Dean Riggott Photography
Surescripts
The following statement was released by SureScripts®:
The federal government took a giant leap forward last week in its efforts to support adoption of information technology by healthcare providers across the U.S. The 2003 Medicare Modernization Act (MMA) mandated the use of standards for electronic prescribing by participants in the Medicare Part D program. The MMA, however, also included an exception that allowed physicians and pharmacists to use computer generated faxes as a substitute for e-prescribing. The proposed rule announced last week by the Centers for Medicare & Medicaid Services (CMS),
when adopted in final form, would eliminate the "fax exception" from the MMA and would require all electronic prescriptions to comply with the NCPDP Script Standard. The proposed rule would establish a deadline for the elimination of computer generated faxes by January 1, 2009.
"With this announcement, Secretary Leavitt is delivering on his promise to use the federal government's leverage as the nation's largest healthcare insurer to promote health IT adoption," said Kevin Hutchinson, president and CEO of SureScripts. "It is now up to private industry to seize upon this important proposed change in Medicare policy. The sooner we take action, the sooner we will establish a safer, more cost effective, more automated process for providing prescriptions to millions of patients across the nation."
"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," said Dave Feeney, pharmacist and owner of Oxnard Pharmacy in Warwick, Rhode Island. "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."
"The proposed CMS rule could potentially generate a dramatic increase in e-prescribing utilization, hugely benefiting pharmacy patients, pharmacists and physician partners," said Phil Keough, senior vice president of pharmacy
operations for Rite Aid. "E-prescribing improves accuracy, eliminates unnecessary phone calls and faxes to physician offices and, most importantly, allows pharmacists to spend more time counseling patients, answering questions, and
ensuring compliance with medication therapy."
"Closing the Part D loophole on computer generated faxes is a critical step towards driving further adoption and utilization of e-prescribing," said John Fegan, senior vice president of pharmacy operations for Stop & Shop, Giant Food LLC, Giant Food Stores and Tops Markets. "Imagine sending an important email to a colleague only to have it arrive in their… 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, most importantly, patients."
"Electronic prescribing is one of the most significant ways the health care system can prevent medication errors, while ensuring more patients take their medication correctly," said Don Huonker, vice president of pharmacy services for Walgreens.
"This new rule from CMS has the potential to improve tens of thousands of lives and significantly reduce overall healthcare costs."
The proposed rule does not impact the ability of physicians to write and pharmacists to fill hand written or printed prescriptions. And faxing is still an option as long as it is not computer generated (i.e., as long as it is sent from a
stand-alone fax machine).
SureScripts estimates that over 150,000 physicians are impacted by the Medicare announcement. Today, most of these physicians use electronic medical record (EMR) or e-prescribing software to send new prescriptions and receive refill requests by fax - instead of electronically. Most are unaware that their computer is only sending faxes to pharmacies. Many have, but do not know they have, software that has been certified for an NCPDP-compliant electronic connection to the Pharmacy Health Information Exchange™.
More than 95 percent of all pharmacies and all major physician technology vendors in the United States are certified for an electronic connection to the Pharmacy Health Information Exchange. Created by the nation's pharmacies and operated by SureScripts, the nationwide network facilitates the electronic transmission of prescriptions and prescription information between physicians and pharmacists.
There are two immediate advantages of electronic prescribing (as defined by the MMA) over faxing:
• Patient Safety: According to the Center for Information Technology Leadership (CITL), use of electronic prescribing systems with a network connection to pharmacy and advanced decision-support capabilities could help prevent 130,000 life-threatening medication errors annually. By comparison, the safety benefits of
fax-based prescribing fall significantly short - pharmacists must re-type prescription orders; faxes can often times be illegible; and faxing prevents electronic information sharing for improved clinical decision making. In
an effort to prevent medication errors, the Institute of Medicine has called for all prescriptions in the U.S. to be written and received electronically by 2010.
• Efficiency: A study by the Medical Group Management Association's (MGMA) Group Practice Research Network (GPRN) estimated that administrative complexity related to prescriptions costs a practice approximately $15,700 a year for each full-time physician on staff. By eliminating paper from the prescribing process, e-prescribing offers significant time savings by eliminating the need for phone calls and faxes.
Once activated for e-prescribing, physicians will be able to electronically send new prescriptions directly from their computer (or PDA) to the pharmacy's computer system - no need for fax machines, printers or handwritten prescriptions. The same applies to processing of prescription refill requests, which are sent electronically from pharmacy computer to physician computer and back to pharmacy computer. Research tied to the 2006 MMA e-prescribing pilots showed that e-prescribing cut in half the average time that physicians and staff spent each day on renewals.
How to Start E-Prescribing
Physicians that currently use EMR or e-prescribing software, and pharmacy owners currently using pharmacy management systems, should call their respective technology vendors and determine the process for switching from computer generated faxes to electronic transmission of SCRIPT transactions. In some cases, an upgrade to the certified version of their existing technology will be required. Physicians and pharmacists can check on the certification status of their vendors by going to www.surescripts.com.