Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, March 12, 2008

E-Prescribing – The US Is Really Moving – We Should be Too!

The following interesting article appeared this week

E-prescription efforts

A handful of large medical groups on Tuesday launched a joint initiative to encourage more physicians to begin using electronic prescriptions.

The American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Cardiology, the American College of Obstetricians and Gynecologists and the Medical Group Management Association are participating in the effort.

Most physicians have been reluctant to adopt e-prescribing technology because of the start-up costs of purchasing the systems needed to link their offices to pharmacies. Policymakers, however, have pushed electronic prescriptions as a means of reducing medication errors and administrative costs.

….

Starting next January, all prescriptions filed for beneficiaries enrolled in the Medicare drug benefit program must be electronic.

“We need to seize the bipartisan opportunity to pass this legislation and make this common-sense reform a reality now,” Kerry said.

President Bush’s health information technology czar, Robert Kolodner, also appeared at the event. “The facts are crystal-clear. E-prescribing reduces medical errors, improves quality and reduces costs,” Kolodner said.

…..

Read the full article here:

http://thehill.com/business--lobby/k-street-in-brief-2008-03-04.html

More information is here:

$3 billion annual savings estimated for Medicare e-prescribing

By Nancy Ferris

Published on March 4, 2008

The Congressional Budget Office has determined that requiring doctors who treat Medicare patients to use electronic prescribing could save the nation $3 billion a year, Sen. John Kerry (D-Mass.) said today.

As a result, prospects for passage of Kerry’s e-prescribing bill are good, former House Speaker Newt Gingrich said. Both were speaking at an e-prescribing event in Washington.

Because of the CBO finding, Gingrich said, lawmakers are likely to attach the e-prescribing bill to some other measure destined for passage this year. “This was a very big breakthrough,” Gingrich said, because CBO rarely determines that health IT bills will reduce the government’s health care costs.

But Gingrich, now a consultant who founded the Center for Health Transformation, did not predict smooth sailing for the measure, which has been introduced in the House and the Senate.

“The next big resistance will come from doctors who are sole practitioners or in very small practices, who don’t want a mandate," Gingrich said. He characterized their positions thus: “I reserve the right to issue paper prescriptions and kill people.”

Continue reading here:

http://www.govhealthit.com/online/news/350249-1.html

These moves should also be considered in the context of the following report from the Massachusetts Technology Collaborative.

The following describes the study – which was a real world rather than academic medical centre study.

http://www.masstech.org/ehealth/cpoe/cpoe08release.html

“The Massachusetts Hospital CPOE Initiative released its latest report, Saving Lives, Saving Money: The Imperative for Computerized Physician Assisted Order Entry Adoption in Massachusetts Hospitals on February 14, 2008. The Clinical Baseline and Financial Impact Study was conducted to address uncertainty in terms of the quality and cost benefits of implementing CPOE.

Massachusetts Technology Collaborative (MTC) and the New England Healthcare Institute (NEHI), joined by a team headed by Dr. David Bates, Chief of the Division of General Medicine at the Brigham and Women’s Hospital, PricewaterhouseCoopers, and other experts in the field, conducted an in depth analysis of six Massachusetts community hospitals. The study teams reviewed 4,200 charts to determine the baseline level of preventable adverse drug events, and the unnecessary use of expensive drug and laboratory tests, that could be improved by implementing CPOE. The results are outlined in this document.”

The report is well worth a download and read as it offers confirmation of one of the key thrusts of this blog.

Also worth a browse is the CPOE website at the following URL:

http://www.masstech.org/ehealth/cpoe.html

Advanced Health IT with decision support works to save both lives and money..and we need to get on with it!

Clearly the US politicians are now persuaded of the value of these technologies – where are ours?

Before all the comments start – yes I know there are all sorts of un-coordinated efforts to get it going around the country and that lots of people are printing prescriptions but that is not happening in hospitals and the quality of the available decision support is still not ideal. We are working on the problem but lacking a central impetus we are likely to fall short for some time yet.

This has to be a high priority area for the proposed Nation Health IT Strategy to co-ordinate, solidify and implement.

David.

4 comments:

Anonymous said...

" yes I know there are all sorts of un-coordinated efforts to get it going around the country and that lots of people are printing prescriptions but that is not happening in hospitals."

This is one power-packed observation - is it not? It raises a lot of serious questions.

1.0 Who should be doing what?

2.0 What are the basic steps required just to get to first base?

3.0 Are you calling for another MediConnect project?

4.0 Do the software suppliers to hospitals have appropriate systems ready for implementation?

4.1 If yes, why do the hospitals (Jurisdictions) not implement them?

4.2 If no - why don't the software suppliers develop them?

5.0 What is NEHTA doing here and what has it done already?

6.0 Who should be developing the solution and who should be paying for it?

That should do for starters.

Anonymous said...

Electronic prescribing is a vital part of the PHR landscape. We really can't have one without the other. Whilst we, and others, are working on PHR solutions that are pervasive to the user base to date we've neglected e-prescribing for fears of adding too much complexity too soon. This needs to change but first we need to establish credible and sizable PHR user numbers to drive these services. The power is in the numbers and with a number of customers walking away from one pharmacy that doesn't offer e-prescribing in favour of another that does will be too loud a voice for the Guild to ignore.

Anonymous said...

Even when HealthConnect was first proposed there was a suggestion that the patient should have some control over their electronic health record. Not much has changed, except that there is an increasing focus on the rights and power of the consumer which is progressively rendering NEHTA and its EHR obsolete before it even gets started.

Anonymous said...

The Guild certainly won't ignore it once supermarkets enter the fray. Take Coles for example - tie e-prescriptions into a supermarket pharmacy integrated with PharmacyDirect and what do we get? The PGA squealing like stuck pigs. Then you'll see some action.