With a host of new incentives, doctors are finally beginning to scrap pen and paper in favor of electronic prescriptions.

Medicare this month began paying doctors a bonus if they switch their patients over to e-prescribing. Some private health plans also have begun offering extra payments along with free equipment, such as digital handheld devices. And a coalition of technology companies is giving doctors free software to encourage them to ditch their paper prescription pads. As a result, the number of physicians prescribing medicines electronically has more than doubled in the past year to about 70,000, or about 12% of all office-based doctors.

E-prescribing allows doctors to transmit prescriptions via a secure Internet network directly to pharmacies using an office or laptop computer or a digital handheld device. The practice has been shown in studies to reduce prescription errors and to cut costs for consumers and health-care providers. It also encourages patients to get more of their prescriptions filled, because it reduces the time spent waiting at drug stores. The Obama administration’s plan to invest $50 billion over five years to encourage broader adoption of health-information technology is expected to include additional incentives for electronic prescribing.

Rx Connection

Where to learn more about electronic prescribing

• Learnabouteprescriptions.com : Sponsored by pharmacies and Sure Scripts-RxHub; lets consumers search for doctors and pharmacies that offer e-prescribing by city or ZIP Code; offers medication-safety advice and benefits of e-prescribing.
• Surescripts.com/Safe-rx : Information from SureScripts-RxHub ranking each state on e-prescribing progress, including growth in doctors and pharmacies using the technology.
• Ehealthinitiative.org : Nonprofit technology advocacy group offers downloadable consumer guide to e-prescribing benefits and questions to ask doctors and pharmacists.

But there are still barriers to full-fledged adoption of e-prescribing. Federal drug laws, which are under review, prohibit electronic prescribing of controlled medications such as narcotics, insomnia drugs and anti-depressants. Safety experts also warn that selecting prescriptions on a computer screen can cause a doctor to inadvertently enter, for instance, a quick-release version of a drug instead of a long-acting formulation because they appear in sequence on an e-prescribing program.

Michael Cohen, president of the Institute for Safe Medication Practices, which analyzes medication errors, says the group favors adoption of electronic prescribing. Still, Mr. Cohen advises patients as a backup to leave their doctor’s office with verbal instructions and a printed version of the prescription that includes the name, dose and directions for use.

E-prescribing can catch many dangerous mistakes, studies show. The software automatically checks a patient’s drug history for potential hazards such as improper dosages, medication allergies and adverse interactions with other drugs the patient is taking. More than four billion prescriptions are written in the U.S. annually, and studies show that as many as 4% contain an error with serious patient risks.

“There are more than 1.5 million people hurt every year by preventable medication errors, and the evidence is strong that patients are far better off when we e-prescribe than when we don’t,” says Janet Marchibroda, chief executive of eHealth Initiative, a nonprofit that includes public-health agencies, consumer groups, health plans and technology companies.

Cost Savings

Electronic-prescribing systems also can save patients money by allowing doctors to check, with a patient’s consent, the relative cost of co-payments for generic, formulary and nonformulary drugs in a patient’s health plan. The main software program being offered free to doctors, by Allscripts Inc. and a coalition of technology companies and health plans, displays a green smiley face next to generic and on-formulary drugs, and a red frowning face next to more expensive nonformulary drugs.

In a study published last month in the Archives of Internal Medicine, researchers at Brigham and Women’s Hospital found that e-prescribing systems that allow doctors to select generic or lower-cost medications can reduce annual costs of delivering drugs to consumers by $845,000 for every 100,000 patients.

Linda Green, an allergist in Havertown, Pa., began using electronic-prescribing software two years ago. She says e-prescribing has enabled her to see a list of medications her patients may have neglected to tell her about, “and I’ve had a few surprises that had an impact on the medication I was about to prescribe.” Moreover, she says, “when you are faced with a patient who is complaining of having trouble paying for medication it makes you think, maybe I can prescribe this cheaper one instead, and having their formulary information in real time makes that much easier to do.”

Virtually all chain pharmacies and about 45% of independent pharmacies now accept electronic prescriptions, says Rick Ratliff, co-chief executive of SureScripts-RxHub. The company, which has patient information from pharmacy-benefit managers, operates the main network over which prescriptions are transmitted electronically. The company stores data on more than 200 million insured patients and provides physicians with ready access to information on patients’ medication histories and which medicines are covered by their health plans.

Electronic Records

E-prescribing also is expected to encourage broader use of electronic medical records, which includes such features as storage of full medical histories, lab reports, and programs that let doctors send alerts and reminders to patients. The cost of the technology to maintain full electronic medical records is roughly $25,000 to $45,000 per physician. While free software and hardware programs are being offered to some doctors, generally the cost of a stand-alone e-prescribing system, including software and training, ranges from $500 to $2,500. The system can later be incorporated into a medical-records system.

The Center for Medicare and Medicaid Services, the federal agency that oversees Medicare, this month began paying doctors a bonus to e-prescribe. The bonus amounts to 2% of charges billed to Medicare for 2009 and 2010, and declines to 0.5% by 2013. Current estimates are that the bonus program could yield an additional $1,700 to $3,500 a year for a doctor.

Medicare Penalties

Medicare also plans a penalty for doctors who don’t e-prescribe. These physicians will have their Medicare reimbursements reduced by 1% beginning in 2012, and by 2% in 2014 and beyond.

Consulting firm Gorman Health Group estimates that the federal government could reduce its health-care costs over 10 years by at least $26 billion by offering bonuses and requiring that all prescriptions for drugs covered by Medicare be sent electronically. The program also could prevent 1.9 million adverse drug events, Gorman predicts.

Printed in The Wall Street Journal, page B7

Out of seventeen companies, OmniMD( A Division of Integrated Systems Inc.) received the highest overall 5-Star rating. The GE Centricity new integrated product is expected to also become a 5-star rated product. Five important caveats to keep in mind as you review the results:

• Literally hundreds of products are identified as EMRs, and while a good faith effort was made to contact as many vendors as possible, many chose not to respond.
• The survey findings are self-reported, that is, they are based on what vendors said about their own products.
• Fourteen vendors were required to participate in face-to-face demonstrations of their product’s functionality in order to receive “validation”. The validation process tested more than 200 scenarios. A number of the vendors have not been tested as of this report and therefore have an (*) next to their company name.
• A few of the highly visible EMR vendors elected NOT to participate in the survey. Many of these vendors are not willing to document their functionality in writing, while others state that either they do not participate in surveys or they were too busy to participate.
• Starting in May of 2005, AC Group added a “confidence factor” which indicates AC Group’s confidence in the vendor’s reported rakings. A vendor with a 5-Star confidence level indicates that their product has been tested and we believe that more than 90% of their answers are validated. A vendor with a 3-Star confidence level indicates that the product has been tested at least once and we are confident that over 70% of the responses are validated. A vendor with a 1-Star confidence level indicates that AC Group has NOT been able to evaluate the vendor’s claims as of this report.

When evaluating functionality by different methods of input, the AC Group team determined that today’s technology allows end-users the same functionality no matter where they are located. In 95% of the cases, the vendor’s application functioned the same on the desktop, from remote locations, and from a wireless tablet. Therefore, the EMR evaluation team was able to consolidate Desktop, Remote and Wireless functionality into one rating. The only major difference was the functionality on a PDA device – given that the screen size is limited. Therefore the EMR team created a separate rating for PDA devices. Simply stated, a number of the vendors that were highly ranked for the triad of desktop, remote and wireless, either did not offer a portable device or had one with limited functionality. When their overall performance ranking included low or nil scores for PDA their ranking dropped, precipitously.

OmniMD™ , a developer of HIPAA compliant Internet-based enterprise healthcare , Electronic Medical Records (EMR) and Practice Management solutions, is pleased to announce its certification by SureScripts®, operator of the Pharmacy Health Information Exchange™. SureScripts ® ’s certification allows for interoperability with the nation’s community pharmacies , which improves the safety and efficiency of the prescribing process and the quality of patient care. Physicians using Omni MD ’s EMR application can now connect directly with local pharmacies connected to the Pharmacy Health Information Exchange, operated by SureScripts ® .

Starting 2009, providers will be able to earn additional money from Medicare if they use electronic prescribing systems, U.S. health officials said Monday.

The bonus program, which will continue for four years, is designed to streamline the prescription process and cut down on errors. In 2009 and 2010, Medicare will give doctors an additional 2 percent bonus on top of their fee for “e-prescribing.” In 2011 and 2012, the bonus will drop to 1 percent, and in 2013, the bonus will drop again to 0.5 percent, officials said.

“There are terrific human and financial costs to illegible prescriptions,” Mike Leavitt, secretary of the U.S. Department of Health and Human Services, said during a Monday afternoon teleconference.

According to the Institute of Medicine , 1.5 million Americans are injured every year by drug errors, Leavitt said. Another study found that each year pharmacists make more than 150 million phone calls to doctors to clarify what was written on the prescription, he added.

“We are dedicated to providing solutions that improve the efficiency of medical practices and the quality of patient care. Omni MD ’s Prescription Writer already has a functionality to check for drug interactions, print patient medication sheets, create favorite prescriptions and check prescription coverage at the point of care. Surescripts ® electronic prescribing will certainly improve the efficiency, safety and overall quality of the prescribing process for our customers. “ said Divan Dave, CEO , Omni MD ™ .

This certification will allow providers to establish a two-way computer-to-computer connection with the majority of pharmacies in their area. Using this connection, providers can send prescriptions electronically to the patient’s pharmacy of choice before the patient leaves the provider’s office. Patients will no longer need to worry about losing paper prescriptions or pharmacies having to call offices to verify illegible prescriptions. When a patient needs a prescription refilled, a pharmacy will be able to send the request to the provider’s office electronically, eliminating the need for time consuming phone calls and faxes. This will also reduce potential errors with prescriptions due to misread handwriting.

About SureScripts®

Founded by the pharmacy industry in 2001, SureScripts® operates the Pharmacy Health Information Exchange™, which facilitates the secure electronic transmission of prescription information between physicians and pharmacists . This also provides access to lifesaving information about patients during emergencies or routine care. Working collaboratively with health plans, health systems, technology vendors and health policy leaders, SureScripts ® is committed to improving the safety, efficiency, and quality of the prescribing process.

More information about SureScripts ® is available at www.surescripts.com .

about Omni MD ™

Omni MD ™ is a developer of HIPAA compliant Internet-based enterprise healthcare practice solutions, designed to fully automate the work-flow of contemporary healthcare organizations. The company is a division of Integrated Systems Management, Inc. – ISM- ( www.ismnet.com ) a leader in Internet consulting and e-business development since 1989 .

Omni MD ™ ’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 www.omnimd.com