Physicians, pharmacists slam e-prescribing technology, rules

CMS has paid a small bonus for electronic prescribing since the beginning of 2009, and e-prescribing will be a component of "meaningful use" of EMR when that incentive program gets underway in 2011. But the technology still has a number of shortcomings, several constituencies said this week.

At a meeting of the federal Health IT Policy Committee this week, Virginia family practitioner Dr. Alex Krist noted that his practice has an EMR with e-prescribing that has allowed the doctors to eliminate ambiguities associated with handwritten prescriptions and keep more complete medication records. But he said that networks that transmit e-prescriptions are prone to outages, and added that it's often hard to discern current medications.

"While systems keep historical records of all medications prescribed, active medication lists easily become cluttered with acute, short-term medications and long-outdated medications--potentially resulting in a new cause for medical errors," Krist told the panel, reports Federal Computer Week.

And, of course, federal regulations still prohibit electronic transmission of prescriptions for controlled substances, meaning that doctors who want to e-prescribe often must have two separate prescribing processes. "Though the impact of the exclusion varies by specialty, in our experience as much as one-third of the prescriptions generated can be for controlled substances," Krist said.

Meanwhile, the National Community Pharmacists Association told the committee that current federal e-prescribing standards were too lenient. To earn the 2 percent e-prescribing bonus on total Medicare charges, physicians only have to write 25 electronic prescriptions the entire year. The group also argued in favor of similar financial incentives for pharmacists.

To learn more:
- check out this Federal Computer Week story
- read this Healthcare IT News article about the NCPA perspective