E prescribing: All aboard by 2010?


Facing a lartely uninspired response from doctors, regulators and evangelists are pushing e-prescribing with a combination of hardball tactics and inspired cajoling to get prescribers on board by 2010.

Simultaneously, a highly influential coalition of technology providers has kicked off a $100 million "adopt e-scripts" campaign, which is offering free e-prescribing technology to every physician in the nation.

The CMS move was also cheered by early e-script adopters David Feeny, pharmacist and owner of Oxnard Pharmacy in Warwick, R.I., and Philip Keough, senior VP of pharmacy operations for Rite Aid. "We fully support the proposed change to the Medicare rule as e-prescribing has brought a lot of efficiencies and economic value to our pharmacy," Feeny said. "We have cut out about two hours a day [Monday through Friday] in the amount of time we spend on faxes and phone calls. Prior to e-prescribing, we would sometimes have to wait up to two days before hearing back from some physicians. Now those same physicians are responding within 20 minutes."

Keough agreed. "The proposed CMS rule could potentially generate a dramatic increase in e-prescribing utilization, hugely benefiting pharmacy patients, R.Ph.s, and physician partners. E-prescribing improves accuracy; eliminates unnecessary phone calls and faxes to physician offices; and-most important-allows pharmacists to spend more time counseling patients, answering questions, and ensuring compliance with medication therapy."

John Fegan, senior VP of pharmacy operations for Stop & Shop, Giant Food LLC, Giant Food Stores, and Tops Markets, was also highly supportive of CMS' move. "Imagine sending an important e-mail to a colleague only to have it arrive in his or her fax machine. Pharmacists and physicians routinely experience similar problems when they prescribe through the use of computer-generated faxes. Eliminating computer-generated faxing will improve the safety, efficiency, and overall experience for all parties concerned-physicians, pharmacists, and especially patients."

Loopholes remain

Of course, even with adoption of the newly proposed rule, some loopholes would remain. Doctors who handwrite their Rxs would still be able to do so under the rule change. And doctors who use stand-alone fax machines-as opposed to computer-generated faxes-would still be able to do so under the proposed rule, according to Donald Huonker, senior VP of pharmacy services for Walgreens.

Meanwhile, the mantle of chief cajoler has been assumed by the National ePrescribing Patient Safety Initiative (NEPSI)-the organization that provided the $100 million funding for free e-scripts technology to all doctors nationwide.

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