Jump-Starting EHR Adoption With E-Prescribing
The gold rush has begun, as communities, states, and software vendors look for ways to cash in on the health information technology provisions of the American Recovery and Reinvestment Act (ARRA) of 2009. The proposals don't concern only electronic health records (EHRs), but also electronic prescribing and health information exchanges.
For example, the University of Southern Florida Health System (USF Health) and Allscripts, a leading EHR vendor, have teamed in a pilot program called "Paperfree Tampa Bay." The title is slightly misleading, as the program's aim is to get all of the 8,000 physicians in the Tampa Bay region to prescribe electronically. While that would not eliminate most of the paper in doctors' offices, it would still be a notable achievement, considering that only about 10 to 15 percent of the nation's physicians prescribe electronically today. And Allscripts hopes that many of the doctors who use its free e-prescribing software will later adopt its electronic health records.
The organizers of PaperFree Tampa Bay, supported by local officeholders and Congressional representatives, are seeking federal funding under ARRA for their initiative. They view the effort as part of President Obama's campaign to wire healthcare communities across the country and also as a way to create jobs. If the Tampa Bay program gets off the ground, it is expected to hire about 110 people to train physicians on the e-prescribing software, according to Stephen Klasko, dean of the USF College of Medicine.
USF Florida and Allscripts will fund the initial phase of the two-year program, targeting the 3,200 physicians in Hillsborough County. If and when the sponsors receive the $18 million they're seeking from the federal government, they'll expand the program to the whole Tampa Bay region, including the counties of DeSoto, Hardee, Hernando, Highlands, Manatee, Pasco, Pinellas, Polk and Sarasota.
Glen Tullman, CEO of Allscripts, told BNET that discussions are underway with communities in Connecticut, Pennsylvania and Iowa that are planning to follow Tampa's lead, and that the vendor would like to do the same in other cities across the nation. He added that he sees this pilot as a "proof of concept" for an approach that could facilitate physicians' transition to EHRs.
A few years ago, Allscripts and a number of other technology companies, health plans, and health providers cofounded the National ePrescribing Patient Safety Initiative (NEPSI). The goal of this program, like PaperFree Tampa Bay, was to form a critical mass of e-prescribers by offering doctors free, web-based software. Adoption of NEPSI's system, however, proceeded slowly until CMS announced it would start paying a 2 percent bonus for e-prescribing, starting Jan. 1 of this year. That amounts to about a $3,500 annual bump for the average physician; beginning in 2012, physicians who do not e-prescribe will see their Medicare payments reduced.
The Allscripts e-prescribing program being offered to the Tampa Bay physicians is now being used by about 30,000 physicians nationwide to write "millions" of prescriptions annually, the company says. None of those physicians received any training from Allscripts, but the Tampa Bay physicians will receive onsite assistance. Tullman believes that the combination of free software, the Medicare incentive, and the training should persuade most area doctors to prescribe electronically. The goal is for 100 percent of area physicians to be registered and trained on the software and for 60 percent of eligible prescriptions (i.e., for non-controlled substances) to be written electronically.
Naturally, Allscripts hopes this effort will grow its own business. But there is something to the idea that physicians will find it easier to go digital if they take it one step at a time, instead of in a big bang. And when communities get involved, that's a step toward communitywide information exchanges.