FRANKLIN LAKES, N.J., Feb. 12 /PRNewswire-FirstCall/ — As Congress
considers a bill that would tie physicians’ Medicare payments to their use
of ePrescribing technology, Medco Health Solutions, Inc. (NYSE: MHS) today
announced the launch of a national initiative to assist physicians of
Medicare Part D patients in switching from hand-written to electronically
generated prescriptions. The pilot program will also be used to study the
impact of ePrescribing on patient safety, increased generic drug use and
formulary compliance on the Medicare population.

“There is strong evidence that ePrescribing reduces medication errors
and increases the use of generic drugs and other lower-cost medication
options. We are proud that Medco will be the first Medicare prescription
drug plan (PDP) to research its impact on the Medicare population,” said
John Driscoll, president of new markets at Medco. “The program is designed
to overcome the cost barriers that have prevented widespread physician
adoption of this technology and to verify the benefits of ePrescribing for
Medicare Part D beneficiaries.”

Initially the study will include 500 physicians currently treating
enrollees in the Medco Medicare Prescription Plan(TM). Medco — working
with RxNT, a leading provider of ePrescribing technology – will provide
these physicians with free RxNT ePrescribing software and training. Over a
six- month period, the physicians’ rate of generic drug dispensing,
formulary compliance and generated safety alerts will be compared to a
control group of 500 doctors who did not receive ePrescribing software or
training. Ultimately, 2,000 doctors, primarily general practitioners and
internists, will participate in the ePrescribing program.

Advantages of ePrescribing

The Centers for Medicare and Medicaid Services (CMS) estimates that
nationally, use of e-Prescribing technology could eliminate as many as two
million harmful drug events each year. The benefits of ePrescribing
technology include reducing potentially harmful drug interactions by
alerting physicians to possible risks and eliminating illegible physician
hand-written prescriptions that can lead to medication dispensing errors.
Additionally, ePrescribing has been shown to promote the use of generic
drugs and increase formulary compliance, saving money for both patients and
health plans. Despite these benefits, only about three percent of U.S.
physicians actively use ePrescribing technology.

Medco Leads the Way on ePrescribing

This is Medco’s second major ePrescribing effort. In 2005, Medco joined
forces with the three largest U.S. auto companies – General Motors, Ford
and Chrysler – to launch the Southeast Michigan ePrescribing Initiative
(SEMI). Between 2005 and 2007, approximately 2,700 participating physicians
have generated nearly 6.2 million prescriptions using ePrescribing
technology.

A recent analysis of SEMI found that ePrescribing substantially
improved patient safety by alerting physicians of risks related to drug
interactions and other potential medication errors and resulted in a
significant number of prescription changes that prevented potential adverse
events. Formulary compliance also improved. The review of 3.3 million
electronic prescriptions showed:

– A severe or moderate drug-to-drug alert was sent to physicians for more
than 1 million prescriptions (33 percent), resulting in nearly 423,000
(41 percent) of those prescriptions being changed or canceled by the
prescribing doctor;
– More than 100,000 medication allergy alerts were presented, of which
more than 41,000 (41 percent) were acted upon; and
– When a formulary alert was presented, 39 percent of the time the
physician changed the prescription to comply with formulary
requirements.

“The SEMI program results show that ePrescribing can have a big impact
on patient safety and overall health care costs,” continued Driscoll.
“Medicare Part D provides the right opportunity to introduce many more
physicians to ePrescribing, a key step toward improving patient safety for
this critical segment of the population and reducing the cost of
prescription health care in the Medicare program.”

This is right off the BUSINESS WIRE:
ROCKVILLE, Md.–(BUSINESS WIRE)–DrFirst™, the leader in electronic prescribing and medication reconciliation services, today announced that physicians will have access to an unparalleled e-prescribing experience on the Apple iPhoneTM through DrFirst’s RcopiaTM e-prescribing system. For the first time, physicians and their staff will be able to perform all of the essential functions of electronic prescribing in real-time on a mobile browser through a WiFi or wireless carrier’s broadband connection.

RcopiaMini is formatted for the smaller screen of today’s mobile devices and allows providers to easily navigate a full-featured version of Rcopia on this exciting new platform. DrFirst designed the application to provide a real-time interaction between physicians, pharmacies, and health plans, so there is no need to update or sync the device.

“Now physicians can quickly, safely, and securely prescribe from anywhere—through the always-on connectivity of the iPhone, the WiFi connection of the iPod Touch, or while seated at the desktop computer in the practice,” said Peter N. Kaufman, Chief Medical Officer of DrFirst, Inc.. “DrFirst’s goal is to ensure that its new web-based, mobile Rcopia experience delivers the same high levels of innovation and usability as the original Web version.”

To be useful to physicians, e-prescribing must be easily and securely accessible. With the addition of the iPhone and iPod Touch, DrFirst provides physicians with a broad set of eprescribing platforms, including Apple, Treo, and HP iPaq handheld devices as well as desktop and tablet systems.

E-prescribing on the iPhone with RcopiaMini allows physicians to provide a higher level of patient service and safety, streamline practice workflows, and save time and money through the efficiency of electronic medication orders, renewals and formulary checking. New prescriptions and renewals are sent electronically to the patient’s retail or mail order pharmacy.

RcopiaMini checks for patient insurance eligibility, formulary, and patient medication history. The application also offers clinical decision support tools to check prescriptions for drug-drug and drug-allergy interactions and appropriate dosing.

Busy doctors, large practices, and health systems require software that is adaptable to the practice workflow and that draws the practice staff into the prescribing process. To meet this need, RcopiaMini is designed to be accessible to all staff members, to be highly configurable and to accommodate workflow features that make it a perfect solution for
groups of any size.

From the Detroit News by Sofia Kosmetatos

Online Rx program helping cut errors
Big 3’s e-drug plan boosts the use of generics while reducing glitches, analysis shows.

A Big Three-driven effort to replace prescription pads with computers is significantly reducing patient risk from medication errors and helping increase generic drug use, according to an analysis released today by the Southeast Michigan ePrescribing Initiative.

Launched nearly two years ago, the first review of the initiative shows that it is not only protecting patients from the harmful consequences of medication errors, but is also helping them have better discussions with their doctors about medications at the time a prescription is written.

“The benefits of ePrescribing are overwhelming in terms of reducing medication errors, lowering prescription drug costs for patients and plans, and decreasing physician practices’ administrative costs,” said Marsha Manning, General Motors Corp.’s manager of Southeast Michigan Community Health Care Initiatives, in a statement.

Through the initiative, doctors access online software on computers in patient rooms to write the prescriptions, prompting discussions about generic alternatives, drug interactions and allergies at the time a prescription is written. The results are savings on drug costs and fewer medical complications, doctors and coalition members say. EPrescribing also eliminates doctors’ handwriting as a source for error, and saves patients and doctors’ offices time because the scripts are sent to pharmacies electronically.

The analysis of a sample of 3.3 million prescriptions showed:
• The ePrescribing technology sent alerts of severe or moderate drug interactions to doctors for about one-third of those prescriptions. Doctors changed or canceled 423,000 (or 41 percent) of those prescriptions.
• The technology informed doctors of more than 100,000 medication allergies, and doctors acted on 41,000 of these alerts.
• When an alert showed a drug was not on a formulary, the doctor changed the prescription to comply 39 percent of the time.

The initiative, involving the automakers, Henry Ford Health System, Blue Cross Blue Shield of Michigan and others, aimed to help doctors set up electronic prescribing in their offices.

The three automakers — GM, Ford Motor Co. and Chrysler LLC — are involved because they think the initiative can cut down on their health care costs, which add up to billions of dollars. So far, some 6.2 million prescriptions have been written by 2,500 doctors using ePrescribing technology, with more than 282,000 written each month. The coalition plans to extend the initiative through March 2008.

Generic drug use up
GM spokeswoman Carey Osmundson said it’s difficult to quantify how much the company has saved with ePrescribing, but GM has seen increases in its rates of generic drug prescribing and compliance with preferred drug lists, both of which save money. For each 1 percent shift to generic drugs from a brand name, GM saves nearly $20 million, she said.
GM spent $1.5 billion on prescription drugs alone last year for 1 million enrollees, a growing tab it had worked for years to stem.

Henry Ford Health System conservatively estimates it is saving $4 million a year with ePrescribing, mostly from switching HAP patients from brand-name drugs to less costly generic alternatives.

That’s not including the savings patients see from reduced co-payments, said Matt Walsh, associate vice president of purchaser initiatives at Health Alliance Plan, a health insurer owned by Henry Ford.

Royal Oak’s Dr. David Allard was one of the first Henry Ford doctors to use ePrescribing. His office has had electronic medical records for years, but had relied on pen and paper for prescriptions until January 2005. He says his staff saves a lot of time that used to be spent on the phone with pharmacies handling prescription refills and questions on scripts. “That was hours a day in my office,” he said.

But more importantly, he sees the benefit in reducing the potential for errors. Refilling prescriptions, for example, involved a lot of hand-offs between staff members and interaction with pharmacies. With each step came a chance for a mistake.

Handwriting kills
More attention is being focused nationally on drug errors and how to avoid them. According to an Institute of Medicine report issued last year, drug errors kill 1.5 million Americans each year. The report said eliminating handwritten prescriptions is the most vital step health care providers must take to cut down on errors, and recommended that all prescriptions be written electronically by 2010.

The institute is a branch of the National Academy of Sciences, an independent adviser to the government on scientific issues.
Allard’s patient Susan Smith said she appreciates saving money with generic alternatives that ePrescribing has brought up during her office visits. She loves the convenience of ePrescribing even more.

Because the script goes directly to the pharmacy, she doesn’t have to wait to pick it up. “It’s so much more efficient,” she said. “My time is real precious to me.”

For outside observers, the ePrescribing effort is laudable. “It not only reduces costs but improves the quality of care by reducing drug interaction,” said Eileen Ellis, principal of Health Management Associates, a Lansing-based consulting firm.
Recognizing the benefits of electronic records, health systems across southeast Michigan have been spending millions to install electronic medical records.

But doctors’ offices have lagged because of the cost, which can be in the tens of thousands and more for a practice.
At about $2,000 a doctor to implement, ePrescribing is much less expensive, but is nevertheless a step in that direction. The coalition helps participating doctors with a $1,000 subsidy.

“This is a great way to get technology into the doctor’s office. It’s not real expensive; it’s fairly easy to adopt,” Walsh said.

E-prescribing PDAs save millions for Mississippi Medicaid BY Nancy Ferris

Mississippi’s Medicaid program is saving about $1.2 million per month in prescription costs as a result of equipping 225 doctors with handheld e-prescribing devices.

State officials say the system not only reduces medication costs, it also increases the quality of care for patients. That’s because doctors have access to patients’ recent medication histories and can avoid prescribing medicines that would interact with ones they are already taking.

In addition, doctors can find out whether patients are filling and refilling their prescriptions. This allows them to detect when patients’ continued poor health is due to noncompliance with the doctors’ treatment plans.

Prescribers who use the handheld devices write fewer prescriptions on average, state officials said, and those prescriptions are likely to cost the state less.

After 18 months of steady savings, the Mississippi Division of Medicaid is negotiating with its contractor to expand the e-prescribing program, officials said.

Besides cutting drug costs, the state is saving nearly $27,000 a month on hospitalizations avoided because the doctors are getting real-time alerts about drug interactions, they said.

The program costs the state about $35,000 per month, so the hospitalization savings come close to covering the cost of the handheld devices from Informed Decisions, based in Tampa, Fla.

Florida has launched a similar program, with comparable results.

Asked whether there was any negative aspect to the program, Mississippi officials said they knew of none.

“I can see which medications patients are taking regardless of who prescribed them. As a result, we are now able to keep comprehensive, up-to-date medication lists for all our patients,” said Dr. Kurt Bruckmeier, who cares for about 200 Medicaid beneficiaries through Pacific Physicians Services in Hattiesburg, Miss. “It has also helped identify drug abusers who would very likely have gone undetected were it not for our ability to evaluate the full scope of prescriptions they were taking.”

COMMENTS:
I think this is a fantastic program that will pay for itself over a very short time. ePrescribing and medication adherence go hand in hand – especially when it comes to refills. I am not familiar with pharmacy policy, but do they tell the MD when you do not refill a script? I don’t think so. With all scripts and patient information linked up via these PDAs or hand tablets, MDs have all the info at their fingertips – as well as drug-drug interaction information to reduce ADRs.

The problems arise however when the technology fails and the MDs have no idea what is going on with the patient. I’m sure there are back-ups and colocation servers, but in Ol’ Miss there could be flooding, hurricanes, fires, etc…. Also, as we have seen with Pfizer of the last couple of weeks, what happens when someone hacks into the system? Not that medical records of the elderly have that much value (no offense) but it is protected information that anyone can blast out over the internet or use to for blackmail (that might not happen but it could!).

This works into the EHRs that many tech companies, MDs and healthcare providers are trying to adopt. I like the idea, and use one on Revolution Health but at the same time I am wary about that information out there. Not that I have anything to hide, but I do not know who is looking at that information. Some techie who is performing a system analysis? They also capture what you are interested in, what medications you are on, etc…. which they can then use to market your “eyes” to advertisers.

Also health social networking sites which encourage you to sign up for chat groups and the like – all that information goes somewhere and is monetized somehow. Sorry for that little rant. These are all opt-in websites and have strict privacy policies and terms of use.

This of course would not happen with the proper EHRs and ePrescribing tools since they are covered under HIPPA and would be gross misconduct if that information was shared. So I encourage the technological advances – if you are heli-skiing in Canada and break your leg, the mountain MD with a handheld internet browser can see what meds you are on and your history of broken bones, your allergies, etc… And this makes for safe practices. Scuba diving in the Maldives and black-out from NO2 poisoning – same thing. When all medical records are computerized and on servers, it will be safer to get into an accident /life threatening situation!

Go forth Ol’ Miss and show us the benefits of ePrescribing and adopt that new technology!