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e-Prescribing: Something that Works

by Malorye Allison

As the pundits compare Senator Barack Obama and John McCains’ plans ad nauseum, it’s getting a bit depressing seeing the list of things that are broken in our health care system, and how difficult it is going to be to fix them. So, I’m going to focus on something that works — e-prescribing.

Yes, going paperless is painful, and yes it can be expensive too, but just don’t say that the upside has been way overblown. The eRx Collaborative in Massachusetts has hopefully put that fear to rest. This bold effort was launched in 2003 to “jumpstart” e-prescribing in the state, and it’s raking in some impressive numbers. In late August, the group announced that Collaborative prescribers transmitted 15.6 million prescriptions over the last 4.5 years. Approximately 50,000 of those prescriptions, or 2.3% were changed due to drug safety alerts, a key feature of the system.

That probably doesn’t translate to 50,000 lives saved, or anything nearly that dramatic, but given the number of medication misshaps that harm Americans each year (IOM estimates that at about 1.5 million) it’s clearly a good thing.
More than 5,600 doctors are already ePrescribing thanks to eRx Collaborative, and the group is on track to bring 200 new prescribers onto the system this year. Last week Blue Cross Blue Shield of Massachusetts (BCBSMA), one of the Collaborative’s founding members, announced it is upping the ante: As of January 1, 2011, docs must be using e-prescribing to qualify for any of its physician incentive programs.

The e-Rx program helped Massachusetts garner the safest prescriber of all title at the Safe-Rx annual awards this summer. But what I like best about this initiative is the whole idea of “getting out ahead” of health care reform, and setting up information systems that supported the goals of the state’s then looming new health care law.

Clearly, e-prescribing works. It saves lives, it’s doable, and in this case, it came about through the efforts of actual stakeholders—BCBSMA, Tufts Health Plan and Neighborhood Health Plan, who tagged some useful applications (Zix Corp.’s PocketScript and DrFirst’ Rcopia) to get the ball rolling.

They could still be sitting there, debating how to do this, instead, they are watching the prescriptions roll in while saving money and lives.

Now the Centers for Medicare and Medicaid Services has announced that doctors who use e-prescribing can get a 2% bonus starting in 2009. Doctors fees are going up 1.1%, and they can also earn up to 2% extra for reporting quality measures. Add the e-prescribing bonus and that’s a total of 5.1% raise.

Could this be a trend?

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