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

Trends in E-Prescribing

A recent report from the electronic prescribing network Surescripts found that the number of prescriptions submitted electronically increased from 68 million in 2008 to 191 million in 2009. According to Surescripts, about 25% of all office-based physicians have the technology necessary to e-prescribe.

Policy Changes

Last year, CMS started providing physicians with incentive payments for e-prescribing. Starting in 2012, CMS will begin penalizing physicians that have not adopted e-prescribing systems.

Meanwhile, the Drug Enforcement Administration’s new final rule easing restrictions on e-prescribing for controlled substances is expected to contribute to an uptick in e-prescriptions. The rule allows physicians to e-prescribe for most medications, rather than maintain a separate paper process for controlled substances.

Concerns

Some health care providers and experts have cautioned that e-prescribing does involve certain risks.

For example, some physicians have reported prescription errors that resulted from pressing the wrong computer key when filling out drug and dosage information (Martin, Wall Street Journal, 4/20).

Above article publish on http://www.ihealthbeat.org/articles/2010/4/20/eprescribing-expected-to-rise-in-wake-of-dea-rule-cms-incentives.aspx

Surescripts will adopt a new version of a technical standard that’s recommended by federal regulators as part of a $19 billion incentive program to encourage greater use of electronic health records.

The standard – referred to by industry participants as “NCPDP SCRIPT 10.6″ – allows physicians using electronic health record software to electronically access prescription information from pharmacies and health plans while also making use of electronic prescriptions.

“Surescripts and the nation’s e-prescribing leaders support the federal government’s efforts to define and drive meaningful use of electronic health records,” said Harry Totonis, president and CEO of Alexandria, Va.-based Surescripts. “E-prescriptions are a clear example of how EHRs can provide meaningful improvements in cost, quality and safety. We are collaborating with the nation’s software vendors, pharmacies, pharmacy benefit managers and health plans to support the new version of the standard and ensure its rapid implementation.”

Assuming the Centers for Medicare and Medicaid Services adopts the National Council for Prescription Drug Programs (NCPDP) SCRIPT 10.6 as a standard under the MMA, pharmacies, pharmacy benefit managers and health plans, along with makers of electronic health record software, can on May 1, 2010, begin certifying and deploying their systems to support the Surescripts implementation of the NCPDP SCRIPT 10.6 standard.

The standard will allow physicians and other prescribers using software certified by Surescripts to continue a secure, electronic link to the Surescripts network and thousands of retail pharmacies, pharmacy benefit managers and health plans nationwide. With patient consent, this link will allow physicians and other prescribers to continue to access their patients’ prescription histories. Prescribers using the standard can also use the Surescripts network to send e-prescriptions to any of 51,000 retail pharmacies (representing 84 percent of all retail pharmacies in the United States) and six of the largest mail-order pharmacies.

Last June, the Health IT Policy Committee – an advisory arm of the Office of the National Coordinator for Health Information Technology – proposed that the capabilities enabled by the NCPDP SCRIPT 10.6 implementation be included in a larger set of capabilities aimed at defining “meaningful use” of an electronic health record.

Beginning in 2011, the federal government will make incentives available to physicians caring for both Medicare and Medicaid patients based on this definition. The incentives fall under the HITECH provisions of the American Recovery and Reinvestment Act.

Last July, the National Committee on Vital and Health Statistics recommended that the federal government support the NCPDP SCRIPT 10.6 standard within the Medicare Part D e-prescribing initiative.

“Surescripts and the industry will be ready to support the final ruling from CMS,” said Totonis. “The nation’s e-prescription network and industry leaders nationwide will ensure a smooth and successful migration from the old version of the standard to the new.”

Above article published on http://www.healthcareitnews.com/news/surescripts-adopt-standard-aimed-meaningful-use-ehrs

The Centers for Medicare and Medicaid Services (CMS) plans to test its ability to accept selected clinical quality data directly from hospital electronic health record systems as early as July 2010.

CMS said it would seek volunteer hospitals to report stroke, blood clot and emergency department measures of care via EHR systems as part of the Reporting Hospital Quality Data for Annual Payment Update program, which provides higher Medicare payments to hospitals that report quality measures to the agency.

The agency detailed the plans in the Aug. 27 Federal Register in announcing changes to its rule for the Reporting Hospital Quality Data for Annual Payments Update. The program, a provision of 2003’s Medicare prescription drug legislation, required hospitals by 2010 to report on 42 quality measures to receive additional incentive payments.

Reporting to CMS is generally paper-based or through a mix of manual and automated systems.

Participating hospitals and their vendors will have to be able to transmit clinical EHR data that adhere to interoperability standards, such as cross document sharing, cross community access, clinical data architecture and Health Level 7 version 3, CMS said.

CMS has encouraged hospitals to adopt EHRs that can report quality data directly to a CMS data repository. Ideally, the use of EHR systems would improve the quality of care by providing physicians with pertinent clinical data as they were treating patients.

“The testing of EHR submission is an important and necessary step to establish the ability of EHRs to report clinical quality measures and the capacity of CMS to receive such data,” the agency said in the published interim rule.

The reporting of selected quality measures is also a key provision of the stimulus law. The Health IT Policy Committee, led by Dr. David Blumenthal, the national coordinator for health IT, has recommended that quality reporting be a part of the criteria providers must meet to demonstrate meaningful use of electronic health record systems, CMS said.

The stimulus law authorized Medicare and Medicaid incentive payments to providers who prove they are meaningful users of health IT starting in 2011.

Above article published on http://govhealthit.com/newsitem.aspx?tid=10&nid=72031

Health and Human Services Department officials looked to spark the adoption of e-prescribing at a conference this week attended by some 1,400 health care professionals and industry representatives.

The meeting, held in Boston and sponsored by the Centers of Medicare and Medicaid Services, was put together in six weeks in preparation for the planned launch of the federal e-prescribing incentive program, set for January. Incentive payments for physicians who institute e-prescribing will initially be set at 2 percent.

We need to raise awareness in plenty of time to be ready for Jan. 1 said Kerry Weems, acting CMS administrator. We have a very short period of time to begin and end the education process.

The next milestone in the adoption push will come in November, when CMS plans to publish its final rule regarding incentive payments to providers. That rule will lay out definitive guidelines on what constitutes complete and successful e-prescribing, Weems explained. He said CMS continues to formulate that guidance and will use the conference to obtain feedback as it prepares the final rule.

Barry Straube, CMS chief medical officer, said the rule for qualifying for bonus payments is potentially reachable by many physicians’ offices.  He said the likelihood of qualifying is quite high for those offices obtaining an e-prescribing system.

HHS officials said they believe the bonus payments will provide the financial driver to accelerate adoption. There is a lot of money on the table here, said HHS Secretary Mike Leavitt.

Leavitt cited a $1 billion estimate as the dollar value of prescriptions that fall under the Medicare incentive.

Some physicians, however, remain skeptical of e-prescribing. Questioners during a conference session brought up the cost of adoption and the need for tort reform as issues affecting e-prescribing adoption.

Some anecdotal evidence, however, points to increased adoption.

Randy Boldyga, president and chief executive officer of RxNT, an e-prescribing vendor in Annapolis, Md., said 50 doctors implemented his company’s solution during one recent week, about double the usual number of installations. He said the Medicare incentives are playing a role in the increased activity.

Above article published on http://govhealthit.com/newsitem.aspx?tid=77&nid=69403