e-Prescribing Crash Course


By Neil Versel, contributing editor

October 14, 2008 | Acting Centers for Medicare and Medicaid Services (CMS) administrator Kerry Weems called last week’s national conference on electronic prescribing a “crash course in e-prescribing.” The Oct. 7 event brought more than 1,400 physicians, pharmacists, practice administrators, health-IT professionals, vendors, and government representatives to Boston for an intensive study of the technology ahead of a Medicare incentive program that begins in January. (See “CMS Focuses on E-Prescribing.”)

If there is such thing as a textbook from the course, it would be “A Clinician’s Guide to Electronic Prescribing,” also suitable for independent study. “It’s a guide developed by doctors for doctors,” says Janet Marchibroda, chief executive of the eHealth Initiative, the not-for-profit organization that released the document last week.

The 40-page how-to guide is meant to educate physicians and other prescribers about the cost-saving and patient-safety benefits of e-prescribing in the short period of time before CMS starts paying a 2 percent bonus for writing electronic prescriptions for Medicare beneficiaries on Jan. 1. The guide also walks practices through the IT selection and implementation processes and provides a state-by-state list of e-prescribing initiatives and promotions already in place.

The guide discusses workflow considerations for practices considering moving to e-prescribing, including a current major hurdle, the U.S. Drug Enforcement Agency’s prohibition on electronic prescribing of Schedule II controlled substances. Under much pressure from members of Congress and from Bush administration health care officials, the DEA has proposed rules for e-prescribing controlled substances, though that proposal has been controversial.

“The DEA rule as written represents a separate process [for clinicians to follow,]” says Mark Gorden, director of policy for the eHealth Initiative. “No one’s going to do it.”

Weems promises to publish guidelines for the incentive program by Nov. 15. For now, CMS expects to exclude controlled substances from the bonus plan.

“The best thing to do until they get all the bugs out [of the DEA plan] is to leave that out of the bonus,” Gorden says.

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