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or

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Thursday, July 17, 2008

E-Prescribing Gets a Huge Boost in the US.

This week we have had some very good news about the use of e-Prescribing.

Congress Passes Medicare Bill with Veto Proof Margin

After multiple unsuccessful attempts in June to pass a Medicare bill, on July 9th the Congress passed the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), which prevents a scheduled 10.6% cut to Medicare payments to physicians, and includes financial incentives to accelerate the use of electronic prescribing by physicians, among other things. Not only did both houses of Congress pass the measure, but they also passed it by a veto-proof margin, so even if President Bush refuses to sign, Congress could still force the measure through. The Senate voted 69-30 to approve the bill, while the House voted 355-59.

In addition to addressing the annual need to offset the Medicare Sustainable Growth Rate (SGR) cuts, the Medicare Improvement for Patients and Providers Act will provide positive Medicare payment incentives of up to 2% for practitioners who use qualified e-prescribing systems in 2009 through 2013, and a reduction in payments of up to 2% to providers who fail to e-prescribe by 2012. The bill permits the Secretary to establish a hardship exception to providers who are unable to use a qualified e-prescribing system. The bill also calls for a Government Accountability Office (GAO) report on the effect of the e-prescribing incentives included in the legislation.

More here:

http://www.himss.org/ASP/ContentRedirector.asp?ContentId=68157&type=HIMSSNewsItem

This is really good news as the legislation has a neat mix of carrot – extra pay and stick – a financial penalty – to really encourage adoption and use – while providing a sufficient period of time to allow prescribers to get used to the idea.

More important is that this move is the ‘thin end of the wedge’ in getting US physicians to start using computers. This will hopefully flow on to the use of more EHR functions over time with the benefits that will flow from that.

Best news is that President Bush can’t veto the legislation. If he does not sign – it becomes law in 10 days anyway because of the 2/3 majority obtained in both Congress and the Senate.

I wonder what cool functionality will not emerge to assist docs prescribing with a market of this size to compete for!

David.

6 comments:

Anonymous said...

The voting of more than 2 to 1 in favor in the Senate and 6 to 1 in favor in the House overriding the President’s Veto is impressive.

Even so, with George ‘dubblya’ Bush (who needs two of him?), it’s a good bet he won’t sign (how long has he got to stonewall?), and it’s an even better bet he will do something to scare the crap out of Congress to divert them from forcing the measure through. How about another invasion somewhere? Maybe the election cycle can get in the way?

Ahhh, now if only we had the power to Veto War!

Dr David G More MB PhD said...

He vetoed the Bill day before yesterday and Congress the passed the veto-override. The Bill is law.

David

Anonymous said...

Increasing Medicare payment incentives of up to 2% for practitioners who use qualified e-prescribing systems in 2009 through 2013 sounds good, but do you have any idea what that is worth to a practitioner?

What is a ‘Medicare Payment incentive’? Does it mean that if a doctor can show he uses an e-prescribing system in his practice ALL his Medicare Consultation fees will be automatically increased by 2%?

Also, if the reports say only approximately 10% of doctors use clinical desktop systems will we see a tsunami of clinical desktop systems being installed across the US or will some alluringly simple, standalone, ‘print-a-script’ or ‘send-a-script’ systems become the norm - not integrated with anything?

Anonymous said...

I saw a recent announcement that the two biggest players AllScripts and RxHub were in merger talks. I bet they have been doing some heavy lobbying of late. With this announcement they they probably think they have the game all stitched up.

Anonymous said...

Is there a definition available which specifies what makes up a qualified eprescribing system?

Dr David G More MB PhD said...

The CCHIT Ambulatory Care Specification (www.cchit.org) might be a good place to look. The US tends to look to both prescription formation and transmission as part of e-prescribing - not just printing.

David.