Two New e-Prescribing Reports

The Summer of 2008 will not be a time of rest for the e-prescribing and medication management industry. As part of what may be only an initial new round of industry and organizational activity, two reports have been released within the past week.

• The Center for Health Transformation has released a report entitled "Electronic Prescribing: Building, Deploying and Using E-prescribing to Save Lives and Save Money"
• The eHealth Initiative and the Center for Improving Medication Management have released a report entitled "Electronic Prescribing: Becoming Mainstream Practice"

The CHT report provides an optimistic review with a highlight of many of the activities taking place across the country. The Southeast Michigan initiative, in particular, is worth note. The report emphasizes the value realized when medication management changes are implemented in a systematic and thoughtful way.

The eHI / CIMM report has a more thoughtful, cautionary tone.

The report identifies six issues that require additional work; none of these issues prohibits effective use, but each issue must be considered carefully as policy evolves:

1. Financial cost
2. Workflow change
3. Change management
4. Ban on transmitting prescriptions for controlled substances
5. Hardware and software selection
6. Pharmacy, payer/PBM, and mail order connectivity
7. Remaining standards require approval: prior authorization, structured and codified SIG, and RxNorm.
8. Unresolved challenges in medication reconciliation

The steering group also made five very important recommendations. Summarized, they are:

1. The federal government must address the DEA prohibition on e-prescribing of controlled substances.
2. Payers, employers, health plans, health systems, and federal and state governments should consider replicating and expanding successful incentive programs.
3. Care providers across every setting of health care should adopt and effectively use e-prescribing.
4. Create a public-private multi-stakeholder advisory body to monitor, assess, and make recommendations to accelerate the effective use of e-prescribing.
5. All stakeholders should advance the e-prescribing infrastructure.The federal government and the private sector should continue, and accelerate, the development of standards for e-prescribing.

These are good reports, well worth the read before the rhetoric increases to an even greater extent.