Entries Tagged 'Basics' ↓

Now that we’ve taken a look at the whole of what is deemed a qualified e-prescribing system in the eyes of CCHIT, I think its time to get into the weeds a bit and see what those high level requirements really mean.  Just as we have to crawl before we walk, I’m going to address the primary goal of getting a prescription order from your EHR to the pharmacy for fulfillment.  It’s a straightforward requirement, but there are a lot of things you must think about before being ready to e-prescribe.

The reality is that any transactions between your system and the pharmacy system will be handled by a third party delivery service.  This service company is Surescripts RxHub.  Some may be familiar with the history of the company, but for those not, in a nutshell they used to be two companies serving two very different user bases.  Surescripts worked with the retail pharmacies, while Rx Hub worked with the Pharmacy Benefit Managers (in other words, the insurers).   I’m sure Surescripts RxNorm are working towards a unified system, but until then you can still think of Surescripts RxHub as two different systems.

Implementing ePrescribing for the first time will be a lot of development work, so if you wanted to stage the development over time and get more bang for your buck it may be a good idea to start with one group rather than the whole kit and caboodle.

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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.

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Electronic prescribing is not just the ability to send prescriptions electronically to pharmacies. E-prescribing can also increase care quality in a number of ways:

• E-prescribing makes sure that the prescriber is providing enough specific information for the pharmacist to fill the prescription, including the name of the drug, the dosage, its physical form, the route, and the physician’s instructions.
• Electronic prescribing software eliminates the time and effort of trying to understand the prescriber’s handwriting, as well as the chance of an error in that translation.
• E-prescribing significantly reduces the chance that the prescriber’s intentions are misinterpreted.
• E-prescribing is often used in conjuction with clinical decision support to ensure that any drug to drug interactions or drug to diagnosis issues are found and reported to the physician before the prescription order is completed.

Electronic prescribing is considered one of the most important areas of Healthcare IT, which is why Medicare created payment incentives for physicians who use a qualified e-prescribing system. In 2009, the incentives are an increase of 2% in revenue for each patient when e-prescribing is used. Due to the 2009 HITECH Act, electronic prescribing is required as part of any EMR (EHR) which qualifies for Medicare reimbursement in 2011.