CMS to bar computer-faxing of scripts
Since January 2006, physicians who prescribe electronically for Medicare patients have been required to use the same standard for sending scripts online to pharmacies that SureScripts uses in its electronic network. But despite the spread of pharmacy interoperability, the majority of e-prescribing doctors still computer-fax their scripts to pharmacies.
Now, in an effort to force practices to go online with pharmacies, CMS has moved to bar physicians from faxing prescriptions for Medicare patients. It has proposed that physicians either send their scripts online, using the mandated standard, or go back to paper prescribing. If this provision is included in the final rule, it will go into effect Jan. 1, 2008.
Naturally, SureScripts is delighted. “The sooner we take action, the sooner we will establish a safer, more cost effective, more automated process for providing prescriptions to millions of patients across the nation,” said SureScripts CEO Kevin Hutchinson in a statement.
However, though most pharmacies are technically capable of going online with doctors, only two-thirds of them are operationally ready today, and fewer are outside major metropolitan areas. Moreover, only about half of EHRs have the functionality required to send scripts online. So it remains to be seen how practical this will be for physicians.
[Via Medical Economics Infotech Bulletin]
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I have Sure Scripts and find it frustrating because I still have to use a printed medication reference to find the size of tubes of creams/ointments as well as the various available doses of medications. In addition, it is supposed to give you reference to interactions and adverse effects. I sometimes get blank screens when I try to bring up the adverse reactions. I has some refining to be done.
I am a big fan of EHR promotion. However, this CMS proposal is short sighted and full of adverse consequences (hopefully unintended ones). It also represents an unfunded mandate, all of which should be vigorously opposed. Secure e-prescribing is a worthwhile goal. However, there is no single true path to get there. NEPSI (http://www.nationalerx.com/) admits to portions of the market in cannot serve or penetrate electronically, in which case it sends prescriptions by fax. Many prescriptions are neither e-prescribed nor faxed, but are called in. The issue of proper identification and security is much worse in this scenario; but it would create havok and a lot of unhappy folks to have CMS trump all the state prescribing laws that allow for telephone call ins. If telephone call ins are legal, how can it be logically possible for CMS to claim that fax prescriptions are “not safe”? Many current EHR’s are not truely ready or able to do e-prescribing (that is, the EHR can electronically generate a prescription or a fax, but cannot receive and integrate refill requests into the individual patient’s electronic record. There are also significant security issues to overcome with allowing external sources such as pharmacies to access a patient record in the physician’s computer system. ePrescribing is idea worth exploring. In 2007, it is nowhere close to being an appropriate subject for a mandate.