Managed Care - February 2008 - (Page 46) IOM), the total annual cost would be $3.5 billion in this one group. A CMS report to Congress in November 2007 went further than the IOM report. According to this report, titled Pilot Testing of Initial Electronic Prescribing Standards, a shift to e-prescribing systems “could avoid more than two million adverse drug events annually, of which 130,000 are life-threatening. E-prescribing also has enormous potential to create savings in health care costs, through reduction of adverse drug events and in improved workflows. One recent study estimated the potential savings at $27 billion per year in the United States.” the next decade and help physicians to prevent nearly 1.9 million ADEs over the same time. “Approximately 70 percent of the safety and savings advantages of e-prescribing result from doctors being given immediate access to patient medication histories, safety alerts, preferred drug options, and pharmacy options so that they can better counsel patients on safe and affordable choices,” states the report, echoing Sawyers’s concerns. The report says that the federal government has three options when it comes to e-prescribing: • Option 1 — Requirement and incentive: Implementing a requirement that e-prescribing be used for all Part D prescriptions by 2010 combined with annual incentives for participating physicians equal to 1 percent of their allowed Medicare payments could reduce 2008–2017 federal health care costs by $26 billion and help physicians avoid 1.9 million adverse drug events over the next 10 years. • Option 2 — Requirement only: Implementing only a requirement that all Part D prescriptions be written electronically by 2010 could reduce 2008–2017 federal health care costs by $29 billion and help physicians avoid 1.6 million adverse drug events over the next 10 years. • Option 3 — Incentives only: Implementing only incentives for participating physicians equal to 1 percent of their allowed Medicare payments could reduce 2008–2017 federal health care costs by $2 billion and help physicians avoid 300,000 adverse drug events over the next 10 years. Option 1 would no doubt promote electronic prescribing the fastest. And it is beginning to look as if it might happen. Big saving, better outomes According to the Gorman Group, government moves to increase e-prescribing could reduce federal health expenditures by up to $29 billion over E-prescribing has advantages and obstacles ccording to a recent report to Congress by the Department of Health and Human Services, e-prescribing offers several advantages over faxed and handwritten orders: A • It has potential for providing access to the latest drug information, an accurate current medication list, and medical history for patients, and can therefore help avoid potential contraindications or duplicate therapies. • It eliminates the difficulty pharmacists have reading handwritten prescriptions. • It can provide information about the patient’s condition for which the prescription is written. • It can eliminate the time-consuming practice of contacting physicians by phone to clarify what is ordered and to make changes. • It eliminates disconnects between the prescriber and patient in the medication process, with little or no feedback to the prescriber on whether a prescription was filled, or what generic substitution was made. But it also has some obstacles to face: • Physicians are resistant to new technology • Equipment and software can cost $25,000 or more per physician, according to some estimates • Lack of agreement on transmission standards Federal action The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) directed CMS to establish standards to support a voluntary e-prescribing program. The law does not actually require that providers write prescriptions electronically, but it does require that “providers that prescribe or dispense Part D drugs comply with adopted standards when conducting electronic prescription transactions or 46 MANAGED CARE / FEBRUARY 2008
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.