Managed Care - February 2008 - (Page 45) to mandate e-prescribing, but wants to see mandatory participation by all pharmacies, inclusion of prescriptions for controlled substances, adoption of CMS incentive programs to encourage physician and pharmacy participation, and development of a certification process for e-prescribing before all doctors are forced to get on board. WellPoint, the nation’s largest health plan by membership, supports the AHIC recommendations and also supports the idea of a federal mandate, says Charles Kennedy, MD, the plan’s vice president for health information technology. “A mandate for Medicare providers can help bring about significant adoption sooner,” he says. “Then we would see a push toward optimizing e-prescribing workflows in physician offices and improving physician buy-in.” Definition of e-prescribing ccording to the American Health Information Community (AHIC), a federal advisory body, electronic prescribing is transmission, using electronic media, of prescription or prescription-related information between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary, including an e-prescribing network. E-prescribing includes, but is not limited to, two-way transmissions between a prescriber and the dispensing pharmacist. A technology, it improves quality and efficiency and can reduce overall costs. Our mandate is to help make that happen. But as of now, e-prescribing is voluntary in Medicare and throughout the marComplicated business ketplace.” The director of clinical pharmacy services The sooner it becomes the law of the land for one regional health plan that is particithe better, according to the Pharmaceutical pating in Medicare Part D, as both a standCare Management Association, the lobbying alone and Medicare Advantage prescription organization for pharmacy benefit mandrug plan, says that implementation is a agement companies. It recently announced complicated business. “To begin with there an advertising campaign titled “Before More is a multitude of technologies, including inPeople Die” that promotes e-prescribing. It terfaces for hand-held and PC products,” stars Lyle Bootman. “Requiring e-prescribsays Tim Sawyers, RPh, MBA, of Healthing in Medicare would dramatically improve Spring in Nashville and member of the MANAGED CARE editorial advisory board. When a doctor sub- patient safety and accelerate physician adoption of other life-saving health information “One way around that is for health plans to mits a prescription, technologies,” said Mark Merritt, PCMA push a specific technology onto their physi- he should be told president and CEO, in a statement ancians. CMS wants to move to e-prescribing, right away if there’s nouncing the campaign. to force it into the environment. But there a problem, says Tim Sawyers, RPh, PCMA commissioned the Gorman are a lot of unanswered questions about cost of HealthSpring. Health Group (consultant to many of the and standards.” PBMs participating in the Medicare drug benefit) Sawyers’s concerns are reflected industrywide, to examine the safety and financial benefits of esays Tony Trenkle, director of the Office of E-Health prescribing. Although Preventing Medication ErStandards and Services at the Centers for Medicare rors concluded that preventable medication errors & Medicaid Services. He says that the creation of (called adverse drug events or ADEs) harm an estechnology that is reliable (and provides complete timated 1.5 million Americans each year, killing privacy) and the cost to physicians of implementhousands, it did not specify how many of those ertation are the two biggest barriers to implemenrors could be eliminated by universal adoption of tation. e-prescribing. But he is unequivocal in saying that the federal The IOM report also said that in one study it regovernment plans to push hard for industrywide viewed, each preventable ADE taking place in a adoption. hospital added about $8,750 (in 2006 dollars) to the “It has the potential for improving health outcost of the stay. Assuming 400,000 such events each comes, and Congress recognized that,” Trenkle says. year (a conservative estimate, according to the “When providers choose to invest in e-prescribing FEBRUARY 2008 / MANAGED CARE 45
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