Generic Resources

HHS Postings

• 27-Jan-05 HHS Proposes New Medicare E-Prescribing Rules Process Will Improve Quality, Accuracy
• 4-February 2005 - Federal Register proposed rules for e-Prescribing
• 7-November 2005 - Rederal Register final rules for e-Prescribing
• 17-Jan-06 HHS Announcement of e-Prescribing Pilots

NCVHS Links

• 2-Sept-2004 Report to Secretary Thompson on e-prescribing
• 13-August-2004 E-Prescribing work plan
• 4-March-2005 Report to Secretary Leavitt on electronic signatures
• June 22, 2006 Letter to Secretary Leavitt on HIPAA update
  
  

eHealth Initiative Report - 2004

• Final Report (154 pages)
• Executive Summary

What are the Critical Standards?

• NCPDP Formulary & Benefit Standard
• Medication History function of NCPDP SCRIPT
• Fill Status function of NCPDP SCRIPT
• Prior Authorization (X12N 278)
• RxNorm
• Structured & Codified Sig
  
• Follow this link to the Health Information Technology Standards Panel (ANSI) site

NCPDP Links

• Script v8.1 impact
  
• Script and standards matrix
• NCPDP letter to CMS on LTC e-prescribing (25-Jan-2006)
  
  

Other Presentations
The Who, What, When, and Where of the MMA 2006 E-Prescribing Pilots (Ken Wittemore, Surescripts) - ppt

Medicare Drug Benefit Resources

• Kaiser Family Foundation resources
• PHRMA Study on Medicare Part D

NACDS

• State tracking on electronic transmission / e-Rx
  

CMS Pilots

• CMS eRx RFA

RAND Corporation

RAND Corporation, Santa Monica, Calif., in conjunction with the New Jersey E-Prescribing Action Coalition, an industry-academic partnership involving RAND Health; Horizon Blue Cross Blue Shield of New Jersey; the e-prescribing vendors AllScripts, Caremark iScribe, and InstantDx; Caremark's prescription benefit management plans; the electronic prescription routing companies RxHub and SureScripts; Caremark's mail-order pharmacy and Walgreen's retail pharmacies will conduct the pilot in New Jersey. In addition to testing the standards, the project will determine changes in drug use, clinical outcomes, and patient satisfaction as a result of e-prescribing.

• Bell et. al. A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities. JAMIA 11(1), 2004: 60-70.
• figure from above article - conceptual framework

There are various conditions under which e-prescribing takes place:

• No e-prescribing - paper and fax only.
• E-prescribing with only the foundation SCRIPT functions for new and renewal prescriptions - a minimalist approach
• e-prescribing with the inclusion of a broader package of standards added to SCRIPT, including eligibility

an alternative formulation (mef):

• Paper and fax
• e-Rx on computer to Fax to pharmacy
• e-RX with minial SCRIPT functionality transmitting to pharmacy or through RxHub
• e-prescribing in the context of a full-blown CDS and EHR (along the lines of a CITL top-level interoperable system)

Brigham and Women's Hospital

Brigham and Women's Hospital, Boston, Mass., in conjunction with physician practices in Massachusetts associated with a hospital network, will use an existing community utility for e prescribing called the eRx Gateway. The pilot will test the e-prescribing standards and will conduct needed research into ambulatory drug safety and the impact of e-prescribing on physician workflows.

SureScripts

SureScripts, Alexandria, Va., partnering with Brown University and five vendors (Allscripts, DrFirst, Gold Standard, Medplus/Quest Diagnostics, ZixCorp.) will recruit physicians and pharmacies for participation in Florida, Massachusetts, Nevada, New Jersey, Tennessee, and potentially Rhode Island. The pilot will evaluate how the e-prescribing standards work in a variety of practice settings, geographic areas, and e-prescribing technologies. In addition, the project will assess how prescriber and vendor characteristics influence e-prescribing adoption and what "best features" of vendor software improve medication-related safety outcomes.

Three standard information flows:

• NewRx - new prescription generated by prescriber , sent to SureScripts, sent to pharmacy, and picked up by patient
• RefReq - request for refill generated by pharmacy, sent to prescriber, approval given, and patient picks up medication from pharmacy
• RefRes - request generated by prescriber, sent to SureScripts, sent to pharmacy, filled, and picked up by patient

Achieve Healthcare Information Technology

Achieve Healthcare Information Technology, Minnesota, in conjunction with nursing facilities in Minnesota associated with the Benedictine Health System and Preferred Choice Pharmacy will be the first program to evaluate how the e-prescribing standards work in certain long-term care settings. The project also will assess the impact of e-prescribing on the workflow among prescribers, nurses, the pharmacies and payers.