"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.
Those providers who are
adopting e-prescribing early will be eligible
for the following Medicare
reimbursements: |
Providers are adopting
e-prescribing by year |
Receive Medicare
reimbursements (
%) |
2009 |
2 |
2010 |
2 |
2011 |
1 |
2012 |
1 |
2013 |
0.5
| |
Those providers who are not
adopting e-prescribing by 2012, their Medicare
reimbursements will decrease as
follows: |
Providers are not
adopting e-prescribing by year |
Medicare reimbursements
decrease by (%) |
2012 |
1.0 |
2013 |
1.5 |
2014 |
2.0 |
2015 and subsequent years |
2.0 |
|
| |
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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References:
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
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