Electronic Prescription

Key step in national initiative toward adoption of electronic health records

The Certification Commission for Health Information Technology (CCHIT), Chicago, Ill. and the Drummond Group Inc. (DGI), Austin, Texas, were named today by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems for compliance with the standards and certification criteria that were issued by the U.S. Department of Health and Human Services earlier this year.

Announcement of these ONC-Authorized Testing and Certification Bodies (ONC-ATCBs) means that EHR vendors can now begin to have their products certified as meeting criteria to support meaningful use, a key step in the national initiative to encourage adoption and effective use of EHRs by America’s health care providers.

“Less than two months following the issuance of final meaningful use rules, we have approved our initial ONC-ATCB certifiers.  EHR vendors can begin immediately to get their products certified.” said David Blumenthal, M.D., national coordinator for Health Information Technology.  This is a crucial step because it ensures that certified EHR products will be available to support the achievement of the required meaningful use objectives, that these products will be aligned with one another on key standards, and that doctors and hospitals can invest with confidence in these certified systems.”

Applications for additional ONC-ATCBs are also under review.

Certification of EHRs is part of a broad initiative undertaken by Congress and President Obama under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of the American Recovery and Reinvestment Act (ARRA) of 2009.  HITECH created new incentive payment programs to help health providers as they transition from paper-based medical records to EHRs.  Incentive payments totaling as much as $27 billion may be made under the program.  Individual physicians and other eligible professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid.  Hospitals can receive millions.

To qualify for the incentive payments, providers must not only adopt, but also demonstrate meaningful use of, certified EHR systems.  The law envisions that defined meaningful use requirements will help ensure that the patient and provider benefits of EHRs are realized.  Initial meaningful use criteria were defined in a final rule issued by the Centers for Medicare & Medicaid Services (CMS) on July 28.

In addition to the CMS rule, ONC also issued standards and certification criteria for EHRs on July 28, aimed at ensuring that EHR systems will support the specific tasks required under meaningful use.  Also, through regulations issued on June 24, ONC created a system by which technology review organizations could also qualify as ONC- ATCBs that will certify EHR products as meeting the requirements necessary for meaningful use.

With the initial two ONC-ATCBs now named, EHR vendors can apply to them for certification of their products.  By purchasing certified products, providers will have assurance that the products will support achievement of the meaningful use objectives.

“Multiple steps are underway to carry out the intent of Congress in supporting rapid and effective adoption of EHRs throughout our health care system,” Dr. Blumenthal said.  “The naming of initial ONC-ATCBs is one important step.  Actual certification of multiple vendors’ systems by the ONC-ATCBs is an important next step.  CMS is also working to create an online system for providers to register and attest for the EHR incentive programs. The first incentive payments are targeted to be made in May 2011.  Meanwhile, ONC is also carrying out new programs of technical assistance and training, especially for smaller hospitals and physician practices.”

Dr. Blumenthal said the Health IT initiative “is on an aggressive schedule to meet the urgent targets set by Congress and the President toward realizing the quality and safety improvements that we can achieve through health information technology.”

To learn more about the ONC-ATCBs named today visit www.cchit.org  and www.drummondgroup.com.

For more information about the ONC certification programs visit http://healthit.hhs.gov/certification.

For more information about other HHS Recovery Act Health Information Technology funding and programs, visit http://www.hhs.gov/recovery/programs/index.html#Health.

This news is published on : http://www.hhs.gov/news/press/2010pres/08/20100830d.html

Tags: Comprehensive Ambulatory EHR, EHR, electronic health records, meaningful use ehr, meaningful use of ehr, Outpatient EHR
Posted August 31, 2010 by admin under EHR, EMR

This week, the Medical Group Management Association sent a letter to CMS urging the agency to modify provisions of its proposed 2011 physician fee schedule relating to the electronic prescription and electronic health record programs, Modern Healthcare reports (Lubell, Modern Healthcare, 8/25).

The letter comments on CMS’ proposed rules for the Medicare Part B physician fee schedule for 2011 (Goedert, Health Data Management, 8/25).

E Prescription, EHR Incentives

The e-prescribing program — implemented in 2009 — offers a 1% bonus payment beginning in 2011 for physicians or group practices that are deemed to be “successful electronic prescribers” under the Medicare Improvements for Patients and Providers Act of 2008.

In 2012, the program will begin penalizing health care providers who do not qualify as successful e-prescribers (Modern Healthcare, 8/25).

According to the letter, there is “significant overlap” between the 2011 Medicare e-prescribing initiative and the EHR “meaningful use” incentive program included in the federal stimulus package. The letter states that health care providers might have difficulty discerning whether they have qualified for the incentive payments.

The group suggested that CMS quickly report whether a health care provider qualifies for either program (Health Data Management, 8/25).

MGMA also said that health care providers who meet meaningful use requirements should not be subject to penalties through the e-prescription program (Modern Healthcare, 8/25).

Quality Reporting Site

In its letter, MGMA also commented on proposed changes to CMS’ Physician Quality Reporting Initiative.

The group urged CMS to continue claims-based PQRI reporting and to refrain from listing health care providers who unsuccessfully participate in PQRI on its Physician Compare website (Health Data Management, 8/25).

Source     :      http://www.ihealthbeat.org/articles/2010/8/26/mgma-seeks-revisions-to-eprescribing-ehr-incentive-pay-policies.aspx

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx
Posted August 30, 2010 by admin under E-Prescription, Electronic Prescription

ROCHESTER, NY – The electronic prescribing rate in upstate New York increased from 12 percent in 2009 to 17 percent in the first quarter of 2010, representing 3.6 million new and renewed prescriptions on an annual basis, according to a new report. The report suggests that this number will grow significantly as the result of the technology becoming more affordable, due in part to the government’s incentives for health IT adoption.

Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, which finances and delivers healthcare services to 1.7 million people across upstate New York, conducted the report.

The report estimates that 18 percent, or 3.8 million, prescriptions are still telephoned or faxed and 65 percent, or 13.7 million, prescriptions are handwritten or printed on paper. Estimates were based on an FLRx (the pharmacy benefit management division of Excellus Health Plan, Inc.,) review of a sample of claims submitted for new and renewed prescriptions from January 2010 through March 2010.

With manual and verbal handoffs still predominant, medical errors are more likely to occur, the report suggests. According to the nonprofit Institute for Safe Medication Practices, handwritten prescriptions and drugs with similar names are among the most risky conditions associated with medication use.

The report finds that more than two million adverse drug events could be avoided in New York state if all physicians in the region made the switch to E Prescription.

“Handwritten prescriptions can lead to errors that can potentially put patients at risk and also waste time and precious healthcare dollars,” said Joel Owerbach, PharmD, vice-president and chief pharmacy officer for Excellus BCBS.

The report finds that e-prescribing’s ability to alert prescribers to money-saving opportunities with generic or other lower-cost alternatives to prescription drugs has the potential to save healthcare dollars.

“If e-prescribing alerts raised the generic fill rate by just one percent, healthcare spending in upstate New York could be reduced by more than $64 million a year,” Owerbach said.

“Based on numerous national studies, our analysis of upstate data shows that e-prescribing holds the potential to annually prevent 35 deaths, 160 permanent disabilities, 400 hospitalizations and 3,000 physician office visits,” he added. “Right now, about 17 percent of prescriptions are sent electronically, but we’re on the verge of seeing explosive growth that will save lives, time and money.”

Earlier this year, when Alexandria, Va.-based Surescripts released its 2009 National Progress Report on E-Prescribing, its CEO and President Harry Totonis, said the past year had been the “tipping point” for e-prescribing. He noted that one of the top drivers to e-prescribing growth were the federal incentives for adopting information technology in a meaningful way.

On Tuesday the Centers for Medicaid & Medicaid Services and Office of the National Coordinator released the final rules for achieving meaningful use. More flexibility for meeting requirements were built into the final rules, including the lowering of e-prescribing requirements for eligible professionals from 75 percent of prescriptions transmitted electronically to 40 percent. The final rule also included the adoption of the National Council for Prescription Drug Programs’s (NCPDP) SCRIPT Standard for the secure, electronic transmission of prescriptions and prescription-related information.

“The final rules will help clinicians achieve better and more effective patient care,” said Lee Ann Stember, president of NCPDP. “We are very pleased with the final rule as it relates to e-prescribing and using the NCPDP SCRIPT Standard to achieve meaningful use.”

The Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt said that while they applauded the final rule as a step forward they said they hoped regulators “will do more down the road to ensure that the full safety and savings benefits of e-prescribing are realized on behalf of America’s patients. We believe, for example, that providers who receive HITECH payments should perform ‘e-prescribing safety checks’ to prevent dangerous medication errors, and think that certified EHR products should support – and providers should use – all the safety and savings components of   E Prescription as defined in Medicare Part D.”

Source   :    http://www.healthcareitnews.com/news/erx-rate-ny-state-see-explosive-growth-0

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx
Posted August 19, 2010 by admin under E-Prescription, Electronic Prescription

With a regulatory stroke, the Obama White House has swept away the last serious legal hurdle set by the federal government to the nationwide conversion of the healthcare system to the electronic prescription and transmission of prescription drugs.

The breakthrough came in June when the U.S. Drug Enforcement Administration struck down legal impediments to the electronic prescribing of controlled substances. The change comes with the agency’s release in June of interim final rules governing prescribing practices, which successfully culminated a 10-year battle by pharmacy and technology interests to modernize all facets of the prescription prescribing and dispensing process.

The federal prohibition against paperless prescribing of controlled substances—a prohibition based on outmoded concerns over the safety of digitally prescribed and stored prescriptions for higher-risk medications—had long bedeviled efforts by pharmacy and industry groups to spur universal adoption of the technology by the nation’s prescribing physicians. The DEA’s decision to eliminate that barrier marked a major victory for those groups.

Chain pharmacy representatives were jubilant. “This is the first time ever that there can be a coordinated e-prescribing system for both controlled and noncontrolled prescription medication,” the National Association of Chain Drug Stores stated. “The prior inability to utilize e-prescribing for controlled substances frequently was reported as a major barrier to physician adoption of e-prescribing.”

NACDS president and CEO Steve Anderson said the DEA’s decision marked “truly a historic day for the healthcare system, as this rule will allow much-needed health information technology solutions to better serve patients.”

NACDS and other groups have worked collaboratively over the past decade with the DEA, the Department of Health and Human Services, pharmacy partners, such intermediaries as Surescripts, technology vendors and others to extend paperless prescribing to controlled substances. In partnership with the National Community Pharmacists Association, the chain pharmacy group created Surescripts in 2001 to foster the nationwide adoption of e-prescribing and provide a network platform for its use.

More than 97% of the nation’s chain community pharmacies now use pharmacy applications that have been tested and certified through Surescripts, according to NACDS, and the number of prescriptions routed electronically grew from 68 million in 2008 to 191 million in 2009.

Despite those gains, however, a large majority of family physicians and their practices—roughly 3-out-of-4 of them—still hand-write prescriptions and rely on their patients to carry them to the pharmacy for dispensing.

Although “electronic health record adoption is picking up rapidly, with an estimated 27% of physicians using some kind of EHR, the vast majority of medical records in the United States are still on paper, with the average appointment taking 13 pages to document,” confirmed Karen Riley, a spokeswoman for the New York eHealth Collaborative and the NYC Regional Electronic Adoption Center for Health.

The adherence problem—whereby many patients simply never even fill a written prescription—also points to the gap that remains between the point of prescribing and the local pharmacy. That gap swallows many written scripts. In one recent study, researchers at Harvard Medical School found the problem of “primary nonadherence” is rampant. Tracking 75,000 patient visits, they found that 22% of first-time patient prescriptions were never filled.

Allowing e-prescribing of tightly controlled pain relievers and other medications likely won’t bridge most of that gap. But it will help simplify the prescribing process for family doctors and specialists.

Opening controlled substances to the world of electronic data storage and communications has long been a top priority for Surescripts. “There’s a high demand for it, both at the state level, where they want to track the use of controlled substances, as well as at the federal level,” former Surescripts CEO Kevin Hutchinson told Drug Store News.

Now, that hurdle has been vaulted. The real transformation of the nation’s healthcare system still depends on how quickly doctors embrace health information technology.

Source  :  http://drugstorenews.com/story.aspx?id=145743&type=print

Posted August 11, 2010 by admin under E-Prescription, Electronic Prescription

The rate of electronic prescribing in upstate New York increased from 12% in 2009 to 17% in the first quarter of this year, a new report by Excellus BlueCross BlueShield found, Healthcare IT News reports (Merrill, Healthcare IT News, 7/15).

The report also concluded that the percentage of physicians across the U.S. who use the technology doubled from 2008 to 2009,  the Rochester Democrat and Chronicle reports.

Benefits of E-Prescribing Systems

E-prescribing systems transmit prescriptions from the health care provider directly to pharmacies.

The report found that use of the systems by every upstate New York physician would prevent two million adverse reactions or events annually, including:

• 35 deaths;
• 160 permanent disabilities;
• 400 hospitalizations; and
• 3,000 physician consultations.

In addition, the report found that greater use of the technology overall would:

• Increase the use of more cost-efficient drugs;
• Provide greater security;
• Limit “doctor shopping” and illegal prescription practices;
• Boost efficiency for physicians, patients and pharmacies; and
• Save money for insurers (Matthews, Rochester Democrat and Chronicle, 7/15).

Predicted Increase in Use

On an annual basis, 3.6 million new and renewed prescriptions are handled regionally using the technology. That number is likely to grow as the systems become more affordable and as government incentives to spur the use of health IT take effect, the report predicted.

Source  :  http://www.ihealthbeat.org/articles/2010/7/16/report-on-eprescribing-in-new-york-predicts-growth-in-technology.aspx

Tags: Certified Prescription, E-Prescribing, E-Prescribing Systems, E-Prescription, Electronic Prescription
Posted August 4, 2010 by admin under E-Prescription, EHR, EMR, Electronic Prescription

The National Council for Prescription Drug Programs (NCPDP) today acknowledges and applauds the U.S. Health and Human Services Department (HHS) on its Final Rules announcement on “meaningful use” of an Electronic Health Record (EHR), including the adoption of NCPDP SCRIPT Standard for the secure, electronic transmission of prescriptions and prescription-related information.

The Final Rule on Standards to meet Meaningful Use announced the NCPDP SCRIPT Standard Implementation Guide Version 8, Release 1 (Version 8.1) October 2005 or NCPDP SCRIPT Standard, Implementation Guide, Version 10.6 can be used. This allows flexibility for those prescribers – eligible practitioners, hospitals, provider associations, state and federal governments, software vendors and more – that already are using the SCRIPT Standard as well as flexibility for implementers.

“The Final Rules will help clinicians achieve better and more effective patient care,” stated Lee Ann Stember, President of NCPDP. “We are very pleased with the Final Rule as it relates to ePrescribing and using the NCPDP SCRIPT Standard to achieve Meaningful Use.”

The NCPDP SCRIPT Standard was first published in 1997 and has been updated annually based on the business needs identified by the industry. SCRIPT is a standard created to facilitate the transfer of prescription data between pharmacies, prescribers, intermediaries and payers. This standard allows for quick and accurate communication between the prescriber, pharmacist and payer to provide information for the prescriber and pharmacist to make informed decisions with the patient while reducing the potential for medication error.

Source:http://www.financialpost.com/markets/news/NCPDP+Script+Standard+Adopted+Core+Requirement+ePrescribing+Meaningful/3273572/story.html

Tags: ePrescribing, Meaningful Use, NCPDP Script
Posted July 16, 2010 by admin under E-Prescription, Electronic Prescription

In an interim final rule released Tuesday, CMS “recognized” the use of version 10.6 of the National Council for Prescription Drug Programs SCRIPT Standard for electronic prescribing under the Medicare Part D drug benefit, Health Data Management reports.

According to CMS, “recognition” means the agency approves the use of the updated standard for e-prescribing; however, it is not yet formally adopted as the new standard.

New features in the version 10.6 standard will allow users to provide:

• Prescriber order numbers;
• Drug NDC source data;
• Pharmacy prescription fill numbers; and
• Date of prescription sale.

According to CMS, the new functions will “facilitate better record matching, the identification and elimination of duplicate records, and the provision of richer information to the prescriber between willing trading partners.”

CMS plans to publish the final version of the interim final rule on July 1 (Goedert, Health Data Management, 6/29).

Source: http://www.ihealthbeat.org/articles/2010/6/30/cms-recognizes-updated-eprescribing-standard-for-medicare-part-d.aspx

Tags: CMS, Medicare Part D, prescriber, prescribing
Posted July 13, 2010 by admin under E-Prescription, Electronic Prescription, Medicare Incentive, Medicare Law

Four pharmacy organizations say they support the Drug Enforcement Administration’s efforts to allow electronic prescribing of controlled substances but called for further clarification on the new e-prescribing rule, Modern Healthcare reports.

On March 31, DEA published in the Federal Register its interim final rule on e-prescribing of controlled substances. According to DEA public affairs officer Barbara Carreno, the rule took effect June 1.

NCPA Letter

On Tuesday, the National Community Pharmacists Association sent a letter to DEA offering to provide guidance on a requirement for digital signatures on e-prescriptions.

NCPA also asked the agency to allow nurses to act as liaisons between long-term care facilities and pharmacies because most long-term care centers do not employ full-time physicians.

Letter From Four Groups

In another letter, four pharmacy groups asked DEA to clarify:

• The steps that prescribers must take to account for changes in e-prescriptions;
• The responsibilities associated with digital signatures;
• Work flow procedures in long-term care facilities; and
• E-prescribing options for emergency situations.

The groups also requested that third-party audits occur less frequently and that pharmacies be allowed more time to respond to security concerns identified in internal audits.

The letter’s signatories were the:

• American Pharmacists Association;
• American Society of Consultant Pharmacists;
• American Society of Health-System Pharmacists; and
• NCPA (Robeznieks, Modern Healthcare, 6/3).
• Emdeon Makes Recommendations

In a comment letter on the interim final rule, software and service vendor Emdeon Business Services noted that it will take time to add a new field to e-prescribing transactions to indicate that a prescription has been digitally signed.

As an interim solution, Emdeon recommends placing the signature indicator inside an XML “envelope” or “wrapper” in the header of the prescription.

Emdeon also offered recommendations about archiving, altering content and verifying eligibility (Goedert, Health Data Management, 6/1).

Source: http://www.ihealthbeat.org/articles/2010/6/4/pharmacy-groups-call-for-dea-to-clarify-new-rule-on-eprescribing.aspx

Tags: DEA, E-Prescribing, Pharmacy Groups
Posted July 1, 2010 by admin under E-Prescription, Electronic Prescription

OmniMD™ one of the leading healthcare information technology companies, which provides Electronic Medical Records (EMR), Practice Management (PMS) and other Healthcare IT products and services to their providers and clinics across the nation is proudly announcing achievement of Surescripts^® Gold Solution Provider status for its OmniMD Version 8.2 e-prescribing product.  This designation has only been achieved by a handful of EMR companies in the US.

Now OmniMD™ gives clients electronic access to:

• New e-Rx
• Change e-Rx
• Cancel e-Rx
• Refill Requests
• Insurance (PBM) Coverage Verification
• Formulary Details and Alternatives
• Patient e-Rx History
• Activity Report
• Directory Service
• Enhanced Security
• Excellent Customer Support and Service

Surescripts Gold Solution Provider status recognizes that OmniMD™ is leveraging the complete resources and

capabilities of Surescripts and its network to improve the safety, efficiency and quality of the prescribing process.

Gold Solution Provider status is granted to vendors whose software products have surpassed Surescripts’ baseline product certification, by demonstrating a higher level of commitment to e-prescribing.

To manage prescription information electronically through the Surescripts network, prescribers, pharmacies and PBMs must use software that has completed the Surescripts certification process.

It shows OmniMD™’s commitment to add value to different clinic practices and at the same time follow stringent Healthcare IT regulations which are going to lead OmniMD™ to achieve new heights. OmniMD™ is keeping pace with the latest technologies and strive to achieve industry standards and recognitions.

Divan Dave (CEO, OmniMD)

For more information about Surescripts certification,

visit www.surescripts.com/certification-status.html.

OmniMD™ integrated Electronic Medical Records and Practice Management (PMS) products and services, offers unparalleled reliability, ease-of-use, efficiency and customizability. The solution is a HIPAA compliant, web-enabled and support device, which can range from tablet PCs, Smart phone and handhelds to desktop computers. Version 8.2 of this product has achieved Surescripts Gold Solution Provider status, which also provides real-time alerts for drug-drug, drug allergy and other interactions based on a patient’s EMR. The solution captures complete documentation such as HPI, ROS and Physical Exams, Assessment & Plan to complete patient visits. The system follows HL7 standards for information sharing and integration across practices and hospitals. The solution is secured by Thawte, which uses 128–bit encryption and digital certificates to ensure complete data security.

About OmniMD^™

OmniMD^™ is a developer of HIPAA compliant Internet based enterprise healthcare practice solutions. OmniMD EMR, Version 6.0.5 is a CCHIT Certified® 2006 Ambulatory EHR, designed to fully automate the work-flow of contemporary healthcare organizations. The company is a division of Integrated Systems Management, Inc. – ISM Inc. – (www.ismnet.com) a leader in Internet consulting and e-business development since 1989.

OmniMD^™’s suite of products and services empowers hundreds of clinics with the ability to efficiently automate and manage clinical processes and patient information electronically. With its comprehensive and flexible product modules, the suite allows you to choose a customized solution that grows with your practice needs and electronic readiness over a period of time.

For additional information, please visit http://www.omnimd.com/html/news_SureScripts-Gold-PR.html

Tags: E-Prescribing, EMR, SureScripts Gold
Posted June 23, 2010 by admin under E-Prescription, Electronic Prescription

By Jim Frederick

WASHINGTON (Jun. 1) Capping a decade-long -– and ultimately victorious -– battle by pharmacy and technology interests to modernize all facets of the prescription prescribing and dispensing process, the Drug Enforcement Administration has struck down legal impediments to the electronic prescribing of controlled substances.

In an announcement this afternoon, the DEA issued its interim final rule allowing for the paperless prescribing of controlled substances. Publication of the new rule clears away the last barrier preventing doctors and pharmacists from shifting controlled medicines into information technology and the digital age, and it marks a dramatic victory for e-prescribing advocates.

Chain pharmacy representatives were jubilant. “This is the first time ever that there can be a coordinated e-prescribing system for both controlled and non-controlled prescription medication,” the National Association of Chain Drug Stores crowed in a statement. “The prior inability to utilize e-prescribing for controlled substances frequently was reported as a major barrier to physician adoption of e-prescribing.”

NACDS president and CEO Steve Anderson said the DEA’s decision marks “truly an historic day for the healthcare system, as this rule will allow much-needed health information technology solutions to better serve patients.

“For the first time ever, electronic prescribing of controlled substances will be permitted,” Anderson added. “We thank DEA officials for issuing a workable rule to help make this technological capability a reality for physicians, pharmacies and their patients.”

NACDS and other groups have worked collaboratively over the past decade with DEA, the Department of Health and Human Services, pharmacy partners, intermediaries such as Surescripts, technology vendors, and others to extend paperless prescribing to controlled substances, which have long been restricted under former federal guidelines. In partnership with the National Community Pharmacists Association, the chain pharmacy group created Surescripts in 2001 to foster the nationwide adoption of e-prescribing and provide a network platform for its use.

More than 97% of the nation’s chain community pharmacies now use pharmacy applications that have been tested and certified through Surescripts, according to NACDS, and the number of prescriptions routed electronically grew from 68 million in 2008 to 191 million in 2009.

Source: http://drugstorenews.com/story.aspx?id=141375&menuid=335

Tags: DEA, E-Prescribing, NACDS
Posted June 11, 2010 by admin under E-Prescription, Electronic Prescription