News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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Clinical Laboratories and Pathology Groups

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Effective January 1, 2009, Physicians can get extra 2% for paperless prescribing

February 27, 2009

Medicare’s newest cash incentive program for physicians who use e-prescribing services has caught the attention of the medical community. In the months leading up to the January 1, 2009 implementation date for the physician e-prescribing bonus, the number of doctors using paperless prescribing services doubled.

The Centers for Medicare and Medicaid Services (CMS) is offering a 2% payment bonus in 2009 to physicians who get onboard. The payment incentive is intended to offset the physicians’

cost of going paperless. Physicians who make the switch will continue receiving a 1% increase until 2012. That is the carrot from Medicare, but there is also a stick. Starting in 2012, physicians not using e-prescribing will see their Medicare reimbursement reduced by 1%, a number which grows to 2% by 2014.

The CMS E-Prescribing Incentives program worked magic: e-prescription volume began rising 15% per month in August, up from 5% to 8% previously, as physicians began gearing up for the January launch. According to SureScripts, an estimated 70,000 physicians participated in e-prescribing 2008. By contrast, just 35,000 physicians were using paperless prescribing services in 2007.

The significant point is that e-prescribing is still an infant trend. Approximately 3.5 billion prescriptions are issued each year. The increase in physician participation during 2008 boosted e-prescription volume to 100 million, compared to 35,000,000 e-prescriptions in 2007.

The pharmacy industry is ahead of physicians in its adoption of e-prescribing. About 70% of the nation’

s pharmacies are already connected to the Pharmacy Health Information Exchange network, including all the major chains, according to SureScripts, the company that operates the prescription routing network. Yet, less than 10% of U.S. physicians use this tool due to initial cost to implement and lack of knowledge about e-prescribing technology and time or staff to digitize patient medication histories.

Patient safety is a primary reason why Medicare wants to encourage widespread use of e-prescriptions. Statistics indicate that up to 1.5 million Americans are harmed by medication mistakes. Among other things, electronic prescribing is expected to eliminate errors due to poor handwriting, while making it possible to check for adverse reactions with a patient’

s other drugs.

E-prescribing is a trend which will touch upon laboratories across the country. That’s because laboratory test data plays a role in many decisions to prescribe. In recent years the Care360 Physician Portal that Quest Diagnostics Incorporated offers to physicians has included an e-prescribing function. Among other things, it allows physicians to “identify drug-interactions within a prescription and provide available drug/allergy interaction checking.”

Another laboratory portal product which offers e-prescribing capabilities is 4Medica, Inc. of Culver City, California. Its laboratory test ordering/results reporting system includes a module called Meds4IHR. Among its features are:

• Eligibility and formulary checking
• Automatic alerts and notifications
• Drug to drug interactions
• Drug to allergy interactions

Drug to lab interactions

At the upcoming 14th Annual Executive War College on Laboratory and Pathology Management, 4Medica CEO Ravi Sharma will conduct a session on how laboratories can incorporate e-prescribing features into the interface solutions for lab test ordering/results reporting that they offer to office-based physicians.

Dark Daily predicts that, within a few years, most laboratories will be doing two things. One, laboratories will have interface solutions with physicians’ EMRs (electronic medical records) that, among other functions, provides both relevant lab test data and automatic flags to guide physicians during the prescribing process. Two, like Quest Diagnostics and 4Medica, many laboratories will build an e-prescribing module into the solution they offer physicians for electronic lab test ordering and results reporting.

P. Kirk

Related Information:
Medicare to pay docs to switch to paperless prescriptions

CMS Web Page on E-Prescribing

“How To”

Implement the Medicare E-Prescribing Incentive Program

Medicare: E-Prescribe … Or Else—Docs’ reluctance to go online will result in federal penalties

Executive War College on Laboratory and Pathology Management

4Medica CEO Ravi Sharma Information