Medco Leads the Way in ePrescribing for Medicare Part D

This wire release is a few days old, but strengths my belief in Medco as a positive force in the dirty world of PMBs. Granted they had net revenue of $42 BILLION in 2006, and they wouldn't do anything that doesn't improve their bottom line, but sometimes, big companies do good things. Well, this could be a good thing if they prove it increases profits and they roll out the program! This leads me to another point which is doctor's doling out medications in the office. I have never been to an MDs office that fill scripts, but I think this would greatly reduce medication errors as well.

FRANKLIN LAKES, N.J., Feb. 12 /PRNewswire-FirstCall/ -- As Congress
considers a bill that would tie physicians' Medicare payments to their use
of ePrescribing technology, Medco Health Solutions, Inc. (NYSE: MHS) today
announced the launch of a national initiative to assist physicians of
Medicare Part D patients in switching from hand-written to electronically
generated prescriptions. The pilot program will also be used to study the
impact of ePrescribing on patient safety, increased generic drug use and
formulary compliance on the Medicare population.

"There is strong evidence that ePrescribing reduces medication errors
and increases the use of generic drugs and other lower-cost medication
options. We are proud that Medco will be the first Medicare prescription
drug plan (PDP) to research its impact on the Medicare population," said
John Driscoll, president of new markets at Medco. "The program is designed
to overcome the cost barriers that have prevented widespread physician
adoption of this technology and to verify the benefits of ePrescribing for
Medicare Part D beneficiaries."

Initially the study will include 500 physicians currently treating
enrollees in the Medco Medicare Prescription Plan(TM). Medco -- working
with RxNT, a leading provider of ePrescribing technology - will provide
these physicians with free RxNT ePrescribing software and training. Over a
six- month period, the physicians' rate of generic drug dispensing,
formulary compliance and generated safety alerts will be compared to a
control group of 500 doctors who did not receive ePrescribing software or
training. Ultimately, 2,000 doctors, primarily general practitioners and
internists, will participate in the ePrescribing program.

Advantages of ePrescribing

The Centers for Medicare and Medicaid Services (CMS) estimates that
nationally, use of e-Prescribing technology could eliminate as many as two
million harmful drug events each year. The benefits of ePrescribing
technology include reducing potentially harmful drug interactions by
alerting physicians to possible risks and eliminating illegible physician
hand-written prescriptions that can lead to medication dispensing errors.
Additionally, ePrescribing has been shown to promote the use of generic
drugs and increase formulary compliance, saving money for both patients and
health plans. Despite these benefits, only about three percent of U.S.
physicians actively use ePrescribing technology.

Medco Leads the Way on ePrescribing

This is Medco's second major ePrescribing effort. In 2005, Medco joined
forces with the three largest U.S. auto companies - General Motors, Ford
and Chrysler - to launch the Southeast Michigan ePrescribing Initiative
(SEMI). Between 2005 and 2007, approximately 2,700 participating physicians
have generated nearly 6.2 million prescriptions using ePrescribing
technology.

A recent analysis of SEMI found that ePrescribing substantially
improved patient safety by alerting physicians of risks related to drug
interactions and other potential medication errors and resulted in a
significant number of prescription changes that prevented potential adverse
events. Formulary compliance also improved. The review of 3.3 million
electronic prescriptions showed:


-- A severe or moderate drug-to-drug alert was sent to physicians for more
than 1 million prescriptions (33 percent), resulting in nearly 423,000
(41 percent) of those prescriptions being changed or canceled by the
prescribing doctor;
-- More than 100,000 medication allergy alerts were presented, of which
more than 41,000 (41 percent) were acted upon; and
-- When a formulary alert was presented, 39 percent of the time the
physician changed the prescription to comply with formulary
requirements.

"The SEMI program results show that ePrescribing can have a big impact
on patient safety and overall health care costs," continued Driscoll.
"Medicare Part D provides the right opportunity to introduce many more
physicians to ePrescribing, a key step toward improving patient safety for
this critical segment of the population and reducing the cost of
prescription health care in the Medicare program."

Dr.First For The iPhone

With mobile platforms opening up to outside vendors more and more applications can be developed. For medication adherence, eprescribing plays a role - mostly with medication errors, which account for 12% of so of all medication non-adherence. Can you read your MDs handwriting? Dr.First is a great application and now an MD can send the prescription in while speaking to the patient and it will be ready for pick-up by the time the patient gets to the pharmacy. I am also a fan of tablet PCs, where MDs can also access their patients EHR, but I haven't seen any news about them lately.

This is right off the BUSINESS WIRE:
ROCKVILLE, Md.--(BUSINESS WIRE)--DrFirst™, the leader in electronic prescribing and medication reconciliation services, today announced that physicians will have access to an unparalleled e-prescribing experience on the Apple iPhoneTM through DrFirst’s RcopiaTM e-prescribing system. For the first time, physicians and their staff will be able to perform all of the essential functions of electronic prescribing in real-time on a mobile browser through a WiFi or wireless carrier’s broadband connection.

RcopiaMini is formatted for the smaller screen of today’s mobile devices and allows providers to easily navigate a full-featured version of Rcopia on this exciting new platform. DrFirst designed the application to provide a real-time interaction between physicians, pharmacies, and health plans, so there is no need to update or sync the device.

“Now physicians can quickly, safely, and securely prescribe from anywhere—through the always-on connectivity of the iPhone, the WiFi connection of the iPod Touch, or while seated at the desktop computer in the practice,” said Peter N. Kaufman, Chief Medical Officer of DrFirst, Inc.. “DrFirst’s goal is to ensure that its new web-based, mobile Rcopia experience delivers the same high levels of innovation and usability as the original Web version.”

To be useful to physicians, e-prescribing must be easily and securely accessible. With the addition of the iPhone and iPod Touch, DrFirst provides physicians with a broad set of eprescribing platforms, including Apple, Treo, and HP iPaq handheld devices as well as desktop and tablet systems.

E-prescribing on the iPhone with RcopiaMini allows physicians to provide a higher level of patient service and safety, streamline practice workflows, and save time and money through the efficiency of electronic medication orders, renewals and formulary checking. New prescriptions and renewals are sent electronically to the patient’s retail or mail order pharmacy.

RcopiaMini checks for patient insurance eligibility, formulary, and patient medication history. The application also offers clinical decision support tools to check prescriptions for drug-drug and drug-allergy interactions and appropriate dosing.

Busy doctors, large practices, and health systems require software that is adaptable to the practice workflow and that draws the practice staff into the prescribing process. To meet this need, RcopiaMini is designed to be accessible to all staff members, to be highly configurable and to accommodate workflow features that make it a perfect solution for
groups of any size.

Online Rx program helping cut errors

Just an article about the automakers efforts to implement ePrescribing.

From the Detroit News by Sofia Kosmetatos

Online Rx program helping cut errors
Big 3's e-drug plan boosts the use of generics while reducing glitches, analysis shows.

A Big Three-driven effort to replace prescription pads with computers is significantly reducing patient risk from medication errors and helping increase generic drug use, according to an analysis released today by the Southeast Michigan ePrescribing Initiative.

Launched nearly two years ago, the first review of the initiative shows that it is not only protecting patients from the harmful consequences of medication errors, but is also helping them have better discussions with their doctors about medications at the time a prescription is written.

"The benefits of ePrescribing are overwhelming in terms of reducing medication errors, lowering prescription drug costs for patients and plans, and decreasing physician practices' administrative costs," said Marsha Manning, General Motors Corp.'s manager of Southeast Michigan Community Health Care Initiatives, in a statement.

Through the initiative, doctors access online software on computers in patient rooms to write the prescriptions, prompting discussions about generic alternatives, drug interactions and allergies at the time a prescription is written. The results are savings on drug costs and fewer medical complications, doctors and coalition members say. EPrescribing also eliminates doctors' handwriting as a source for error, and saves patients and doctors' offices time because the scripts are sent to pharmacies electronically.

The analysis of a sample of 3.3 million prescriptions showed:
• The ePrescribing technology sent alerts of severe or moderate drug interactions to doctors for about one-third of those prescriptions. Doctors changed or canceled 423,000 (or 41 percent) of those prescriptions.
• The technology informed doctors of more than 100,000 medication allergies, and doctors acted on 41,000 of these alerts.
• When an alert showed a drug was not on a formulary, the doctor changed the prescription to comply 39 percent of the time.

The initiative, involving the automakers, Henry Ford Health System, Blue Cross Blue Shield of Michigan and others, aimed to help doctors set up electronic prescribing in their offices.

The three automakers -- GM, Ford Motor Co. and Chrysler LLC -- are involved because they think the initiative can cut down on their health care costs, which add up to billions of dollars. So far, some 6.2 million prescriptions have been written by 2,500 doctors using ePrescribing technology, with more than 282,000 written each month. The coalition plans to extend the initiative through March 2008.

Generic drug use up
GM spokeswoman Carey Osmundson said it's difficult to quantify how much the company has saved with ePrescribing, but GM has seen increases in its rates of generic drug prescribing and compliance with preferred drug lists, both of which save money. For each 1 percent shift to generic drugs from a brand name, GM saves nearly $20 million, she said.
GM spent $1.5 billion on prescription drugs alone last year for 1 million enrollees, a growing tab it had worked for years to stem.

Henry Ford Health System conservatively estimates it is saving $4 million a year with ePrescribing, mostly from switching HAP patients from brand-name drugs to less costly generic alternatives.

That's not including the savings patients see from reduced co-payments, said Matt Walsh, associate vice president of purchaser initiatives at Health Alliance Plan, a health insurer owned by Henry Ford.

Royal Oak's Dr. David Allard was one of the first Henry Ford doctors to use ePrescribing. His office has had electronic medical records for years, but had relied on pen and paper for prescriptions until January 2005. He says his staff saves a lot of time that used to be spent on the phone with pharmacies handling prescription refills and questions on scripts. "That was hours a day in my office," he said.

But more importantly, he sees the benefit in reducing the potential for errors. Refilling prescriptions, for example, involved a lot of hand-offs between staff members and interaction with pharmacies. With each step came a chance for a mistake.

Handwriting kills
More attention is being focused nationally on drug errors and how to avoid them. According to an Institute of Medicine report issued last year, drug errors kill 1.5 million Americans each year. The report said eliminating handwritten prescriptions is the most vital step health care providers must take to cut down on errors, and recommended that all prescriptions be written electronically by 2010.

The institute is a branch of the National Academy of Sciences, an independent adviser to the government on scientific issues.
Allard's patient Susan Smith said she appreciates saving money with generic alternatives that ePrescribing has brought up during her office visits. She loves the convenience of ePrescribing even more.

Because the script goes directly to the pharmacy, she doesn't have to wait to pick it up. "It's so much more efficient," she said. "My time is real precious to me."

For outside observers, the ePrescribing effort is laudable. "It not only reduces costs but improves the quality of care by reducing drug interaction," said Eileen Ellis, principal of Health Management Associates, a Lansing-based consulting firm.
Recognizing the benefits of electronic records, health systems across southeast Michigan have been spending millions to install electronic medical records.

But doctors' offices have lagged because of the cost, which can be in the tens of thousands and more for a practice.
At about $2,000 a doctor to implement, ePrescribing is much less expensive, but is nevertheless a step in that direction. The coalition helps participating doctors with a $1,000 subsidy.

"This is a great way to get technology into the doctor's office. It's not real expensive; it's fairly easy to adopt," Walsh said.