Your source for the latest news and events on E-Prescribing and the Health IT community, as well as an open discussion forum for medical and prescription management. Blog.DrFirst.com brings together physician practices, IPAs, hospitals, health plans, pharmacies and many others.

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Weill Cornell Medical College and one of their research teams led by Dr. Rainu Kaushal authored a study published on February 26th in the online version of the Journal of General Internal Medicine on how using an electronic system, instead of writing prescriptions by hand, affects the frequency of prescription errors among ambulatory physicians.
The study closely reviewed 30 health care providers and the 7,000+ prescriptions they wrote over the course of one year. The clinicians using an electronic prescribing system began the study with an above average error percentage at 42.5%, but ended the year long study with only 6.6%, an impressive seven fold decrease. The 15 clinicians writing prescriptions by hand actually saw a very slight increase in the percentage of prescription errors as they went from 37.3% to 38.4% by the end of the year.

Survey Shows Increased Confidence in Meeting Meaningful Use for Healthland Users
Healthland, a DrFirst Certified Partner, has just released the results collected from a February, 2010 survey on the ARRA incentives and Meaningful Use criteria at the HIMSS10 Conference.
The study surveyed over 100 critical access and small community hospitals from across the country, asking respondents to share how they feel their knowledge of the ARRA incentives and Meaningful Use guidelines has changed compared to just 1 year ago.

As industries across the country are recognizing both the ecological and economical benefits of adopting so called “green practices,” it is time for the healthcare industry to take a step forward and join the fight!
Only a few years ago being environmentally conscious entailed recycling and trying take advantage of public transportation. Recent advances in technology have allowed all industries to capitalize on both the cost saving and waste reducing benefits of the electronic systems available.
For the medical world, going green is almost synonymous with going electronic – or going paperless. Just how the banking industry has evolved into a nearly entirely online system, the medical industry has the potential to be close behind with the adoption of electronic prescribing and EMRs.
The word is out:
Starting in 2011 and ending in 2015, physicians and other “eligible professionals” who see Medicare and Medicaid patients will potentially receive between $44,000 – $64,000 in HITECH stimulus incentives under the American Recovery and Reinvestment Act (ARRA) passed and signed into law early last year.
Although every group practice and physician’s decision to get involved requires individual considerations, here are some very brief thoughts:
Paraphrasing “Maslow’s Hierarchy of Needs” in the Health IT world, e-prescribing is a proven, off-the-shelf, low-cost, low-risk first step towards computerizing clinical functions and populating an EHR with data. To help moderate IT investment costs, practices should consider adopting a strategic approach in which e-prescribing is the first clinical application as part of your overall health IT system – with other applications and functions added in a modular fashion over time.
The benefit of doing this is that a practice can make a very small initial investment in the standalone e-prescribing system while receiving current annual incentives averaging $2,000+ a year (MIPPA – in effect as of 1/1/09). Later on – a practice can scrutinize more knowledgeably the potential $44K over a 4 year period through ARRA beginning eligibility in 2011 (up to 64k for high volume Medicaid clinicians).
In addition, this approach allows your staff to ease their way into the clinical workflow changes surrounding the adaptation of new technology instead of taking one giant leap. Plus, so-called “Cloud Computing” represents one of the new approaches that have great promise in terms of being less costly overall and allowing flexibility and choice especially for small practices. DrFirst works with nearly 100 EMR/PMS vendors who can work with you on this stepping stone process of taking baby steps into your future EMR.
Should I try a free e-prescribing system?
I would advise caution to physicians who are thinking about getting a free e-prescribing program. Frequently, the ultimate goal of these “free” vendors is start with sub-standard or mediocre e-prescribing in hopes of leading physicians into purchasing an expensive, full package EHR from the same vendor in the future. In addition, the free programs usually require a la carte upgrades to make the product truly usable in an office setting. This is truly an example where “free is not cheap enough”. On the other hand, these upgrades come standard with most e-prescribing systems that require a fee, along with better customer service, better features, and fewer headaches.
DrFirst’s partnerships allow clinicians to move their patient data to one of our Certified Partners and selectively choose the right EMR for their practice based on factors such as specialty, financial resources, and workflow, as well as local support and market penetration of the vendor. Local support and penetration may be important factors when considering the potential for interoperability.
Stay tuned to these blogs as the field is rapidly evolving
* The requirements to actually see the money are a bit lengthy and complex. The interim proposed specifications and rules were released on December 30, 2009 and are subject to final tweaks and comments that will be published by CMS in late spring 2010.
** They generally revolve around employing Health IT tools and certain functions characterized as ”Meaningful Use” that are just starting to become incorporated in selected EMR/EHR packages.
Tom Sullivan, MD
*http://www.cms.hhs.gov/Recovery/11_HealthIT.asp
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3561

Your chance to voice your opinion on the previously announced meaningful use requirements and the interim final rule on the Standards & Certification Criteria is quickly coming to an end on March 15th.
This 60 day comment period that began in mid-January is the public’s last opportunity to offer their invaluable suggestions before the proposed rules are finalized for 2011. We can all agree that these rules will inevitably change over the years as the needs of the industry and the capabilities of technology change, but this first set of guidelines is the foundation for the years to come. It is important for the public to comment on these guidelines because the public will be directly affected but their outcome. The health IT industry needs to step up and voice our opinions to ensure that our needs and concerns are heard and acted upon.


