AHIC Recommends E-Prescribing Mandate For Medicare

E-Prescribing

The American Health Information Community on Wednesday recommended that HHSSecretary Mike Leavitt seek authority from Congress to mandate electronicprescribing in Medicare, CQ HealthBeat reports. AHIC, the public-private advisory group convened by Leavitt,reached the decision during a conference call on Wednesday that includedLeavitt and Robert Kolodner, the agency's national coordinator for healthinformation technology.

The recommendations would allow Leavitt to make exceptions to the mandate athis discretion, according to CQ HealthBeat. AHIC also recommendedthat the agency create incentives for physicians and pharmacies that usecertified electronic health record systems; allow prescriptions to beelectronically submitted to the pharmacy chosen by a patient; and authorize theAgency for Healthcare Research and Quality to designate patient safetyorganizations that would monitor and address any potential problems withe-prescribing.

The group's recommendations follow a proposal by CMS thismonth that would develop new standards in e-prescribing to supplement thosealready adopted by the agency governing transactions between physicians andpharmacies. Medicare does not require e-prescribing, but health and stand-aloneprescription drug plans that provide Medicare Part D coverage must have thecapacity to support e-prescribing and must follow CMS' standards.

In a statement, AHIC board member and Blue Cross andBlue Shield Association President and CEO Scott Serota said AHIC's decision "is a clearsignal that Congress must act now to protect senior and disabled beneficiariesfrom preventable medication errors that cost billions and harm millions everyyear" (Carey, CQ HealthBeat, 11/28).

Letter to the Editor

Sen. John Kerry (D-Mass.)and former House Speaker Newt Gingrich (R) in a Nov. 16 Wall StreetJournal opinion piece made "a strong case for adoption" ofe-prescribing and "acknowledge the lack of alignment of financialincentives as a major barrier to what would seem like a 'no-brainer'implementation decision," but they "fail to mention a couple ofcomplicating factors," Steven Hanks, chief medical officer of The Hospital of Central Connecticut, writes in a Journal letter tothe editor.

Hanks writes that "in order for electronic prescribing to be trulyeffective, the information has to flow bidirectionally" because"[m]any patients have prescriptions written by a multitude ofpractitioners" that are "filled at a number of differentpharmacies." In addition, "Uninsured individuals sometimes 'borrow'insurance cards of insureds in order to access needed medications." Hankssays, "E-prescribing systems will do little to protect against errors ineither of these regards."

He concludes, "We should absolutely forge ahead with e-prescribing," and those involved "should simultaneouslywork to assure that all the data repositories talk to one another and that somemethod of definitely identifying patients, such as a biometric standard, beadopted as well" (Hanks, Wall Street Journal, 11/29).

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