Coalition Promises Free, Easy ePrescribing Access


WASHINGTON — Doctors who have yet to get on the health information technology bandwagon no longer have any excuses, according to members of the National ePrescribing Patient Safety Initiative, a coalition of health insurers and software companies.

The initiative—called NEPSI—is offering physicians' offices access to a secure, easy-to-use system that is compatible with the software in 99% of the nation's pharmacies, coalition members said at a press briefing to announce the launch the initiative.

NEPSI also includes regional organizations, university hospitals, and medical centers, which will act as a support network for physicians who choose to use the online tool.

“According to [the Institute of Medicine], 1.5 million Americans are injured and more than 7,000 die from medication errors every year. As a practicing physician, I find that unacceptable,” said Dr. Nancy Dickey, a family physician and president of the Health Science Center at Texas A&M University in College Station.

In a report released last year, the IOM identified electronic prescribing as the single most significant step physicians can take to reduce drug-related medical errors. That report also found that many of the errors are caused by illegible handwriting, unclear abbreviations, and miscalculated doses.

“More than 3 billion prescriptions are written every year, and even though we have the technology to make this problem virtually go away, less than one in five of my colleagues are using electronic prescribing,” said Dr. Dickey, former president of the American Medical Association.

No More Excuses

Dr. Dickey said time and money have been major barriers for the adoption of electronic prescribing, despite the fact that widespread use of electronic prescribing could save the U.S. health care system as much as $27 billion, as estimated by the Center for Information Technology Leadership.

“Part of the problem is that the people who are being asked to take the time and to spend the money to put this in their offices—the physicians—aren't necessarily the ones who get the financial benefit,” she said.

That's why the coalition has come together to offer physicians an option that is not only free, but takes 15–30 minutes to learn, said Dr. Dickey.

“It is a truly easy system,” said Dr. Azar Korby, a family physician in Salem, N.H., who has been testing the software for the past year. Even someone who is not computer savvy should be able to learn the system in under 40 minutes, Dr. Korbey guessed.

NEPSI's efforts may be just the kick-start some physicians need, said Dr. Wilson Pace, director of the American Academy of Family Physicians' National Research Network and a member of the IOM committee that produced last year's report on medication errors.

“This appears to be a relatively safe way to try out something and get started for somebody who is not quite clear where they want to go,” Dr. Pace said in an interview.

There also is a growing incentive to adopt electronic prescribing, Dr. Mark McClellan said at the NEPSI launch.

Part D plans already are required to support electronic prescribing and Medicare Advantage plans are moving toward adoption of similar standards.

Even in traditional fee-for-service Medicare, the Centers for Medicare and Medicaid Services (CMS)is expanding efforts to boost reimbursement to physicians who report quality data, said Dr. McClellan, former CMS administrator and now a senior fellow at the AEI-Brookings Joint Center, a Washington think tank.

“It all fits together in supporting the movement toward electronic prescribing to get to better quality care at a lower cost.”

But this is not something that the government can achieve alone. Partners in the private sector are crucial, he said.

Patient Safety Is the Goal

To that end, the initiative is being wholly funded by the coalition of private stakeholders at an estimated cost of $100 million for the first 5 years. That is in contrast to other free electronic prescribing software that requires physicians to market personal health records or other products to patients.

The companies that are supporting and paying for NEPSI see this as an investment in the future, said Glen Tullman, chief executive officer of Allscripts Inc., which is leading the effort.

“Down the road, we're very hopeful that this encourages adoption of full electronic health records, and Allscripts is a leading provider of those health records,” he said at the briefing.

“But I want to make it very clear that our first objective is to equip every physician in the United States with electronic prescribing software that is absolutely free of charge,” in an effort to improve patient safety, Mr. Tullman added.


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