NCPDP Script Standard Adopted as Core Requirement for ePrescribing in Meaningful Use

The National Council for Prescription Drug Programs (NCPDP) today acknowledges and applauds the U.S. Health and Human Services Department (HHS) on its Final Rules announcement on “meaningful use” of an Electronic Health Record (EHR), including the adoption of NCPDP SCRIPT Standard for the secure, electronic transmission of prescriptions and prescription-related information.

The Final Rule on Standards to meet Meaningful Use announced the NCPDP SCRIPT Standard Implementation Guide Version 8, Release 1 (Version 8.1) October 2005 or NCPDP SCRIPT Standard, Implementation Guide, Version 10.6 can be used. This allows flexibility for those prescribers – eligible practitioners, hospitals, provider associations, state and federal governments, software vendors and more – that already are using the SCRIPT Standard as well as flexibility for implementers.

“The Final Rules will help clinicians achieve better and more effective patient care,” stated Lee Ann Stember, President of NCPDP. “We are very pleased with the Final Rule as it relates to ePrescribing and using the NCPDP SCRIPT Standard to achieve Meaningful Use.”

The NCPDP SCRIPT Standard was first published in 1997 and has been updated annually based on the business needs identified by the industry. SCRIPT is a standard created to facilitate the transfer of prescription data between pharmacies, prescribers, intermediaries and payers. This standard allows for quick and accurate communication between the prescriber, pharmacist and payer to provide information for the prescriber and pharmacist to make informed decisions with the patient while reducing the potential for medication error.

Source: http://www.eprescriptionservices.com/ncpdp-script-standard-adopted-as-core-requirement-for-eprescribing-in-meaningful-use/

CMS Recognizes Updated E-Prescribing Standard for Medicare Part D

In an interim final rule released Tuesday, CMS “recognized” the use of version 10.6 of the National Council for Prescription Drug Programs SCRIPT Standard for electronic prescribing under the Medicare Part D drug benefit, Health Data Management reports.

According to CMS, “recognition” means the agency approves the use of the updated standard for e-prescribing; however, it is not yet formally adopted as the new standard.

New features in the version 10.6 standard will allow users to provide:

• Prescriber order numbers;
• Drug NDC source data;
• Pharmacy prescription fill numbers; and
• Date of prescription sale.

According to CMS, the new functions will “facilitate better record matching, the identification and elimination of duplicate records, and the provision of richer information to the prescriber between willing trading partners.”

CMS plans to publish the final version of the interim final rule on July 1 (Goedert, Health Data Management, 6/29).

Source: http://www.eprescriptionservices.com/cms-recognizes-updated-e-prescribing-standard-for-medicare-part-d/

E-prescribing growing, but most practices still don’t use it

By Pamela Lewis Dolan,

A new report finds a significant uptick in the number of physicians who prescribe electronically. But the e-prescribers still only account for about one in four physicians, or 26% of office-based doctors.

The numbers come from Surescripts, which operates the nation’s largest e-prescribing network. It released its annual e-prescribing progress report on March 2. The report found that although there was significant progress in adoption of electronic prescribing, there are still barriers to overcome.

The report found that the percentage of eligible prescriptions sent electronically increased from 6% to 18% from the end of 2008 to the end of 2009, as measured by tracking traffic through the Surescripts network. The 2009 total represented 190 million out of about 1.6 billion eligible prescriptions for an overall annual rate of 12%, according to the report, “Advancing Healthcare in America.”

“For e-prescription use to jump from 6% to 18% in one year indicates several things,” said Harry Totonis, president and CEO of Surescripts, in a prepared statement. “First, that the federal government’s leadership and incentive structures are working. Second, that the benefits of e-prescribing — including increased safety, lower costs and increased efficiency — are widely understood. And last, that the nation’s experience with e-prescribing — in building the network and the ecosystem to support it — provides a definitive road map for how to drive adoption of a broader electronic health record for all Americans.”

The Surescripts report found that about 70% of physicians who do e-prescribe use an application on their EMRs. Company spokesman Rob Cronin said many EMRs might not have been certified in 2009 for e-prescribing under the rules that qualify physicians for incentives. Many of those systems are now becoming certified, and that accounted for a large chunk of the e-prescribing growth.

On the subject of electronic prescribing’s safety benefits, in February Weill Cornell Medical College in New York released the results of its study comparing the safety of e-prescribing with paper-based prescribing.

The authors found that nearly two of every five paper prescriptions contained an error. The authors reviewed 3,684 paper-based prescriptions at the start of the study, and 3,848 paper-based and electronic prescriptions written one year later. It found that after a year, the percentage of errors dropped from 43% to 7% for physicians and other prescribers using the electronic system.

The Centers for Medicare & Medicaid Services e-prescribing incentives, which started in January 2009, also were a motivator for adoption of electronic prescribing, according to Surescripts. And the incentives that will be made available through the American Recovery and Reinvestment Act to stimulate EMR growth are expected to motivate even more to adopt e-prescribing, experts said. E-prescribing is one criteria that must be met to qualify for EMR incentive money.

Also cited as drivers of e-prescribing adoption were numerous public and private efforts, including the American Medical Association’s June 2009 introduction of its Zero-In Rx e-prescribing learning center.

But some experts wonder if e-prescribing adoption rates would be higher if it weren’t for a Drug Enforcement Administration rule that requires all controlled substance prescriptions be written on paper.

David Hunt, MD, officer of provider adoption support for the Office of the National Coordinator for Health Information Technology, told a crowd of physicians and others gathered in March for the annual meeting of the Healthcare Information and Management Systems Society that he himself doesn’t e-prescribe because of the DEA issue. Dr. Hunt, a surgeon, said a large percentage of his prescriptions are not eligible for electronic submission. Instead of running his practice with two workflows, to incorporate e-prescribing, he said he has stuck with his paper pad.

Other experts say physician resistance to e-prescribing is not as clear-cut.

In New Hampshire, for example, there was an aggressive campaign launched in 2007 aimed at getting 100% of physicians e-prescribing within one year. New Hampshire State Rep. Cindy Rosenwald, whose husband is a cardiologist, said that three years later, 50% of doctors in New Hampshire use some form of an EMR, but only 20% have e-prescribing capabilities.

“That’s going to be a huge challenge for us,” Rosenwald said at a public policy forum held during HIMSS, which met in early March in Atlanta.

Rosenwald said another contributing factor in New Hampshire could have been a state law that was passed, after the e-prescribing initiative was announced, giving patients the right to a paper prescription for the purpose of shopping around.

Other barriers mentioned by Surescripts in the report were the limited number of state Medicaid programs that can provide formulary and eligibility information to prescribers.

It also says prescriber and pharmacy directories need to be maintained actively to ensure that prescriptions that can be sent electronically are transmitted electronically as often as possible. Generally, a prescription that is sent electronically but comes to the pharmacy as a fax — because the pharmacy doesn’t have the technology to accept the transmission — is not considered e-prescribing.
ADDITIONAL INFORMATION:

2007 2008 2009
Electronic prescriptions 29 million 68 million 190 million
New prescriptions 24 million 55 million 156 million
Renewal requests 5 million 13 million 35 million
Overall growth 131% 180%
Active e-prescribers 36,000 74,000 156,000
Connected pharmacies 41,000 46,000 53,000

Source by Surescripts

Above article publish on http://www.eprescriptionservices.com/eprescribing-growing-practices/

e-Rx growth accelerates, and DEA ruling could spur more adoption

By Neil Versel

Just as predicted at the end of 2008, e-prescribing volume nearly tripled in 2009, according to prescription transaction network Surescripts. And the growth has picked up this year.

Surescripts reports that U.S. prescribers wrote 191 million electronic prescriptions in 2009, up from 68 million a year earlier. That accounts for about 12 percent of all 1.63 billion original prescriptions–not refills–of all scripts written last year. For the first three months of 2010, nearly 20 percent of all new scripts have been filed electronically.

To date, about one-quarter of office-based physicians nationwide have e-prescribing technology, even if they aren’t all using it, Surescripts adds, about twice the rate at the end of 2008.

The rapid growth could further accelerate as the Drug Enforcement Administration moves to lift a restriction on e-prescribing of controlled substances. Last month’s DEA interim final rule “is what we’ve all been waiting for,” Dr. John Halamka tells the Wall Street Journal. “Now we can write prescriptions for Lipitor and Valium on the same program,” adds Halamka, CIO of Boston’s CareGroup Healthcare System and an emergency physician at Beth Israel Deaconess Medical Center.

For more information:

- read this Wall Street Journal story, which includes a discussion of the safety benefits of e-prescribing

Above article publish on http://www.eprescriptionservices.com/erx-growth-accelerates-dea-ruling-spur-adoption/

MIPPA Provides Incentives for E-Prescribing

By Rich Silverman

American health care providers write close to 3 billion prescriptions per year, according to a number of estimates, with about 80% of them being written by hand. A recent study conducted by the Weill Cornell Medical School in New York found that about 4 of every 10 handwritten prescriptions had an error while the rate of errors found in electronic prescriptions is around one-seventh of that, or about 6%.

If those numbers hold true, then almost 1 billion prescriptions each year have an error in them. Small wonder, then, that the government has enacted legislation to encourage providers to switch to electronic prescribing.

Amid the sea of health technology acronyms like HIPAA, HITECH, HIT and EMR floats one we’ve not addressed so far – MIPPA, the Medicare Improvement for Patients and Providers Act of 2008 (we’re really not making this one up). The act contains provisions relating to a host of issues such as physician quality reporting, physician payments and – the one we’re addressing here – electronic prescribing.

Structured with incentives to encourage physicians to adopt electronic prescribing, MIPPA provides for payments of up to 2% of qualifying Medicare billings during 2010 by using a qualified e-prescribing or Electronic Health Record system that meets all of the following requirements:

* Generates a complete active medication list
* Selects medications, prints and electronically transmits prescriptions and conducts all alerts
* Recommends available alternatives that are less expensive and therapeutically appropriate
* Provides information on tiered formulary medications, eligibility and insurance authorization
* Meets specified software technical requirements

Incentives will continue at up to 2% through 2010, drop to 1% in 2011 and 2012, and .5% in 2013. Beginning as early as 2012, penalties for NOT using e-prescribing can and will be assessed by Medicare, rising to as high as a 2% reduction in payments.

As with all government programs, there is a host of fine print to wade through, and there are multiple ifs and ands to deal with, but the overall program does provide incentives to you to adopt electronic prescribing. To help you navigate all that verbiage, HHS has created a comprehensive FAQ section on its website.

If you expect to qualify for incentive payments offered by the government for the adoption of an EMR/EHR system, you will need to be engaged in e-prescribing, because e-prescribing will be an integral part of the definition of meaningful use. And grumble all you want about how that implementation of an e-Prescribing system may require work up front, but the benefits that will accrue to you down the line, such as reduced errors and far fewer phone calls using up your staff time to resolve prescribing problems, will more than make up for it.

http://www.eprescriptionservices.com/mippa-incentives-eprescribing/

DEA issues interim e-prescribing rule

By Joseph Conn

The Drug Enforcement Administration has issued an interim final rule regulating electronic prescribing of controlled substances.

The 334-page rule also contains a request for comments. The rule affords prescribers the option of writing e-prescriptions for controlled drugs and also applies to pharmacies and hospitals.

According to a summary of the rule, it will “reduce paperwork for DEA registrants who dispense controlled substances and have the potential to reduce prescription forgery.”

“The regulations will also have the potential to reduce the number of prescription errors caused by illegible handwriting and misunderstood oral prescriptions,” according to the summary. “Moreover, they will help both pharmacies and hospitals to integrate prescription records into other medical records.”

The effective date of the rule is 60 days from its March 31 publication in the Federal Register, but as a “major rule,” it is subject to congressional review and, consequently, its effective date could be adjusted.

Above article publish on http://www.modernhealthcare.com/article/20100325/NEWS/100329985/1134