A CCHIT Based Guide to a Qualified E-prescribing System – Part I (The 2008 requirements)

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As I mentioned briefly in my previous post, Medicare is providing incentives for practices to implement a “qualified” e-prescribing solution.  The Medicare Improvement for Patients and Providers Act of 2008 (referred to lovingly as MIPPA) describes in detail the schedule of payments for practices (found here), but it falls short on detailing what a qualified system is.  Instead, the Center for Medicare and Medicaid Services (CMS) points to certification authorities to provide the guidance of qualifying a practice’s system. As the Certification Commission for Healthcare Information Technology(CCHIT) will be the basis for the EHR incentives that come with the healthcare stimulus package, I thought it might be a good exercise to see what they had to say about e-prescribing.

I started by going to CCHIT and downloaded the final CCHIT Certified 08 Ambulatory EHR criteria and test scripts.  I then used the excel spreadsheet(CCHITCriteriaAMBULATORY08FINAL.xls)  and filtered by category “9. Medications / ePrescribing”.  For the sake of providing a foundational view of ePrescribing, I then further filtered my results to only include the 2008 provisions.  The list contained requirements that The table below illustrates my results:

I was initially confused by the first two entries.  It makes sense that EHRs be able to handle incoming and generate codified Allergy and Conditions to help in safely ordering medications, but I want to focus strictly on ordering the medication in my EHR and getting that prescription to the pharmacy electronically.  The Continuity of Care Document (CCD) is a subject worthy of its own series of posts.

Once I remove the CCD requirements, there are really only five requirements to satisfy in order to claim victory for the 2008 requirement set.  It may seem simple enough, but to satisfy these requirements you will find that the ordering system your granddaddy used (from paper to even existing electronic ordering) will need to be changed considerably.

Stay Tuned

Now that we’ve looked at all that is required to be a qualified e-prescribing system in 2008 according to CCHIT, I plan on detailing what exactly this entails per requirement.  Eventually, I plan on catching us up to the present year by doing the same with the 2009 requirements.  After that, get your flux capacitors fluxing and we’ll even check out what the future holds for us (2010 and beyond).