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US: HHS Pushes Doctors to Start Electronic Prescribing

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HHS Pushes Doctors to Start Electronic Prescribing

Elsevier Global Medical News. 2008 Jul 21, ME Schneider

Federal officials are urging physicians to begin electronic prescribing as soon as possible now that Congress has authorized bonus payments for the successful use of the technology.

Under recently enacted Medicare Improvements for Patients and Providers Act (H.R. 6331) - the same law that eliminated the 10.6% Medicare physician pay cut - Congress also outlined plans to ramp up e-prescribing beginning next year. Under the law, bonus payments will gradually decrease and eventually physicians will be penalized if they don't transmit prescriptions electronically.

"We expect this will have a profound effect on the adoption and use of e-prescribing," Health and Human Services Secretary Mike Leavitt said during a press conference to explain the details of the new initiative.

The widespread use of e-prescribing will create benefits for patients and the health system as a whole by allowing for real-time cross-checking for drug-drug interactions and providing automatic error screening of prescriptions, Mr. Leavitt said.

It also is expected to save money. Medicare could save up to $156 million over a 5-year period by avoiding adverse drug events, according to the Centers for Medicare and Medicaid Services.

The incentive payments will be awarded through the Physician Quality Reporting Initiative, Medicare's voluntary program that provides incentives to physicians who successfully report on certain quality measures. CMS officials have developed measures specific to e-prescribing and will be releasing guidance on how they define the routine use of e-prescribing. They also plan to host a conference on the technical details of the plan this fall.

The e-prescribing bonuses will be in addition to the current bonuses.

During 2009 and 2010, physicians who successfully report on e-prescribing measures will be eligible to earn 2% of total allowed Medicare charges. In 2011 and 2012, the incentive payment will drop to 1% and then to 0.5% in 2013.

Beginning in 2012, eligible physicians who do not e-prescribe will see their total allowed Medicare charges cut by 1% with that amount increasing to 2% by 2014, according to the provisions of H.R. 6331.

The law grants an exemption for those providers for whom the requirement would be a "significant hardship," such as a physician practicing in a rural area without sufficient Internet access.

CMS officials already have laid the groundwork for the increased use of e-prescribing by issuing standards around the transmission of electronic prescriptions, Mr. Leavitt said. With the authorization of bonus payments, the government will be able ease some of the costs of adopting e-prescribing technology.

According to CMS estimates, the average the cost of acquiring and setting up an e-prescribing system is about $3,000 per prescriber, with ongoing maintenance costs of $80-$400 per month.

Dr. James King, a family physician in Selmer, Tenn., and president of the American Academy of Family Physicians, estimated that he spent about $10,000 to implement an e-prescribing system in his practice. But, even with the technology in place, he is able to e-prescribe only some of the time. For example, not all pharmacies in his area are able to receive electronic prescriptions, he can't prescribe some narcotic drugs electronically, and he cannot prescribe medications electronically across state lines for his patients who live in Mississippi.

That's why Dr. King said he is pleased that Congress chose to proceed first with payment incentives, so that policy makers have time to remove some of these barriers.

He urged physicians to adopt the technology. In addition to improving quality and safety for patients, it allows the physicians to engage in more "two-way communication," he said. For example, e-prescriptions generally allow physicians access to information about whether the patient has filled the prescription. And e-prescribing should improve efficiency, allowing physicians to devote more time to patient care, he said.

A significant number of family physicians are likely to be ready to begin e-prescribing in January, Dr. King said. The AAFP estimates that about half of their members either have electronic health records (EHRs) with e-prescribing capabilities or plan to implement them by the end of the year.

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(Elsevier Global Medical News, By ME Schneider, July 23, 2008)


The information contained in these articles may or may not be in agreement with my own opinions. They are not posted as medical advice of any kind.

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