reid (D-Nev.) invoked a rule to allow the bill to bypass the Senate Finance Committee, which means it could be considered in the Senate as early as today.

The House bill, which was passed by a veto-proof margin of 355-59, is based on a similar bill (S 3101) by Senate Finance Committee Chair Max Baucus (D-Mont.) (Lubell, Modern Healthcare, 6/25).

Source:  http://www.ihealthbeat.org/articles/2008/6/26/House-Subcommittee-OKs-Measure-Aiming-To-Boost-EHR-Adoption.aspx?topicID=54

June 20, 2008

E-prescribing of controlled drugs could be allowed soon

Nancy Ferris
The Drug Enforcement Administration will soon propose a rule change to allow doctors to prescribe painkillers and other potentially dangerous drugs electronically.

The rule would lift the ban at least partially, said DEA spokeswoman Rogene Waite, adding, “We’re close to publication at this point.”

Under current rules, doctors cannot legally use electronic systems to send prescriptions for controlled substances to pharmacies. The rules require a paper prescription with the doctor’s signature.

Experts say the limitation has hampered the adoption of e-prescribing technology because it’s inconvenient for doctors to use two different means of writing prescriptions. Controlled substances account for about 20 percent of prescriptions.

Waite declined to say when the proposed rule would be published or which of the several categories of controlled substances it would cover.

Under the federal rule-making process, agencies must publish proposed rules in the Federal Register and give the public time to comment on them. After reviewing those comments, agencies typically publish a final version of the rule.

DEA has been under pressure to change its e-prescribing rules for some time. In December 2007, 19 senators signed a letter to the Justice Department, the DEA’s parent agency, urging officials to address their security concerns rather than continue postponing progress on adopting the technology.

DEA officials have said they are concerned that e-prescribing systems are not secure and could be used to obtain drugs illegally. Experts say prescription drugs are becoming more widely abused than illegal drugs such as cocaine and marijuana.

Health information technology advocates say e-prescribing could encourage more doctors to use electronic health record systems, which promise to improve care and reduce costs.

Pending legislation in the Senate to avert cuts in Medicare reimbursements would require doctors to use e-prescribing by 2011 or face a reduction in their Medicare fees. Those provisions would cut Medicare outlays by $2 billion or $2.5 billion, depending on which version of the legislation is enacted, said Peter Orszag, director of the Congressional Budget Office.
Source:   Government HealthIT- http://www.govhealthit.com/online/news/350439-1.html

June 11, 2008

eHealth Initiative and The Center for Improving Medication Management Release National Roadmap and Practical Guides for Rapid Expansion of Electronic Prescribing

A new report indicates more than 35 million prescription transactions were sent electronically in 2007, a 170 percent increase over the previous year.  The report, “Electronic Prescribing: Becoming Mainstream Practice,” offers a detailed examination of the progress made, obstacles that remain, and recommendations for helping the nation’s prescribers migrate from paper-based prescriptions to an electronic system. 

The report, developed collaboratively by the eHealth Initiative (eHI) and The Center for Improving Medication Management (The Center) with guidance and leadership from a diverse Steering Group of health care stakeholders, summarizes the national experience with e-prescribing over the past four years – from its pilot phase in several states such as California, Massachusetts, Michigan and Rhode Island, to its present day use in all 50 states and Washington, D.C. It outlines additional steps that should be taken to realize optimal results in health care improvement.  The report includes corresponding guides that offer practical information for health care payers to support effective adoption, and for consumers to better understand e-prescribing’s benefits and use.  A third guide for prescribers is under development now, in collaboration with leading medical societies. 

“Our report and the guides released today reflect a broad consensus among consumers, physicians, pharmacies, employers, insurers and others that e-prescribing can offer significant benefits in terms of patient safety, improved outcomes, and cost savings, especially if remaining challenges are addressed.  The report contains several consensus recommendations to address those challenges effectively, and we look forward to working with all health care stakeholders to move those recommendations forward immediately,” said Janet Marchibroda, Chief Executive Officer, eHealth Initiative.

“E-prescribing works and its benefits for many stakeholders are proven,” said Kate Berry, executive director of The Center. “However, education, incentives, and implementation assistance are needed. We are hopeful that this report and the accompanying guides as well as the efforts of many industry leaders will serve to further accelerate the growth in e-prescribing and move it into mainstream practice.”...

To read the entire article go to:  http://www.ehealthinitiative.org/news/2008-06-11.mspx

June 02, 2008

Minnesota Governor Signs Law Requiring E-Prescribing by 2011

Minnesota Gov. Tim Pawlenty (R) signed into law a bill that requires electronic prescriptions and creates new quality reporting rules for physicians, Modern Healthcare reports (Evans, Modern Healthcare, 5/30).

Under the law, pharmacists, physicians and others who prescribe or dispense medication in the state will be required to use electronic systems by 2011.

The measure also calls on Minnesota's health commissioner to create a set of provider quality measures for public reporting and incentive payments.

Beginning in July 2010, the bill would require the state to publish comparative price and quality information for groups of services typically used to diagnose or treat an illness. (iHealthBeat, 5/20).

The bill is projected to save 10% to 15% from state employee benefits and public health plan spending by 2015.

Pawlenty vetoed an earlier version of the bill because it would have expanded coverage for the state's safety net health plans (Evans, Modern Healthcare, 6/2).

Source:  iHealthBeat.org

May 25, 2008

Electronic prescriptions gain ground

Technology seeks to reduce problems caused by doctors' lousy handwriting
Sunday, May 25, 2008, By Hannah Wolfson, Newhouse News Service

Doctors' sloppy handwriting might be an old joke, but it's no laughing matter. After all, a recent study shows that as many as 7,000 people are killed each year by faulty prescriptions based on illegible handwriting.

To avoid problems, an increasing number of doctors are using a handheld computer instead of an old-fashioned pad to send prescriptions straight to the pharmacy with the touch of a button.

Among them is Dr. Michael Geer, who's in private practice in Birmingham, Ala.

"It's definitely the wave of the future," said Geer, one of an estimated 40,000 doctors nationwide who have switched to e-prescriptions. "I rarely write prescriptions these days, which is nice."

Experts say about 85,000 doctors nationwide will be writing e-prescriptions by the end of this year.

Five medical associations, including the American Academy of Family Physicians and American Academy of Pediatrics, are urging their doctors to use e-prescriptions. And just last month the Pharmaceutical Care Management Association, a national association of drug plan administrators, started a national ad campaign to promote the practice. The group, which supports legislation that would require e-prescriptions in Medicare, claims it could prevent as many as 1.9 million medication errors and save the federal government billions of dollars over the next decade.

"From a patient's perspective, e-prescribing is by far the most important issue in the current Medicare debate because it could save their life or the life of someone they love," association president and CEO Mark Merritt said when the ad was released.

Geer started prescribing electronically at the suggestion of Blue Cross/Blue Shield, which provided him with the necessary hardware and software. Using a Microsoft PocketPC and his office's wireless network, he can check patients' prescription records right in the exam room and see what medications they're taking. The system even warns him of potential drug interactions or allergies.

"It's all in one spot. I can pull them up and see exactly what they're on," Geer said. That's a help, since many patients can't remember the exact medication they're on or may be taking dozens of drugs.

It also transmits the prescription to the pharmacy instantly, saving patients time. More than 70 percent of pharmacies in the country accept e-prescriptions, with more joining every day, according to a Web site operated by SureScripts, an e-prescription company. Another prescription service, eRX NOW, allows doctors to use their own desktop, laptop or handheld computers -- or even a cell phone with wireless access -- to transmit prescriptions over the Internet.

Many pharmacists are enthusiastic, saying it saves them the hassle of having to decode sloppy handwritten prescriptions.

But Jerry Newman, a pharmacist at Harbin Pharmacy in Mountain Brook, Ala., said that although e-prescriptions save time, he worries about not having a hard copy to refer back to as he fills orders calling for multiple medications.

"I'm not sure it's 100 percent safe at this point," he said. "If you're not really careful and paying attention, you could miss something."

Nonetheless, Newman said, there's a sense that his whole business might be wireless someday.

Source:  New Orleans Times-Picayune http://www.nola.com/timespic/stories/index.ssf?/base/living-10/121169293223950.xml&coll=1

May 6, 2008

Arizona Ordered to Step Up E-Prescribing

Governor Janet Napolitano has issued an Executive Order (PDF)  to significantly increase patient safety through the use of e-prescribing in Arizona. It is estimated that patients in the United States suffer 1.5 million preventable adverse drug "events" every year because of mistakes with their medications. Costs associated with those errors are estimated to exceed $4 billion annually.

"E-prescribing can reduce mistakes and the associated costs dramatically," said Governor Napolitano. "Arizona has been a leader in developing electronic health records and the means by which to exchange those records while still protecting personal privacy. This order will ensure that we stay on that cutting-edge of health care technology."

Currently, less than 3 percent of Arizona health care providers use any form of e-prescribing. Yet, by ordering and transmitting prescriptions electronically, providers can avoid the mistakes that often accompany hand-written prescriptions; allow providers to create systems that can catch potential drug interactions; and can help provide accurate patient data quickly, especially in the case of an emergency.

The Governor's Order also urges Arizona's executive branch agencies to develop awareness and use of consumer tools that assist in medication safety. One example is the Med Form, available at www.themedform.com.

In 2005, the Governor created Arizona's Health-e Connection to research, organize and implement a statewide e-health information system. In 2007, Arizona was awarded a $12 million federal grant to enhance and expand that work. Arizona Health-e Connection, along with executive branch agencies, will play a leading role in coordinating the promotion of e-prescription capabilities in Arizona.

For more information about the Office of the Governor, please visit www.azgovernor.gov.

Source: Government Technology - http://www.govtech.com/gt/314909?topic=117677

April 29, 2008

Gingrich calls for medical update

At forum on preventable medication errors he urges a switch to electronic records
By David Kohn, Sun reporter

Former House Speaker Newt Gingrich stressed the merits of switching to electronic medical records in an appearance in Baltimore yesterday.

"It's been a very great disappointment that the administration has not proposed to go to 100 percent electronic health records," Gingrich said yesterday. He was in Baltimore to speak at a health care symposium sponsored by Siemens, which ends today.

He said Congress could have paid for such a changeover with the money now being directed to the subprime mortgage loan bailout. During a wide-ranging speech, he likened the changes in the medical industry to Major League Baseball, which in recent years has increasingly focused on using data to make personnel decisions.

The symposium is concentrating on preventable medication errors, health care information technology and health care issues. Siemens makes software that allows doctors and hospitals to distribute prescriptions electronically; the conference is also focusing on users of its software, which is called Computerized Physician Order Entry.

Gingrich, a Georgia Republican, was first elected to the U.S. House of Representatives in 1978. He was elected speaker in 1995 after Republicans took over the House, a post he held until he left Congress in 1999. He has served as author, speaker and political commentator.

He has long focused on health reform, and he founded the Center for Health Transformation, a think tank in Washington. Siemens is among its funders.

Gingrich said that the current political debate was not really addressing health care. "There's a big lag between the current political conversation and the next generation of ideas," he said.

Many experts say electronic health records will improve care, reduce medical errors and reduce waste. But 90 percent of U.S. doctors and more than two-thirds of U.S. hospitals still use paper for patient records. Experts say the federal government should do more to encourage the switch.

The federal government will spend up to $150 million over the next five years. But many other countries spend more: The United Kingdom allocated more than $11 billion to digitize its health care system, and Canada is spending a billion dollars.

Gingrich also advocated increasing the focus on preventive care instead of treatment, which he said would save billions. "I think we ought to go to K-through-12 physical education five days a week," he said.

He said the Center for Health Transformation is working on proposals to create tax credits for inner city grocery stores to stock more healthy food such as fruits and vegetables. Some researchers have argued that poor inner-city health is partially explained by lack of easy access to healthier food.

Source:  www.baltimoresun.com/news/health/bal-md.gingrich29apr29,0,7578180.story

SureScripts takes on doctors' e-mail resistance
By Mark Albright, Times Staff Writer

The voice mail and facsimile machines got their usual Monday morning workout at the Walgreens at 900 49th St. N in St. Petersburg. By the end of lunch hour, doctors' offices had left 20 prescriptions on the pharmacy voice mail for transcription and a stack of 40 handwritten refills coughed through the fax machine.

And how many prescriptions did doctors e-mail? Four.

"Changing old habits is hard, especially after physicians have been handwriting prescriptions more than 100 years," said Mark Percifield, the 32-year-old pharmacy manager. "But we've been equipped to accept e-mail prescriptions since 2004."

It might seem quaint that in this day of instant communications, prescriptions are still handwritten to be hand-carried, faxed or called in to be filled. But after eight years of getting its act together, SureScripts, a nationwide secure e-prescription service, thinks it is time to juice up acceptance by e-mail.

Started with a $100-million investment from the two big drugstore trade groups seven years ago, SureScripts today kicks off a campaign to get more patients to ask their physician for labor-saving e-mail prescriptions. The brochures and in-store promotional signs will be supported by advertising in coming months.

Nationally in 2007, only 2 percent of 1.47-billion prescriptions were e-mailed from a medical facility to drugstores. Only 6 percent of doctors' offices are equipped to handle it. In Massachusetts, more than 13 percent of all prescriptions are e-mailed. Florida is in 19th place among all states with only 1.6 percent.

The arrival of e-mail prescriptions does not mean doctors cannot keep scribbling down prescriptions if patients prefer them that way.

"We've been educating the physician and medical community for some time," said Rob Cronin, spokesman for SureScripts. "Now it's time to engage the patients so they'll start asking their doctors for it."

The company is armed with a study showing physicians' offices could save about $8.5-billion in medical practice staff time by equipping their staffs to file prescription traffic to the secure Internet site.

The savings are big for drugstores, too. Phoned-in prescriptions must be transcribed. The faxed and handwritten ones frequently require pharmacy workers to make followup calls to the doctors' offices to ensure accuracy. Questions range from verifying chicken scratch signatures to matching pill counts. Interns at Percifield's Walgreens stores did a study that found that each day his staff phones a doctor's office 20 times for clarification.

E-mail prescriptions arrive ready for a visual verification and the bottle label printer.

Many medical clinics have steered a cautious course. Early on there were questions of security, then of how few drugstores were equipped to handle the Internet option. Today more than 70 percent of all drugstores can accept them.

Another holdup: E-mail equipment becomes entwined in the technical difficulties and expense of shifting clinics to paperless record keeping. That's not required to send e-mail prescriptions. The hardware and software cost less than $200 a month.

"It sounds simple, but it's really a lot more complex," said Dave Bailey, CEO of Suncoast Medical Clinic, a huge practice in St. Petersburg that invested $1.25-million over five years to make all its medical records paperless this year and will be ready for e-prescriptions by winter. "There's a lot of making sure everything fits and a huge training component. Changing habits from paper files to computer screens is enormous."

Source:  St. Petersburg Times http://www.tampabay.com/news/business/retail/article477809.ece

April 9, 2008

E-Prescribing Can Cut Costs and Improve Patient Safety, but Physicians Are Slow to Embrace It

Reprinted from HEALTH PLAN WEEK, the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans.

While physicians have been slow to embrace electronic prescribing, the experiences of several health plans in the forefront of e-prescribing point to four critical ingredients that, when used, will help such an initiative succeed and produce a significant return on investment.

There are quantifiable costs and safety benefits being realized by health plans, physicians and patients, the insurers contend. E-prescribing, they say, not only can bolster a health plan's quality measurement efforts and are a logical part of pay-for-performance (PFP) programs, but also there's a bigger-picture benefit: E-prescribing is the logical first step in getting physicians to move to the use of electronic health records (EHRs).

Insurers uniformly cite several cost and safety benefits associated with e-prescribing. "The patient's history is all there on the screen," says Matt Walsh, associate vice president, purchaser initiatives at Health Alliance Plan (HAP), a part of the Henry Ford Health System and a member of the Southeastern Michigan ePrescribing Initiative (SEMI). "Plus there's real-time alerts concerning drug interactions and messaging about therapeutic duplicates and more appropriate drugs, including generics."

In 2006, a survey of Henry Ford Medical Group physicians, the first to test e-prescribing through SEMI, found that of 500,000 e-prescriptions, 80,000 were changed or canceled due to drug interaction alerts, and more than 50,000 prescriptions were changed or canceled due to formulary alerts, which increased the use of generic drugs. Walsh says that helped the medical group improve its overall generic use rates by 7.3%.

Increased use of generic prescriptions is one of three "value drivers" used by HAP to prove the business case for e-prescribing, Walsh tells HPW. The other two: reduced administrative costs and reduced adverse drug events, tracked by the number of times physicians changed or canceled prescriptions because of an alert. The result: a $4 million annual savings.

Kate Wodecki, a manager in the Electronic Business Interchange Group at Blue Cross Blue Shield of Michigan, points to results of a study released October 2007 by SEMI, of which the Michigan Blues plan is also a member. That study reviewed 3.3 million e-prescriptions written by physicians participating in SEMI during 2007 and found that physicians changed prescriptions 39% of the time, often to less expensive generics, when a formulary alert was presented at the point of care. More than 1 million alerts were sent on moderate to severe drug-to-drug risks, resulting in 41% of those prescriptions being changed or canceled by the physician.

Savings to health plan members is also a benefit. Blue Cross Blue Shield of Massachusetts, a member of the eRx Collaborative, found that providers who used e-prescribing during 2007 saved 5% on drug costs by selecting more cost-effective drugs. That translated to members saving approximately $800,000 in copayments associated with their prescriptions, says Steve Fox, vice president of provider network management.

Getting physicians to e-prescribe isn't easy. "You're competing with a piece of paper that the physician hands to the patient and never sees again," says Anthony Schueth, CEO and managing partner of Point-of-Care Partners, a Coral Springs, Fla.-based consulting firm. Schueth also is the SEMI project manager. Other barriers: getting physicians over the technology hump, which includes the cost of the technology, the time and effort required to install the technology, and psychological resistance to adopting new technology and new ways of doing business.

Four Ingredients to Boost e-Prescribing

Health plans point to four ingredients in their e-prescribing initiatives that they say will help propel physicians over that hump and into the game. And they report that once physicians start e-prescribing, most become true believers.

(1) Be sure e-prescribing is embedded in the medical practice. And this requires skills that the average medical practice doesn't have. Walsh says HAP is using the experience it gained from working with Henry Ford Medical Group sites to build a team that is now working with the health plan's independent practice associations (IPAs) to get their e-prescribing systems up and running. "This isn't something a practice can do on its own," Walsh says. "They need training, and they need ongoing support with the process and technology issues. You provide training for physicians, but you must also sit with them after the system is up and running to work through the real-time problems and glitches."

(2) Use incentives to encourage adoption and build e-prescribing into PFP programs. SEMI provides medical practices with a $1,000 subsidy paid in two installments. The first payment, typically $500, is provided after the system is installed, training is complete and the practice has submitted 10 e-prescriptions. The balance is paid after the practice has used e-prescribing for six months. "By structuring the incentive this way, we not only encourage adoption but also encourage utilization," Schueth tells HPW. "We wanted physicians to cover a fair amount of the install costs so they will have 'skin in the game' and place a value on the process." Schueth says that if the technology is provided free or at minimal cost, physicians will be more apt to abandon the system once they encounter glitches. While the eRx Collaborative provides subsidies to medical practices to help support the cost of the technology, licensing fees, training and six months of Internet connectivity, the Massachusetts Blues plan also offers e-prescribing primary care physicians $1.50 per member per month as part of its larger PFP program. Steve Fox, vice president of provider network management, says that the plan also worked with the Massachusetts Medical Society to create a Continuing Medical Education program for physicians on e-prescribing.

(3) Use physician champions. Using physician "true believers" to help persuade their peers to adopt e-prescribing also helps, says Wodecki. "We started working with larger medical practices during the second phase of SEMI, and at that point we identified a cadre of physician champions to reach out to the groups, participate in training, speak at workshops and lead demonstrations. We found that it makes a tremendous difference."

(4) Involve the entire office staff. Because a significant amount of patient data must be inputted from launch forward, physicians often feel overwhelmed when it comes to using e-prescribing system. One solution: Help the medical practice conduct a work-flow analysis to identify multiple contact points where data can be collected and inputted by office staff. Wodecki says that the Michigan Blues plan helps practices identify key staff who can "pre-ramp" the data for the physician. "Front desk staff can collect information from patients when they sign in, as can the nurse when the patient is being pre-examined," Wodecki says. "That way the physician isn't bearing the entire load."

Top 10 e-Prescribing States

The 10 states where physicians transmit the highest percentage of prescriptions electronically, according to data released this month by the National Association of Chain Drug Stores, National Community Pharmacists Association and SureScripts, are:

(1) Massachusetts
(2) Rhode Island
(3) Nevada
(4) Delaware
(5) Michigan
(6) Maryland
(7) North Carolina
(8) Arizona
(9) Connecticut
(10) Washington

Source:  Reprinted from HEALTH PLAN WEEK, the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans.

March 10, 2008

RxHub’s CAQH CORE Rules Certification Aids Data Exchange Coordination

Washington, DC (March 10, 2008) − CAQH announced today that RxHub, a leader in
e-prescribing, has completed the testing process required to certify its PRN™ clearinghouse product operates in compliance with the Committee on Operating Rules for Information Exchange (CORE) Phase I operating rules. This achievement represents an important step toward synchronizing interoperability efforts in the medical and pharmacy sectors.

“Aligning medical and pharmacy insurance eligibility standards is a natural extension of the work being done by CAQH and RxHub,” said Robin J. Thomashauer, CAQH executive director. “Coordination is an essential part of our vision for administrative simplification. RxHub’s PRN certification means providers will now have even more consistent access to both medical and pharmacy patient eligibility and coverage information at the point of care.”...

Source:  http://www.rxhub.net/images/pdf/press_releases/2008/FINAL_
RxHub_CORE_Rules_Certification_Press_Release_030608.pdf  or FINALRxHubCORErulesCertificationPressRelease030608.pdf (86.54kb)

March 6, 2008

ACS Launches Medicaid Cost Savings Initiative

New Program Offers Millions in Potential Savings

DALLAS, TEXAS: March 6, 2008 – State Medicaid programs can potentially save millions of dollars annually through an innovative initiative of Affiliated Computer Services, Inc. (NYSE: ACS) and RxHub, LLC. The proprietary program helps ACS’ healthcare clients avoid costly, manual recovery of drug claims from commercial insurers.

The new program enables pharmacies to immediately identify pharmacy benefit coverage at the point-of-sale. This eliminates the costly, inefficient “pay and chase” programs state Medicaid agencies currently use to recover monies when other insurance coverage is discovered.

“The potential savings identified through this new program is another way in which ACS provides innovative technology to our state partners to help reduce the costs of administering their Medicaid programs,” said Christopher T. Deelsnyder, ACS senior vice president and managing director, Government Healthcare Solutions...

Source:  http://www.rxhub.net/images/pdf/press_releases/2008/ACS-RxHub_NewsRelease_030608.pdf

March 4, 2008

Medical Groups Launch E-Prescription Advocate Site

GetRxConnected.com helps doctors switch from paper-based prescriptions to online forms that pharmacies can access directly.
Grant Gross, IDG News Service

Five doctors organizations have launched a Web site and campaign designed to persuade physicians to switch from paper-based prescriptions of medications to electronic prescribing.

The Get Connected campaign, along with the GetRxConnected.com Web site, are focused on helping doctors move from prescriptions written on paper pads or entered into a computer and faxed to pharmacies. The Web site, launched Tuesday, includes a technology guide to help doctors move to e-prescribing. It also provides perspectives of other doctors on the benefits of e-prescribing, and points to connected pharmacies.

The effort, with support from such groups as the American Academy of Family Physicians and the American Academy of Pediatrics, is aimed at the 94 percent of doctors in the U.S. who still do not write prescriptions electronically, said Dr. William Jessee, president and CEO of the Medical Group Management Association.

In many cases, doctors who are entering prescription data into an electronic health record are then faxing those prescriptions to pharmacies, where the data has to be re-entered into a computer, Jessee said during an event called the Safe-Rx Awards in Washington, D.C. Re-entering the data increases the risk that a prescription error will occur, he said.

About 150,000 doctors across the U.S. now fax prescriptions, but as of Jan. 1, 2009, the U.S. government Medicare program will require that prescriptions it covers be sent electronically, Jessee said.

"We need to pick up the pace," he said.

Backers of electronic prescribing say it can save lives and reduce medical errors. About 8,000 people in the U.S. die every year because of prescription errors, said Newt Gingrich, founder of the Center for Health Transformation and former Republican speaker of the U.S. House of Representatives. Some doctors are still fighting the move to e-prescribing and suggesting the U.S. government shouldn't mandate the change, he said.

"Their argument is, 'I reserve the right to issue paper prescriptions and kill people,'" Gingrich said at the awards event. "'It's wrong for you to require me to be safe'."...
Source: http://www.pcworld.com/article/id,143106-pg,1/article.html

March 3, 2008

MediVoice LLC Selects Nuance Voice Control To Power New E-Prescription Application

Physicians Can Create Electronic Prescriptions From Mobile Devices Using Only Their Voice
HIMSS 2008, ORLANDO, Fla., February 25, 2008 — Nuance
Communications, Inc. (NASDAQ: NUAN), a leading supplier of speech and
imaging solutions, today announced that MediVoice, LLC has selected Nuance®
Voice Control to provide speech-driven access to a broad range of mobile
healthcare applications. As part of the preferred partnership agreement, Nuance
Voice Control Healthcare Edition will power a new e-prescription service that
enables physicians to create and send an electronic prescription from a broad range
of mobile devices using only their voice. Nuance and MediVoice will demonstrate
the new technology in booth #5846 at the HIMSS 2008 conference, being held this
week in Orlando, Fla.

MediVoice offers a complete enterprise mobility solution that places all the tools
healthcare workers need at the point of care. The voice-activated e-prescriber
platform gives MediVoice customers voice access to electronic medical records...

Source:  http://www.nuance.com/news/pressreleases/2008/20080225_medi.asp

February 28, 2008

Leavitt Wants Medicare E-Rx Mandate

U.S. Health and Human Services Secretary Michael Leavitt has called for mandated electronic prescribing for Medicare patients. At the 2008 HIMSS Conference in Orlando on Feb. 26, he also indicated mandates on use of electronic health records under Medicare are a distinct possibility.

Electronic prescribing can enable physicians to access formulary data at the point of care and prescribe appropriate but less expensive drugs. “The time has come to make the change to e-prescribing,” Leavitt said in his keynote address. “We can no longer afford to pay reimbursements for people to prescribe in the most expensive way.”

And he added this caveat for provider organizations that have been slow to adopt EHRs: “The day is not long off until we do the same for electronic health records..."

Source:  http://www.healthdatamanagement.com/news/legislation_rules25773-1.html

HHS chief supports mandatory e-prescribing in Medicare

Congress should make e-prescribing a condition of participation in Medicare by 2011, said Health and Human Services Secretary Michael Leavitt at a Feb. 6 Senate Finance Committee hearing. "It saves lives. It saves money. And it's time," he said in response to a question by Sen. John Kerry (D, Mass.).

Kerry is a sponsor of the Medicare Electronic Medication and Safety Protection Act. The bill would reduce by 10% the payment for Medicare evaluation and management services provided in connection with a medication prescription that the physician could have made electronically but did not. On the flip side, the measure also would give E&M bonuses to doctors who e-prescribe.

Source:  http://www.ama-assn.org/amednews/2008/02/25/gvbf0225.htm

February 26, 2008

Tampa Bay Area Health Care Leaders Partner with National ePrescribing Patient

Safety Initiative to Deliver Free Electronic Prescribing to Area Physicians

ORLANDO, Fla., Feb. 26 /PRNewswire-FirstCall/ -- Direct from the 2008 HIMSS Annual Conference and Exhibition, Allscripts, the leading provider of clinical software, connectivity and information solutions that physicians use to improve health care, announced today a partnership between the National ePrescribing Patient Safety Initiative(TM) (NEPSI(TM)), and two of the Tampa Bay area's largest health care organizations to improve patient safety through electronic prescribing.

BayCare Health System and USF Health together will lead the deployment of free, web-based electronic prescribing to all physicians in the Tampa Bay area as the regional sponsors of NEPSI, a coalition of technology and health care companies led by Allscripts and Dell. Both Florida organizations are proven leaders in quality and safety improvement, and have partnered successfully on several initiatives. They join more than a dozen other major health care provider organizations across the nation in leading the delivery and support of NEPSI technology to physicians in their states and regions by providing education, training, incentives and local physician support.

"BayCare Health System is pleased to play a role in reducing preventable medication errors through participation in the NEPSI initiative," said Bruce Flareau, MD, Chief Informatics Officer of BayCare Health System, the largest full-service, community-based health care system in the Tampa Bay area, comprised of the nine leading not-for-profit hospitals and 11 community-based outpatient centers. "Our support of free e-prescribing will help the Tampa Bay area's physicians automate their prescription process for accuracy and speed, and will also make available easy-to-use drug reference to support their medication choices."

The University of South Florida has found that educational programs including medical students and residents help practicing physicians adopt electronic prescribing quickly, said Stephen Klasko, MD, MBA, Dean of the USF College of Medicine and Vice President of USF Health. "The culture change has to span all age groups and specialties," said Dr. Klasko. "By partnering with BayCare Health System, we believe we can significantly accelerate acceptance of electronic prescribing in both the USF academic setting and BayCare's community care environment."...

Sources:  http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/02-26-2008/0004762614&EDATE=  and
http://investor.allscripts.com/phoenix.zhtml?c=112727&p=irol-newsArticle&ID=1112418&highlight=

February 11, 2008

E-prescribing proves beneficial for payors

A growing number of payors are using e-prescribing, and one expert said the technology is "becoming a required component of a growing number of programs to stay in consideration for the business." It can also help payors with P4P programs and can serve as a first step to the adoption of other health IT tools. Source:  Healthcare IT News

DEA submits long-awaited proposal on e-prescribing

eHealth SmartBrief | 02/11/2008

A proposal from the Drug Enforcement Administration to allow doctors to use electronic prescribing for controlled substances, such as pain medications and antidepressants, has been submitted to the Department of Justice. The agency said it could not estimate how long the Justice Department would need to evaluate the proposed rule.
Source: Health Data Management

February 10, 2008

E-prescriptions gain popularity
In 2007, 35 million prescriptions traveled electronically between health care providers and U.S. pharmacies, according to SureScripts, operator of the Pharmacy Health Information Exchange. Advocates of the system assert that e-prescribing improves efficiency and reduces potential errors, but many doctors do not yet have the software required to send electronic prescriptions.

Source: The Journal Gazette (Fort Wayne, Ind.)

February 7, 2008

"Heath Ledger might be alive today if e-Prescribing were more widespread and we had e-rx for controlled substances.  This never would have happened.  Plus, note the major public health effects of this situation, as more elderly get pain killers and are at risk for unknown adverse reactions. E-Prescribing can help address this trend, as medication history becomes apparent to the range of prescribers who treat the elderly, and will help prevent adverse reactions and addiction (refills monitored)..."     Source:  Public Comment

When Mixing
Medications Can Be Deadly   
By SHIRLEY S. WANG

Actor Heath Ledger's death from a combination of prescription painkillers and sedatives underscores the potential dangers of mixing medicines at a time when medication use is rampant in the U.S.

Patients are often woefully unaware of the potential serious consequences of the additive effects of prescription medications. Although it is often unclear from toxicology reports whether a death by prescription drugs was intentional or not, "frequently, medical examiners find multiple drugs in toxicology reports of people that died of drug overdoses," says Leonard Paulozzi, a medical epidemiologist at the Centers for Disease Control and Prevention's Injury Center who researches prescription-medication poisonings.

Whether the drug levels are at therapeutic levels is one indication, says Ellen Borakove, a spokeswoman for the Office of the Chief Medical Examiner, City of New York, which investigated Mr. Ledger's death. In Mr. Ledger's case, the medical examiner concluded that "the manner of death is accident, resulting from the abuse of prescription medications," according to a press release. Oxycodone and hydrocodone (painkillers), diazepam (anti-anxiety, insomnia), temazepam (insomnia), alprazolam (anti-anxiety) and doxylamine (antihistamine) were found in his system.

Prescription-drug abuse -- using a medication for nonmedical reasons -- is on the rise in the U.S. across all age groups. In 2006, more than 16 million Americans aged 12 or over reported nonmedical use of prescription pain relievers, tranquilizers, stimulants or sedatives, up from 14 million in 2004, according to the Substance Abuse and Mental Health Services Administration.

Nearly 600,000 emergency-room visits in 2005 involved nonmedical use of prescription or over-the-counter pharmaceuticals or supplements, according to SAMHSA, and the majority of those involved patients taking more than one drug.

The most commonly abused groups are strong opioid or narcotic painkillers such as OxyContin or Vicodin, stimulant medications such as Adderall and Concerta, and sedatives for sleep or anxiety, such as Xanax.

Fatal poisonings resulting from high concentrations of prescription medication are also increasing. From 1999-2002, for instance, such poisonings by opioid painkillers rose more than 90% to 5,592 deaths, and in 2002 there were more deaths from painkiller poisoning than from heroin or cocaine use, according to a study released in 2006 by the CDC...
Source:  Wall Street Journal - http://online.wsj.com/public/article/SB120235084872749567-9U16w5mE5ydDe0OjRFLZtp7Timw_20080307.html

January 22 , 2008

Editorial: E-prescriptions merit support

Handwritten Rxs should go the way of the 8-track tape.

For many patients, illegible writing on prescription slips has been a source of wonder and some amusement. How in the world can anyone make out those chicken scratches? Turns out even pharmacists sometimes wonder, too. But prescription mistakes are no joke.

According to the national Institute of Medicine, prescription medication mixups kill nearly 7,000 people each year and injure about 1.5 million.

That's why Congress should pass a proposed measure that would expedite the use of electronic prescribing technology, or e-prescriptions. Some providers have already moved to more electronic record keeping, but others have been dragging their feet. This bill, authored by Sen. John Kerry, D-Mass., would move the conversion process along by offering grants to help with startup costs to help pay for the technology. The measure would:

• Provide Medicare funding for one-time grants to help doctors offset the costs converting to electronic prescriptions.

• Require all doctors to use e-prescriptions beginning Jan. 1, 2011. As an incentive to switch earlier, the bill funds a 1 percent bonus for every Medicare e-prescription issued. Providers who continue to write Rxs by hand would face a per-claim financial penalty.

• Allow the federal Department of Health and Human Services to grant one- to two-year hardship waivers for rural, one-doctor shops or others with special circumstances that make conversion difficult.

Studies have also shown that of the more than 3 billion prescriptions written each year, roughly a third -- that's 1 billion prescriptions -- require some type of follow-up between providers and doctors for clarifications...
Source: http://www.startribune.com/opinion/editorials/13998746.html

January 16 , 2008

Allscripts tops list of e-prescription providers

by Rupa Shenoy

An analysis of the 35 million electronic prescriptions written in 2007 shows that healthcare professionals used Chicago-based Allscripts Healthcare Solutions Inc.'s technology to prescribe more than any other software.

"This validates their efforts to dominate the market," Morningstar equity analyst Rafael Giagarcia said.

SureScripts Inc., operator of the electronic Pharmacy Health Information Exchange which comprised 139 vendors last year, reported that the number of e-prescriptions sent in 2007 was more than 50 times the amount transmitted in 2004, the year the Exchange began...

...Allscripts is poised to make the most of that growth, Giagarcia said.

One version of Allscripts e-prescription software is free, and as doctors warm to it, they will buy other versions, he said. And as the economy continues to be rough and the healthcare industry focuses on reducing expenses, more doctors will turn to the e-prescription system, which saves money, Giagarcia said.

The technology eliminates errors caused by pharmacists misinterpreting the poor handwriting of physicians. Such mistakes cause 1.5 million injuries and 7,000 deaths each year, according to the non-profit Institute of Medicine.

"Electronic prescribing should be the rule not the exception," Allscripts CEO Glen Tullman said in a statement...
Source: http://news.medill.northwestern.edu/chicago/news.aspx?id=74821

January 7 , 2008

Congress considers mandate for Medicare e-prescribing

Bipartisan bill would boost E&M payments for doctors who prescribe electronically but cut these reimbursements for physicians who don't.

By Dave Hansen, AMNews staff. Jan. 7, 2008.

Washington -- Congressional patience with the pace at which physicians are adopting electronic prescribing seems to be wearing thin. House and Senate lawmakers have introduced legislation that would mandate e-prescribing for Medicare beginning in 2011.

At a Dec. 4, 2007, Senate Judiciary Committee hearing, lawmakers also expressed frustration with the lack of movement toward allowing e-prescribing of controlled substances.

Sponsors of the two electronic prescribing bills tried to fold the legislation into a measure to prevent next year's 10.1% Medicare physician payment cut. But the language was not included in a last-minute Medicare package...
http://www.ama-assn.org/amednews/2008/01/07/gvsb0107.htm

December 21, 2007

I.T. Mandate Out of Medicare Bill

Congress has passed legislation reauthorizing Medicare, Medicaid and SCHIP programs without an information technology mandate requested by the Bush administration. President Bush has said he will sign the bill, S. 2499.

The bill’s particular importance is the replacement of a scheduled 10% cut in physician Medicare payments with a 0.5% increase, and continued funding of the State Children's Health Insurance Program (SCHIP).

But Health and Human Services Secretary Michael Leavitt two weeks ago sent congressional leaders a letter that laid out several conditions, including mandated I.T. use, for the bill to be signed. That included conditioning receipt of a portion of any Medicare fee adjustment to adoption of certified electronic health information technology. “Physicians who do not adopt appropriate, available technology should receive a lower payment than those who do,” Leavitt told lawmakers.”

Talk of I.T. mandates, particularly by Leavitt, is a dramatic turnaround in philosophy for the Bush administration. On his Weblog in November, Leavitt endorsed mandated electronic prescribing for Medicare and beyond, indicating he had lost patience waiting for physicians to adopt the technology on their own.

Also in November, the American Health Information Community, an HHS advisory body that Leavitt chairs, announced it would recommend that Leavitt seek congressional authority to mandate e-prescribing in the Medicare program...

December 19, 2007

House, Senate Bills Promote E-Prescribing
Legislation Includes Grants for Physician

'...Sen. John Kerry, D-Mass., and Rep. Allyson Schwartz, D-Pa., have introduced legislation that, if passed, would use financial incentives and disincentives to encourage the adoption of electronic prescribing, or e-prescribing, under Medicare.

Sen. John Kerry, D-Mass., left, urges support for e-prescribing legislation during a recent press conference in Washington. Former House Speaker Newt Gingrich, far right, and Sen. John Sununu, R-N.H., center left, look on. The bills, S.B. 2408 and H.R. 4296, (at the THOMAS Web site, type "S 2408" or "HR 4296" in the search box after selecting "Bill Number") respectively, include provisions for grants to physicians to help with the start-up costs of acquiring and implementing e-prescribing systems. They also propose a system for providing permanent Medicare bonuses to physicians who use the technology...
http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20071219eprescribing.printerview.html

Senators press Justice to permit e-prescribing of controlled substances
By Nancy Ferris
Nineteen senators have written to Attorney General Michael Mukasey, urging him to speed up Drug Enforcement Administration action to permit electronic prescribing of controlled substances.

“DEA regulations permitting [electronic prescribing for controlled substances, or EPCS] have been delayed for years, inhibiting wider uptake of e-prescribing, and postponing the realization of this technology’s benefits,” the senators’ letter said.

“It is our belief that both the health care and law enforcement communities would benefit greatly from a secure EPCS system, and that technological solutions are at hand. We urge your prompt attention to this matter, and request that DEA issue regulations for EPCS as quickly as possible.”

The letter follows a Dec. 4 hearing of the Senate Judiciary Committee at which Joseph T. Rannazzisi, deputy assistant administrator in charge of the agency’s Office of Diversion Control, said he could not be specific about DEA’s plans to revise federal rules governing dispensation of controlled substances, such as painkillers, antidepressants and some drugs used to treat asthma in children. He promised to provide a timetable within two months...
http://www.govhealthit.com/online/news/350150-1.html

December 7, 2007

Google News Alerts

CMS to end e-prescription fax exemption - Beginning January 2009 ...
Beginning January 2009, computer-generated fax prescriptions will no longer be exempted from the requirement to meet the NCPDP SCRIPT standard according to ...

December 6, 2007

Google News Alerts

E-Prescribing Mandate Premature, Says HHS Advisory Group
By sporter@aafp.org
The American Health Information Community, or AHIC, recently submitted a list of recommendations regarding mandatory electronic prescribing, known as e-prescribing, in Medicare to HHS Secretary Michael Leavitt. ...
AAFP News Now - http://www.aafp.org/online/en/home/publications/news/news-now.html

December 5, 2007

Google News Alerts

PCMA Supports Bipartisan Legislation Calling for E-Prescribing ...
Earthtimes - London,UK
Yesterday, the Administration said it wants significant health IT reform in a Medicare bill and that doctors who choose not to e-prescribe or use electronic ...
See all stories on this topic

White House Threatens Veto of Medicare Legislation
Kaiser network.org - Washington,DC,USA
A senate aide said the bill would offer a 1% bonus for every e-prescription written and one-time funding for startup costs. Physicians who do not adopt the ...
See all stories on this topic

December 4, 2007

E-Prescribing Mandate Expected in Senate Medicare Package

Medicare legislation emerging this week in the Senate likely will include a phased-in requirement that physicians use electronic prescribing systems, CongressDaily reports.

Sens. John Kerry (D-Mass.) and Debbie Stabenow (D-Mich.), who also plan to introduce stand-alone e-prescribing legislation this week, are working with Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Sen. Chuck Grassley (R-Iowa) to include the provision in the Medicare bill, according to aides.

The e-prescribing provision will be an essential part of an expensive Medicare package because it is expected to save $5 billion to $15 billion over 10 years, according to some estimates. Most of the savings will come from lower drug costs and fewer harmful medication interactions.

"Requiring e-prescribing in Medicare would be the single biggest patient safety improvement this country has seen in the last 20 years," Pharmaceutical Care Management Association President Mark Merritt said. He added that e-prescribing must be mandatory and adopted in a time frame "that creates a real sense of urgency" among physicians to achieve the predicted savings and safety improvements.

AMA Opposition

"Physicians are eager to adopt new technologies that have the potential to increase patient safety and quality of care, but hitting doctors with an unfunded e-prescribing mandate at the same time the government plans to cut Medicare physician payments 10% next year is untenable," American Medical Association Board Chair Edward Langston said.

E-prescribing startup costs of about $2,500 and productivity losses during transition make small practice physicians reluctant to adopt the technology, CongressDaily reports.

A Kerry aide said, "The Kerry office has met on numerous occasions with the AMA, and we are addressing the vast majority of their concerns" (Johnson, CongressDaily, 12/3).

http://www.ihealthbeat.org/articles/2007/12/4/EPrescribing-Mandate-Expected-in-Senate-Medicare-Package.aspx?p=1&tn=20071204

December 3, 2007

Google News Alert

AMA meeting: Delegates seek tax credit to help pay for EMRs

The AMA House of Delegates said physicians should get a full, refundable tax credit to help them buy and use health information technology such as electronic medical record and prescribing systems...

http://www.ama-assn.org/amednews/2007/12/03/prsj1203.htm

December 2, 2007

AHIC and E-prescribing mandates
By Mark Frisse(Mark Frisse)
And I'm still looking at all of the data that suggests that thousands or tens of thousands of people in this country are impacted each year because we don't have 100 percent e-prescription. And so my question is, this is the 17th ...
Mark Frisse's Policy Blog - http://www.markfrisse.com/policy/

Listen to the November 13 AHIC web cast and view the transcript here http://www.hhs.gov/healthit/community/meetings/m20071113.html

November 28, 2007

CMS to end e-prescription fax exemption

CMS has finalized a rule that will discontinue an exemption for computer-generated faxes from the NCPDP SCRIPT standard. The new rule is set to go into effect January 2009. According to CMS, most e-prescribing software can meet the standard, though some providers may have to upgrade their software to comply. According to the agency, the changes will force additional costs onto pharmacies not currently conducting transactions that comply with the SCRIPT standard, but CMS argues that "those costs would be balanced by administrative savings." The change will not impact the current exemption for long-term care facilities. Noncompliant computer faxes will still be accepted as a backup in instances of transmission failure or other communication problem with a compliant e-prescription.

http://www.drugtopics.com/drugtopics/Drug+Topics+Daily+News/CMS-to-end-e-prescription-fax-exemption/ArticleStandard/Article/detail/475690?contextCategoryId=10239&ref=25

E-Prescriptions
By Newt Gingrich, John Kerry
This document is available here as an Adobe Acrobat PDF.

...According to the Institute of Medicine, Americans average one medication mistake for every day spent in a hospital, accounting for more than 1.5 million injuries each year. Medication errors will kill at least seven thousand Americans this year. Of the more than three billion prescriptions written each year, doctors report nearly one billion require a follow-up between providers and pharmacies for clarification. The cost to our health care system is in the billions.

One reason for this mess is that 95 percent of prescriptions are transmitted using five-thousand-year-old technology: pen and paper...

...The benefits of e-prescribing are so important that the Institute of Medicine has called for every doctor and nurse to prescribe electronically by the year 2010...

...If a majority of doctors do not e-prescribe a few years down the road, the government should require all doctors to adopt e-prescribing or face financial penalties. E-prescribing should become a condition of doing business with Medicare. This is no different than the requirements other suppliers expect to see when they negotiate with customers.

A new study by the Department of Health and Human Services estimates that if 18 percent of doctors in Medicare adopt e-prescribing, the government will save $4 billion and nearly three million adverse drug events can be prevented over five years...

http://www.aei.org/publications/filter.all,pubID.27157/pub_detail.asp

November 16, 2007

E-PRESCRIPTIONS

The benefits of adopting electronic prescriptions are clear and compelling, say John Kerry, a Democratic senator from Massachusetts, and Newt Gingrich, a Republican and former speaker of the House.

For example, when a doctor "writes" an electronic prescription, a computer can warn of potentially dangerous interactions with other medications or allergies and thereby prevent thousands of unnecessary hospitalizations each year.  E-prescribing can also let a physician know whether a drug is covered by a patient's insurance or whether an alternative generic is available at a fraction of the cost.

The federal government can lead by requiring that doctors who do business with Medicare convert to e-prescribing.  This can be done by using market forces and the federal government's purchasing power to align financial incentives, say Kerry and Gingrich:

• First, offer bonus payments to Medicare doctors who already prescribe electronically or who adopt the technology.
• Such payments will help doctors, especially those with small practices without many patients, to pay for startup costs.
• If a majority of doctors don't e-prescribe a few years down the road, the government should require all doctors to adopt e-prescribing or face financial penalties. 
• E-prescribing should become a condition of doing business with Medicare. 

A new study by the Department of Health and Human Services estimates that if 18 percent of doctors in Medicare adopt e-prescribing, the government will save $4 billion and nearly three million adverse drug events can be prevented over five years.

Source: John Kerry and Newt Gingrich, "E-Prescriptions," Wall Street Journal, November 16, 2007.

For text: http://online.wsj.com/article/SB119518213622195332.html

http://www.ncpa.org/sub/dpd/index.php?page=article&Article_ID=15266

November 15, 2007

Google News Alert

AHIC weighs recommendation to require e-prescribing
Government Health IT - Falls Church,VA,USA
"Yet we are stilling looking at data showing thousands of people are impacted each year because we don't have e-prescription. "This is an obvious issue and ...
http://www.govhealthit.com/online/news/350118-1.html

November 14, 2007

Google News Alert

HHS proposes standards for voluntary e-prescribing
Healthcare IT News - New Gloucester,ME,USA
If some members of an HHS advisory panel have their way, however, the government will force doctors to e-prescribe. The standards follow yesterday's meeting ...
http://www.healthcareitnews.com/story.cms?id=8142

November 06, 2007

Medicare To Pay Bonuses for Use of EHRs, E-Prescriptions

Medicare in 2008 for the first time will provide bonuses to doctors and other providers for using electronic health records and electronic prescriptions, according to an official notice of its 2008 payment rules, Government Health IT reports.

EHRs and e-prescribing technology are two of the 119 quality measures listed by CMS for 2008. Doctors who report their compliance with as many as three of the measures will qualify for a bonus of as much as 1.5% of their Medicare fees. A pool of $1.35 billion will be available to pay incentives in 2008, Government Health IT reports...

http://www.ihealthbeat.org/articles/2007/11/6/Medicare-To-Pay-Bonuses-for-Use-of-EHRs-EPrescriptions.aspx?topicID=53

October 31, 2007

Google News Alert

E-prescription initiative reduced drug interaction errors
An examination of data in Michigan reveals that e-prescribing reduces potential drug interaction problems.
Drug Topics - Drug Topics Daily News - http://www.drugtopics.com/drugtopics/Drug+Topics+Daily+News/Article/list/10239

October 22, 2007

Google News Alert

Gingrich's causes — and health group clients — can be profitable
Atlanta Journal Constitution - GA, USA
Gingrich then cited three companies for helping provide free "e-prescription" software to connect physicians directly to pharmacies. ...

October 16, 2007

E-prescribing ups number of prescriptions filled
By: Joseph Conn / HITS staff writer
Story posted: October 16, 2007 - 9:43 am EDT
Pharmacists saw better than an 11% increase in the number of prescriptions at their stores and, maybe, their cash registers, too, when physicians started using electronic prescribing systems, according to a recently released announcement about a study conducted by the giant drugstore chain Walgreen Co., the electronic prescribing exchange SureScripts and data-miner IMS Health.

Researchers tracked the prescription data provided by IMS Health on 100 prescribers in five states for three months before and three months after they began using e-prescribing systems from 15 different vendors, a joint Walgreen-SureScript news release about the study said.

In the three months before the participating prescribers started using an e-prescription system, their pharmacies received 272,103 prescriptions, the statement said. In the three months after the prescribers started using e-Rx systems, prescriptions from them jumped by 30,513, or 11.2%, to 302,616, it said. The study included data from 93 pharmacy organizations—not just Walgreen Co.—at 14,638 locations.

The 19-month study period stretched from April 2005 through November of last year. Results were adjusted for seasonal differences in prescribing…

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20071016/FREE/71016001/0/FRONTPAGE

September 27, 2007

Google News Alerts

East Cleveland Ohio - Cleveland History - Decades
By Administrator
the not-for-profit Cleveland Clinic is a leading academic medical center serving the Cleveland, Ohio Enable e-prescription functionality between clinic and retail pharmacies; Improve physician. Richter & Associates, Cleveland ...
East Cleveland Ohio Local Blog - http://eastclevelandohio.net/east-cleveland-oh-blog

Tips For Buying Quality Medicines Online
By wpman2
E-Prescription features offer 24 hour online services to you and shopping this way will take only few minutes. Online drug store pharmacies present information on baby matters, health matters and ... Besides, the patients should be able ...
Online Drug 1 - http://onlinedrug1.thedruginfo.com

August 17, 2007

Google News Alert

Alaska is last state with e-prescription
Columbia Daily Tribune - Columbia,MO,USA
By JAMES HALPIN AP Writer AP Photo/Anonymous ANCHORAGE, Alaska (AP) -- Electronic drug prescriptions can be delivered to pharmacists in all 50 states for ...
See all stories on this topic

August 16, 2007

Google News Alert

Think Tank Strives to Reduce Medication Errors
By Jerri Lynn Ward, J.D.
"Because medication nonadherence is estimated to account for between 10% to 20% of hospital admissions and adds up to $100 billion a year to health care costs in the US alone, innovations related to e-prescription and improving ...
Garlo Ward, PC - http://garloward.com

August 15, 2007

Google News Alerts

Pharmacy info exchange now legal nationwide
Government Health IT - Falls Church,VA,USA
Until now, a rule required that an e-prescription go directly from the doctor to the pharmacy rather than through an intermediary network such as the ...
See all stories on this topic

SureScripts(R) Joins With Physicians, Payers and Employers to ...
Market Wire (press release) - USA
... innovations related to e-prescription and improving patients' success in taking medications as prescribed have the potential to greatly improve both ...
See all stories on this topic

August 9, 2007

Google News Alert

Rural Health Center Begins e-Prescription Service
WBOY-TV - Clarksburg,WV,USA
Joe Manchin signed the bill allowing the practice, Marshall University is offering free e-prescription software to doctors in the state. ...
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