Electronic Prescription

The number of office-based U.S. health care professionals who use electronic prescription systems has increased significantly in recent years, according to data released Tuesday by electronic prescribing network operator Surescripts, Reuters reports.

Charting E-Prescription Adoption

According to Surescripts, about 200,000 office-based prescribers — or about one-third of office-based health care workers — currently use e-prescribing systems. The latest figure is up from 156,000 e-prescribers at the end of 2009 and 74,000 at the end of 2008.

Surescripts noted that 47 states more than doubled their use of e-prescribing last year.

Massachusetts has the highest rate of  E-Prescription use, at 57%.

Federal Incentives Providing Impetus

The recent increase in e-prescribing could stem from federal incentives designed to reward health care providers who demonstrate “meaningful use” of electronic health records, Reuters reports.

The incentives, which were included in the 2009 federal economic stimulus package, are expected to encourage even more health care providers to switch to e-prescribing systems over the coming years (Steenhuysen, Reuters, 9/21).

Source   :    http://www.ihealthbeat.org/articles/2010/9/21/report-eprescribing-increasing-among-us-health-care-workers.aspx

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx
Posted September 24, 2010 by admin under E-Prescription, Electronic Prescription

ALEXANDRIA, VA – Officials at Alexandria, Va.-based SureScripts say it is reducing what pharmacies, pharmacy vendors and pharmacy benefit managers pay for e-prescribing.

According to company officials, it has been six years since Surescripts, which operates the nation’s largest E Prescription network, has had a price increase.

“Our decision to lower prices fulfills a public promise made when legacy SureScripts and RxHub were founded,” said Harry Totonis, president and CEO of Surescripts.

Surescripts is the result of a 2008 merger between RxHub, headquartered in St. Paul, Minn., and Alexandria, Va.-based SureScripts.

“Three things have enabled us to keep this promise: Surescripts’ ongoing commitment to its own operational efficiency; the economies of scale resulting from the merger; and Surescripts’ success in working with healthcare organizations across the country to create and meet the growing demand for e-prescribing,” said Totonis.

“And,” he added, “we are not done yet. With this price reduction, we are focused on the opportunity to connect even more physicians, pharmacies, payers and patients…. As we add more participants to the network, this will continue to drive down the cost of e-prescribing, as our efficiency, scale and economics improve. As this occurs, we will again pass those savings along to the industry.”

According to an article in ModernMedicine, Surescripts’s lower prices could mean a 10 to 15 percent reduction for independents or more depending on the third-party software used.

“The widespread adoption of e-prescribing is clearly the right thing for all of us to support,” said Stanton McComb, president of McKesson Pharmacy Systems. “In these times, we are especially sensitive to the economic pressures that our customers are under. We recognize that most everyone wants to support e-prescribing, but there is a real cost to doing so for pharmacies. MPS felt that it was important to support and extend Surescripts’ price reductions as quickly as possible to our software customers to support this advancement in pharmacy care and also support our customers economically.”

In other recent news, SureScripts announced that it has formed a committee to help guide the company’s development of a prescription history service for health information exchanges. The HIE Advisory Committee will help Surescripts to engage, listen and work out the operational details of a prescription history service for HIEs and other appropriate community entities. Officials said Surescripts intends to facilitate a connection to multiple data sources in a way that supports both meaningful use and shared objectives for patient safety, privacy and security.

Committee members are:

• Laura Adams, president and CEO of the Rhode Island Quality Institute
• Michael Matthews, CEO of MedVirginia
• Marc Overhage, CEO of Indiana Health Information Exchange
• Robert Steffel, CEO of HealthBridge

Source  :   http://www.healthcareitnews.com/news/surescripts-lowers-e-prescribing-costs

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx
Posted September 15, 2010 by admin under E-Prescription, Electronic Prescription

The Drug Enforcement Agency recently released its much-anticipated Interim Final Rule (IFR) on electronic prescription of  controlled substances. While additional clarification is needed from DEA, the rule opens the door for electronic transmission of controlled-substance prescriptions to pharmacies and removes a  significant barrier to the overall use of electronic prescribing.

However, until industry transaction standards that fully accommodate the requirements identified by the rule are available, industry stakeholders as well as the Food & Drug Administration must work collaboratively to develop interim solutions.

Electronic prescribing systems in various forms have been around for at least two decades.  In recent years, as regulatory, financial and other barriers have been eliminated, use of these systems has increased significantly. In 2009 more than 12 percent of eligible prescriptions were delivered electronically to a pharmacy, and this rate is expected to increase to almost 20 percent in 2010.

As a result of the IFR, doctors will be able to automate the prescribing process.  However, not all physicians are expected to fully implement E Prescription.  Therefore, pharmacies will be required to develop new systems for electronically transmitted controlled-substance prescriptions, and to continue to maintain and support existing paper-based systems.

The prescription drug industry has historically led the healthcare services industry in the innovative use of technology to deliver cost-effective and safer patient care. As other types of medical claims continue to be processed by cumbersome, paper-based systems, the pharmacy industry has evolved into a highly efficient and coordinated model for secure electronic information exchange.

On a daily basis, millions of prescriptions are electronically reviewed for potential clinical issues, such as drug-drug interactions, and prescription benefit claims are processed in real-time through intermediaries to myriad payers by pharmacies across the nation.

This level of automation would not be possible without nationally recognized transaction standards.  Regarding prescription drug delivery, standards have been developed and maintained through broadly supported, collaborative and consensus-based processes.

Over the last 30 years, the National Council for Prescription Drug Programs (NCPDP), a non-profit standards development organization, has fostered collaboration within this complex, heavily regulated and highly competitive industry, bringing together participants from the retail, mail and institutional pharmacy sectors as well as payers, manufacturers and technology vendors.

Government agencies such as FDA and the Centers for Medicare and Medicaid Services (CMS) have also joined NCPDP to develop and maintain a wide range of pharmacy transaction standards that have enabled the successful automation of prescription drug delivery.

CMS worked collaboratively with NCDPD in the seamless process of Medicare Part D, as did the FDA in developing the Structured Product Labeling (SPL).  The rule will make more prescriptions eligible for electronic transmission and should contribute to an even more rapid adoption of e-prescribing.

However the requirements defined by the DEA Rule cannot be seamlessly implemented.  Existing national electronic prescription transaction standards – SCRIPT Version 8.1 and Version 10.6 (currently under HHS regulatory review) – were developed without benefit of the IFR or input from the DEA. As a result, they are not perfectly aligned.

For example, neither SCRIPT 8.1 nor 10.6 has mandatory fields required by the DEA rule for the prescriber’s first name or patient address. Fortunately, both versions include built-in flexibility and alternative, and potential interim solutions exist that could balance regulatory goals and operational reality.

NCPDP has also identified issues that require clarification that have implications in long term and post acute care settings. The Council has also called for clarification of the digital signature option and references to the SCRIPT Standard, versions and data fields.

The prescription drug delivery system, especially in emerging functions such as e-prescribing, will continue to drive innovation and automation across healthcare. We look forward to working collaboratively with the DEA and other stakeholders to more efficiently and effectively address the immediate need for interim solutions as well as in the ongoing standards development process.

Source   :   http://www.govhealthit.com/newsitem.aspx?tid=77&nid=74035

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx
Posted September 9, 2010 by admin under E-Prescription, 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

Tags: Certified Prescription, E-Prescription, Electronic Prescription, eRx, SureScripts
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