Managing Your Practice

Is This the Year to Try E-Prescribing?


Electronic prescribing was supposed to be standard practice by now.

With all the predictions of increased efficiencies and cost savings, policymakers and health plan administrators were sure physicians would quickly adopt the new technology—but the associated costs and hassles dissuaded most. And many didn't see any benefits, either for patients or for themselves.

The Centers for Medicare and Medicaid Services thought it could turn the tide last year by adding a financial incentive: a 2% bonus on Medicare Part B payments. That didn't do the trick either; accessibility and cost issues remained, and the various “G” codes that had to be added to Medicare claims to document e-prescribing were confusing and annoying.

As 2009 ended, only 10%-15% of American physicians were e-prescribing.

If you're in the prehistoric majority, 2010 may be the year to reconsider: CMS has made it much easier to collect the 2% bonus with a minimum of e-prescribing effort; plus, a consortium of tech companies has made the technology readily accessible and free.

This year, if you can show that you are using a qualified e-prescribing program on only 25 Medicare claims over the course of the entire year, you'll get the 2% bonus on every Medicare Part B claim you file in 2010.

In addition, CMS has simplified the reporting process by eliminating all add-on codes except G8553, the one that indicates you have a qualified e-prescribing program and you used it to provide at least one prescription at the visit being billed.

Of course, CMS is hoping you won't quit after only 25 claims; they're betting you'll notice a decrease in paperwork, simplification of record keeping, fewer misspellings and handwriting misreads, and a greater awareness of contraindications and drug interactions, plus simplified access to patients' medication histories. And they hope you'll see a decrease in pharmacy phone calls, prior authorization nonsense, and treatment delays because of formulary issues. Further, they hope, your patients will appreciate seeing their prescriptions filled faster, with fewer errors.

To address cost and accessibility problems, a coalition of insurance and technology companies, the National e-Prescribing Patient Safety Initiative (NEPSI), has provided $100 million in funding to offer free e-prescribing technology to all phsyicans nationwide. NEPSI members include Allscripts, SureScripts, and NaviMedix, as well as Google, Dell, Cisco, Fujitsu, Microsoft, Sprint, Aetna, Horizon Blue Cross/Blue Shield, WellPoint, and Wolters Kluwer Health.

Thanks to the efforts of NEPSI and others, e-prescribing is now quick and easy for most practices to set up and use. Pharmacies have already done most of the work to make themselves compatible; about 70% of U.S. pharmacies can now handle electronic prescriptions. You can incorporate e-prescribing into many electronic health record systems, or set it up as a separate, stand alone system.

In most cases, all you need to get started is an Internet-enabled computer with a high-speed connection (not dial-up), and a database of patients.

A nonprofit foundation called eHealth Initiative has released an excellent guide for physicians who are considering making the switch to e-prescribing, as well as for those who have already switched. You can find it at

You can learn more about NEPSI and sign up for their free, online-based prescribing software at their Web site,

A list of other companies that currently offer e-prescribing software, along with links to their respective Web sites, can be found at

Details of the CMS incentive program are available at

With cost, accessibility, and hassle roadblocks removed, bureaucrats hope 75% of us will be prescribing electronically by 2014, 90% by 2018. And that, in turn, they claim, will save the government $22 billion over the next decade due to increased use of generic drugs and decreased prescribing errors.

Maybe, maybe not. But with only 25 e-prescriptions required to collect the 2% bonus this year, it's a “no-brainer” to give electronic prescribing a try.

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