E-prescribing: Missives from the Front

E-PRESCRIBING: MISSIVES FROM THE FRONT

Volume 29, Issue 508 February 4, 2008

Kory Mertz

As spring approaches, states are stepping up their efforts to expand the use of health information technologies. Prominent among these is e-prescribing, the electronic generation and transmission of a prescription between the prescriber and pharmacy. By reducing medication errors, e-prescribing is expected to one day save billions of dollars and thousands of lives.

New Hampshire hopes to be the first state in which all providers can e-prescribe. The state is working with the New Hampshire Citizens Health Initiative, which brings together payors, providers, employers and citizens, to achieve that goal by October 2008. Anthem Blue Cross Blue Shield, the state’s largest payor, is helping practitioners adopt e-prescribing by offering access to a discounted wireless plan, free e-prescribing software and free personal data assistants (PDAs).

Minnesota is expanding e-prescribing to state employees. By 2009, the state employee health plan will require all in-network pharmacies to accept e-prescribing. By 2011, all network providers must e-prescribe. Failure to meet these deadlines could mean removal from the network.

A growing number of states are adding health and insurance information to the list of items protected against a breach of confidence.

California enacted a bill (AB 1298) during its last session that seeks to protect the privacy of personally identifiable unencrypted medical and health insurance information. Any state agency or business that operates in California would have to inform any potentially affected state resident of the loss of that individual’s health information. In addition, the bill would prohibit any organization that holds electronic personal health record data from disclosing that information without patient consent.

Medicaid Too

Meanwhile, 21 states have initiatives to add or expand e-prescribing in their Medicaid programs, according to a recent report from the Office of the Inspector General at the Department of Health and Human Services.

Florida and Mississippi have given personal data assistants (PDAs) to participating providers to enable them to perform such actions as viewing patient medication history, sending prescriptions to pharmacies and being alerted to potentially adverse drug interactions.

Mississippi estimates that its program costs the state about $35,000 per month, but has saved around $1.2 million per month in prescription drug costs and nearly $27,000 per month in foregone hospitalizations. Florida documented savings of $40 per patient per month in 2006, for a total savings to Medicaid of $25 million.

Missouri, Kansas and Tennessee have incorporated e-prescribing systems into Medicaid electronic health records (EHRs). Providers can go to a Web-based portal (a single point of access for EHR data) to see Medicaid prescription drug claims data for their patients, as well as information about the state Medicaid drug formulary.

At the federal level, on January 31, U.S. Health and Human Services Secretary Mike Leavitt launched a 40-city tour to tout a five-year, $150 million pilot to help physicians in small practices adopt EHRs, the AP/Chicago Tribune reports. The pilot will focus initially on Medicare, but could be expanded to include Medicaid.

Physicians would have to pay for the technology, and up-front costs could range from $20,000 to $40,000. However, Leavitt said that in the first year of the project, the Center for Medicare & Medicaid Services (CMS) would pay doctors extra for adopting EHRs, while in the second year, doctors would receive bonuses for reporting data on quality. In the last three years of the pilot, CMS would pay physicians for boosting quality.

For more information, please go to NCSL’s LegisBrief on e-prescribing: www.ncsl.org/programs/pubs/summaries/08LBJan_eprescribe-sum.htm

Helpful resources:

NCSL’s Kory Mertz at Kory.Mertz@NCSL.org; (202) 624-5400, ext. 3580

NCSL Health Information Technology Champions (HITCh) Website: www.ncsl.org/programs/health/forum/hitch

The Henry J. Kaiser Family Foundation has prepared a toolkit on health information technology:
http://www.kaiseredu.org/topics_im.asp?id=655&imID=3&parentID=70#EPrescribing

© Copyright 2008, State Health Notes