Each Patient Counts: Massachusetts Medical Society Weblog

Clinician’s Guide to Electronic Prescribing Now Available

All of the 1,400-plus attendees at the National E-Prescribing Conference received a copy of the just-published Clinician’s Guide to Electronic Prescribing. The 40-page primer introduces the concept of e-prescribing to the uninitiated and provides concrete adoption strategies and advice for practices ready to take the plunge.

The free guide was developed with the assistance of the AMA, the American Academy of Family Physicians, and the American College of Physicians. It contains a buyer’s-guide checklist for comparing different vendors’ systems and a useful listing of national and state E-Rx  initiatives.

Download at www.ehealthinitiative.org

-- Lloyd Resnick

E-Prescribing Lessons Learned Shared in Breakout Sessions

The messages from users and implementers of electronic prescribing systems were loud, clear -- and repetitive. In real-life scenarios, repetition translates into “truth.” Here are some of the oft-cited “best practices” from breakout sessions at the National E-Prescribing Conference:

• Training in -- and use by -- all physicians and staff in a group/practice site is essential. “Dabbling” or piecemeal adoption of e-prescribing does not work.
• The e-prescribing system should interface with the practice management system.
• Notify all local pharmacies in person that you plan to initiate e-prescribing . (More than 90 percent of the nation’s pharmacies have the capacity to handle electronic scripts, but many lack actual experience.)
• The answer to the standalone versus integral-with-an-EHR system question depends on individual practice work patterns and available human and financial resources. (The CCHIT recently agreed to certify standalone e-prescribing systems, which should ease fears about interoperability among these “simpler” systems.)
• Keep a trainer (or in-house “superuser”) on-site for three to five days after you go live.
• When doing a pre-implementation cost-benefit analysis, remember to calculate annual maintenance costs. Incentives alone (from Medicare and/or any private health plan that might offer them) will probably not cover maintenance costs.

-- Lloyd Resnick

VIPs Address Big Picture at E-Prescribing Conference

While in-the-trenches experts covered the nuts and bolts of e-prescribing during breakout sessions at the National E-Prescribing Conference in Boston on October 6-7, attendees received big-picture views from high-level state and federal officials during opening and closing plenaries.

Remarks from the federal side always mentioned the 2 percent bonus from Medicare for physicians who prescribe electronically, beginning January 1. Almost all the VIPs also mentioned the down-to-the-wire agreement on the Medicaid waiver. “The recent Medicaid waiver agreement was a remarkable example of the federal government and Massachusetts working together,” said Massachusetts Gov. Deval Patrick.

The benefits of e-prescribing are rarely debated anymore. Kerry Weems, acting administrator at the CMS, said it best: “We don’t know how much money widespread deployment of e-prescribing will save, but we know it will save lives.”

Later, Massachusetts Sen. John Kerry cited a statistic that “a 5 percent increase in the use of electronic prescribing could save doctors $1 billion over five years.”

At 14 percent, Massachusetts has the highest percentage of electronic prescribing of any state in the nation. If you consider that adoption rate low, physicians nationwide have been adopting even more slowly. Taking a businessperson’s view, Rhode Island Gov. Donald Carcieri said, “The huge growth in American productivity during the last 20 years has been driven by information technology. That same opportunity exists in health care, and e-prescribing is a relatively simple IT application.”

David Brailer, M.D., former national coordinator for health information technology, characterized physician adoption as a “diffusion, not a stampede.”

During a luncheon talk, Kevin Hutchinson, founding president and former CEO of SureScripts, noted that nationwide, 80 percent of prescriptions are written by 30 percent of providers. He suggested that efforts to “convert” physicians focus on that 30 percent.

Michael Leavitt, secretary of the U.S. Department of Health and Human Services, said information technology is a crucial part of a national plan to achieve “value-driven” health care. “We don’t really have a health care ‘system’ today,” he said. “We have a robust and rapidly growing health care ‘sector.’ Electronic prescribing is one important part of transforming health care from a sector into a system.”

-- Lloyd Resnick