CMS, e-health group push e-Rx with meeting, guide

The e-Health Initiative released its A Clinician’s Guide to Electronic Prescribing at a Boston e-prescribing conference sponsored by the CMS.
The guide, clearly aimed at boosting the use of e-prescribing, was introduced Tuesday at the daylong conference, which was promoted by the CMS with full-page ads in the New York Times and Wall Street Journal. The guide differentiates between “stand-alone” e-prescribing software systems, that can either be purchased and loaded onto and then run off of a prescriber’s own computer system, and Internet-based systems where the software is accessed through a Web browser and the service is paid for through monthly fees.

Healthcare IT leaders kick off government’s e-prescribing drive

With the first phase of Medicare’s mandate for e-prescribing rolling out in January, healthcare IT leaders, led by Health and Human Services Secretary Michael Leavitt, gathered Tuesday in Boston to jumpstart the initiative.

“One of the beauties of the system is that it will reduce the number of medical mistakes … and tragic results,” Leavittsaid at the National E-prescribing Conference.

“We know it saves lives, we know it saves money, and it’s time to implement it.”

Leavitt tied the nation’s current economic crisis to the rising costs of healthcare and noted that going electronic with prescriptions helps provide cost-savings for patients, doctors and the entire healthcare system.

“It’s an economic imperative in this country,” he said.

Report: States poised to quickly establish health IT overhaul

As members of Congress weigh legislation to create a nationwide system of electronic health records, states are poised to act quickly through coordinated efforts with healthcare providers, industry, and the federal government, according to a report released today by the State Alliance for E-Health, a panel created by the National Governors Association.
Most urgently, states should encourage electronic prescribing and protect patient privacy, the authors said.
The report said adoption of e-prescribing has been slow, even though the necessary infrastructure and standards exist. Congress helped by approving a veto-proof Medicare reimbursement bill in July that included incentives for physicians who use e-prescribing starting in 2009. In addition, privacy and security measures are important because public trust can make or break an e-health effort, the report said, noting that states must ensure consistent policies to protect data and secure exchange.

A Social Network for Your Doctor, Pharmacist and Insurer

Imagine a virtual health clinic: Your lung doctor and heart specialist can pull up your online medical profile and chat, via instant messenger, about your medications. You schedule checkups online, create a wellness journal or even rate your general practitioner.

WellNet Healthcare, a Bethesda health management company, is launching the beta version of this social network, Point to Point Healthcare, this month. Since 1994, WellNet has built its business collecting detailed data on employees’ medical and pharmacy activity so that companies can better evaluate their corporate health plans.

WellNet’s clients nationwide — including Washington-area firms such as Peterson Cos., Dewberry, and Kiplinger Washington Editors — will be among the first to test-drive the new system. It lets employees create a personal network uniting their insurance claims manager with multiple doctors and pharmacies to better coordinate treatments. An online concierge helps workers find new specialists, and a message system reminds them to pick up prescriptions.

Key to diagnosis info on e-Rx is that it’s optional

- In response to Joseph Conn’s two-part series (Access parts one and two) on policies regarding diagnosis on electronic prescriptions:
It is true that the Certification Commission for Healthcare Information Technology’s 2008 criteria for ambulatory electronic health records requires that a healthcare provider “has the option of including the patient’s diagnosis on the prescription” but the word “option” is the key to this criteria. Including the name of the condition being treated is sometimes required to comply with state formulary restrictions or to help the patient and their family know which medication is for what. So “having the option” makes sense for patient care.

Writing is on the wall for doctors’ e-prescriptions

The move to get doctors to file prescriptions electronically is gathering steam and may get a further boost from new Medicare rules that give doctors money to go electronic — and take it away if they don’t.

From 2004 to 2007, e-prescriptions increased from 700,000 to 35 million, according to the company that routes e-prescriptions from doctors’ offices to pharmacies, Pharmacy Health Information Exchange operated by SureScripts. Still that only amounts to about 6% of U.S. doctors who regularly sent e-prescriptions in 2007.

The government is hoping to change that…

…But privacy advocates warn of problems.

Transforming prescriptions from scrawl into a standardized electronic format can make them even easier for pharmacies to sell and trade, violating patient privacy, says Tim Sparapani, senior legislative counsel for the American Civil Liberties Union. “Any time you put something in a digital format and standardize it, it becomes much more profitable and easy to move those records,” he says.

Top newsmakers: Making good on visions deployed in 2007

They dominated the headlines and made bold announcements that created huge impacts in the healthcare industry and across America.

Marquee names topped the results in our reader surveys for top policymakers, provider-based healthcare IT leaders who did the most innovative work in 2007 and vendor-based leaders who have advanced the cause of healthcare IT the furthest in 2007.

Policymakers: walking the walk

It seemed that every week Health and Human Services Secretary Michael Leavitt was making announcements. That constant visibility accounted for his being the runaway vote-getter as top policymaker of 2007.

From new standards for e-prescribing, personalized healthcare goals and global electronic health record standards to Medicaid transformation grants and commitment to healthcare system transparency, Leavitt is being touted for his healthcare IT focus. “Consistent messaging of the impact of technology on healthcare is penetrating every component of the industry,” said Kevan Nasserzadeh of Fair Isaac.

“I do not believe that the health IT battle will be won locally,” wrote in one reader. “Meaningful change will come from national initiatives such as those Mike Leavitt is driving, or at the least, the way will be paved by these early initiatives.”

President George W. Bush garnered support from businesses and other stakeholders for his value-driven healthcare plan with four cornerstone goals, including adoption of healthcare IT interoperability.

Despite his second-place finish, Bush has his detractors, most notably Deborah Peel, MD, of the Patient Privacy Rights. “Bush and his administration have pressed forward to create an illegal and unethical HIT system by eliminating patients’ right to control their personal health information,” she complained.

Peel: Electronic prescribing is no panacea

When a coalition of technology companies, insurers and health care providers launched a $100 million project last month to provide free electronic prescribing software to every physician in the United States, it was greeted with cheers. The presence of brand name vendors was supposed to ensure that sensitive prescription records would be private and secure.

But those who believe there is anything private about e-prescribing under the National ePrescribing Patient Safety Initiative (NEPSI) — or any other e-prescription system — are simply incorrect.

Security makes little difference because every identifiable prescription in the country is data mined and sold daily. Nobody needs to break into pharmacies to steal our prescriptions; they are for sale. For example, market intelligence firm IMS Health reported revenues of  $1.75 billion in 2005 solely from the sale of prescription records, primarily to drug companies.

Privacy is the right to control who sees your sensitive health records and the right to decide if those records are even entered into electronic systems. But it is impossible for anyone to have a private prescription — meaning that it is never disclosed without a patient’s consent — because data mining has eliminated that right.

Furthermore, many people refuse to take psychiatric medication or other medications in an attempt to prevent the pharmacy benefits management industry from reporting to employers that they are on antidepressants or other medications.

Knowing that prescriptions are not private also keeps people with other sensitive illnesses from taking medications. And that exerts pressure on doctors to avoid prescribing pain medications — out of concern that the Drug Enforcement Administration is tracking their prescribing patterns. The lack of prescription privacy is a problem that endangers people’s lives and quality of life.

Bush signs bill creating electronic prescription monitoring

President Bush signed into law a bill to create electronic monitoring programs to prevent the abuse of prescription drugs in all 50 states.
The new law creates a grant program for states to create databases and enhance existing ones in hopes of ending the practice of “doctor shopping” by drug abusers seeking multiple prescriptions. It would authorize $60 million for the program through fiscal 2010.
The bill, signed late Thursday at the president’s Crawford, Texas, ranch, was sponsored by Rep. Ed Whitfield, a Republican representing Kentucky’s 1st District.
Kentucky’s existing electronic prescription monitoring database, called KASPER – Kentucky All Schedule Prescription Electronic Reporting – would be eligible for enhancement grants under the bill. Establishing programs in adjacent states would help prevent abusers from crossing borders to get prescription drugs and then bring them back into Kentucky.
“It’s going to be a tremendous boost (for the Kentucky program) and be much more effective,” Whitfield told The Associated Press.
A July letter from the American Medical Association in support of the bill called prescription drug abuse “one of the fastest growing public health problems” in the United States. The letter cited a 2002 Substance Abuse and Mental Health Services Administration survey that estimated there were 6.2 million recreational prescription drugs users then.
The bill passed the House by voice vote and the Senate by unanimous consent in July.
Robert Benvenuti, inspector general of the Kentucky Cabinet for Health and Family Services, said he hadn’t seen full details of the new law yet. However, Benvenuti said he thought it was going to “be very positive” for Kentucky.
“If all states had the ability to tap into each others’ information we would know that that person is doctor shopping,” Benvenuti said. “It will allow states to see not only what’s going on in their states but what’s going on in other states.”
Nineteen states have existing programs that vary in effectiveness, Whitfield said. Illinois, which borders his western Kentucky district, has a program that only tracks Schedule II drugs, such as cocaine and oxycodone, leaving drugs such as codeine and the brand names Vicodin and Valium unreported, said John Halliwell, Whitfield’s legislative director.
Neighboring Tennessee and Indiana do not yet have such programs, Halliwell said.
Some federal money has been appropriated for state monitoring programs in the past on a limited basis. Those grants were administered by the Department of Justice, but this law will place the program under the Department of Health and Human Services instead.
“This is a health problem, and the Department of Health and Human Services is the most logical place to run a prescription drug program,” Whitfield said.
Some in Congress worry the law will invade privacy. “This bill lacks fundamental privacy protections, such as notifying patients if their information has been lost or stolen,” said Democratic Rep. Edward J. Markey of Massachusetts, whose amendment to add that notification to the bill was defeated in committee. “The lack of such safeguards virtually guarantees that this well-meaning effort to combat drug abuse will become a scandalous invasion of the privacy of innocent bystanders.”
Whitfield said his staff worked with Markey and others to address many of those privacy concerns, including requiring states to have standards for the protection of information and requiring states to establish penalties for the unauthorized use of data.
“If we feel like it’s being abused we would definitely take action,” Whitfield said.
Associated Press writer Joe Biesk in Frankfort, Ky., contributed to this story.