"Those providers who are not adopting E-prescribing, their Medicare reimbursements will decrease by 1 percent in 2012, 1.5 percent in 2013 and 2 percent in 2014 and later."

"BalineMDeRx surpasses the criteria of "Qualified eRx" which would facilitate providers to get incentive from Medicare."

Electronic Prescribing (eRx):

A prescriber's ability to send electronically, accurate, error-free and clear prescription directly to a pharmacy from the point of care is a significant element in order to improve the quality of patient care. E-prescribing facilitates physicians and providers to electronically transmit a prescription to a pharmacy.

A more formal definition of e-prescribing is given in the Medicare Part D prescription drug program.

"E-prescribing means the transmission, using electronic media, of prescription or prescription-related information between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary,including an electronic prescription network. E-prescribing includes, but is not limited to, two-way transmissions between the point of care and the dispenser."

The present scenario of eRx:

Only 2% of the estimated 1.47 billion new and renewal prescriptions were sent electronically in 2007. However, currently over 35,000 providers e-prescribe in the US.  According to the study conducted by Gorman Health Group for the Pharmaceutical Care Management Association, nearly 80% of all US prescriptions would be generated with (eRx) and 1.9 million adverse drug effects will be avoided by 2017. However, according to Sure Scripts about 7% of new prescriptions have been sent electronically in the year 2008.

Major Problems in Prescription:

The number of patients that die due to prescription errors are as high as 7000, which indicates clearly the critical situation of Medical Industry. Some of the critical problems come into sight due to prescription, which are mentioned below.

• Illegible writing causes 25% of prescription-related medical mistakes
• No records for past medications
• Lack of drug-drug or drug-allergy interactions information
• Adverse drug events
• High turnaround time to refill
• 40% of traditional prescriptions require pharmacists and doctor coordination
• Undue waiting delays due to prescription
• Clarification calls on patient arrival

Benefits of eRx:

• Reduce medical errors
• Improve quality of care
• Reduce need of pharmacy callback and overhead costs
• Improve Patient safety
• Reduce medication cost
• Increase efficiency
• Save staff's time by decreasing requirements of pharmacy coordination
• To track records of patients' medication history
• Eliminated paper work
• Reduce the need for phone calls between prescribers and dispensers.
• Increase the overall medication management process
• Provide real-time alerts for drug - drug, drug - allergy and other interactions based on patients EHR.
• View patient flow-sheet with drug and lab history

Major Challenges to eRx:

The cost is the one of the major obstacles to adopting eRx for practices to overcome. As far as stand along e-prescribing system is concern, the cost is relatively less expensive.  At the same time, cost of interfaces with practice managements, customization, training, maintenance etc, would be difficult for providers to manage initially.

A major impediment to implementing eRx is the Drug Enforcement Administration's (DEA) prohibition of electronically sending prescriptions for controlled substances, however about 10 - 11 % of all written prescriptions in US constitutes controlled substances.

Some of the providers are reluctant to adopt eRx, hence they need to change the entire workflow of the practices if they implement eRx, which would increase time. These providers would need to change the role and responsibilities, and require adequate training of the staff at initial level.

Selection of hardware and software is a cumbersome task for providers thus they are very busy in their routine, their information technology staff lack expertise, they have insufficient information of the product etc.

Medicare Incentive for "Qualified eRx":

According to the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, any provider who meets an annual threshold of e-prescribing/ patients volume will get incentive payments from Medicare which will start at 2 percent for 2009 and 2010, and then drop to 1 percent in 2011 and 2012 and subsequently fall to 0.5 percent in 2013.

However, those providers who are not adopting E-prescribing, their Medicare reimbursements will decrease by 1 percent in 2012, 1.5 percent in 2013 and 2 percent in 2014 and later.

A "Qualified eRx" must be competent enough to performing all of the following functions. 

• Generate a complete active medication list
• Select medications, print prescriptions, electronically transmit prescriptions, and conduct all time alerts(safety checks include: automated prompts that offer information on the drug being prescribed, potential inappropriate dose or route of administration, drug-drug interactions, allergy concerns, or warnings or cautions)
• Provide information on lower-cost, therapeutically appropriate alternatives (if any)
• Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan (if available)

BalineMDeRx:

The BalineMDeRx meets the criteria of "Qualified eRx" which would facilitate providers to get incentive form Medicare.

• BalineMD eRx brings you the power of connectivity without the complexity. BalineMD connects you seamlessly to the pharmacy and Integrates with the SureScript reference system.
• BalineMD eRx streamlines the entire prescription writing process making it simple, fast and accurate.
• It prevents common medication errors and automatically checks drug interactions, which greatly improves patient safety.
• The system allows providers to write patients' prescriptions directly from their Tablet PC, Pocket PC, or Desktop and send the prescription via fax to the pharmacy of patient's choice, so the medication is ready when patient arrives at the pharmacy.
• To manage the impact of insurance plans and ensure access to the latest information, an electronic prescribing application must connect the many systems.

BalineMD eRx: Key Features

• Write electronic prescriptions on handheld or desktop computers
• Real-time alerts for drug-drug, drug-allergy and other interactions based on patient's electronic medical record
• Manage list of commonly prescribed ("favorite") drugs and lab tests ordered
• Supports custom prescription and pad templates
• Fax prescriptions directly to pharmacy from the point of care
• Compliant with electronic prescription regulations
• Automatically updates patient's current medication list
• Supports quick and accurate drug refill process
• Allows ordering of lab test along with prescriptions
• Integrated with Lab Order system and EHR
• View patient flow -sheet with drug and lab history

BalineMD eRx: Benefits

• Medical error prescribing chances are reduced by 95 % with BalineMD eRx
• Automated refills are up to 5 times faster than manual refills
• Eliminate medication errors due to drug and allergy interactions
• Automated tracking of patient's past medication history
• Reduce patient and pharmacy callback
• Reduced overhead cost
• Manage refills or discontinue medications with one-click process
• Save time of staff by decreasing requirements of pharmacy coordination
• Ability to Track record of patients' medication history
• Customized prescription pad template will optimizes time and patient care
• Provider can achieve 10% reduction of time spend per patient encounter through BalineMD prescription writer as compare to manual Rx writer.

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http://www.ehealthinitiative.org
http://www.cms.hhs.gov/
http://www.ehealthinitiative.org.
http://www.theCIMM.org.
www.ama-assn.org.
http://www.nmmra.org\
http://www.aafp.org
http://www.iom.edu
http://www.nitc.ne.gov/
www.surescripts.net
www.medicare.gov
healthit.ahrq.gov
www.himss.org
govhealthit.com