AHIC Recommends E-Prescribing Mandate For Medicare

Main Category: Medicare / Medicaid / SCHIP
Also Included In: IT / Internet / E-mail
Article Date: 30 Nov 2007 - 7:00 PST

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The American Health Information Community on Wednesday recommended that HHS Secretary Mike Leavitt seek authority from Congress to mandate electronic prescribing in Medicare, CQ HealthBeat reports. AHIC, the public-private advisory group convened by Leavitt, reached the decision during a conference call on Wednesday that included Leavitt and Robert Kolodner, the agency's national coordinator for health information technology.

The recommendations would allow Leavitt to make exceptions to the mandate at his discretion, according to CQ HealthBeat. AHIC also recommended that the agency create incentives for physicians and pharmacies that use certified electronic health record systems; allow prescriptions to be electronically submitted to the pharmacy chosen by a patient; and authorize the Agency for Healthcare Research and Quality to designate patient safety organizations that would monitor and address any potential problems with e-prescribing.

The group's recommendations follow a proposal by CMS this month that would develop new standards in e-prescribing to supplement those already adopted by the agency governing transactions between physicians and pharmacies. Medicare does not require e-prescribing, but health and stand-alone prescription drug plans that provide Medicare Part D coverage must have the capacity to support e-prescribing and must follow CMS' standards.

In a statement, AHIC board member and Blue Cross and Blue Shield Association President and CEO Scott Serota said AHIC's decision "is a clear signal that Congress must act now to protect senior and disabled beneficiaries from preventable medication errors that cost billions and harm millions every year" (Carey, CQ HealthBeat, 11/28).

Letter to the Editor
Sen. John Kerry (D-Mass.) and former House Speaker Newt Gingrich (R) in a Nov. 16 Wall Street Journal opinion piece made "a strong case for adoption" of e-prescribing and "acknowledge the lack of alignment of financial incentives as a major barrier to what would seem like a 'no-brainer' implementation decision," but they "fail to mention a couple of complicating factors," Steven Hanks, chief medical officer of The Hospital of Central Connecticut, writes in a Journal letter to the editor.

Hanks writes that "in order for electronic prescribing to be truly effective, the information has to flow bidirectionally" because "[m]any patients have prescriptions written by a multitude of practitioners" that are "filled at a number of different pharmacies." In addition, "Uninsured individuals sometimes 'borrow' insurance cards of insureds in order to access needed medications." Hanks says, "E-prescribing systems will do little to protect against errors in either of these regards."

He concludes, "We should absolutely forge ahead with e-prescribing," and those involved "should simultaneously work to assure that all the data repositories talk to one another and that some method of definitely identifying patients, such as a biometric standard, be adopted as well" (Hanks, Wall Street Journal, 11/29).

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