Physicians introduced to e-prescribing at AAOE

A new incentive is being offered under Medicare for physicians who choose to prescribe electronically, or e-prescribe. At the American Academy of Ophthalmic Executives (AAOE) meeting, a panel of academy representatives and members presented, "Introduction to e-prescribing: Improving the safety and efficiency of medication management."

Kate Berry, senior vice president of business development, SureScripts Rx Hub, and executive director of the Center for Improving Medication Management, Alexandria, VA, said, "Electronic prescribing is the use of a computer system . . . to enable you to write a prescription, generate that prescription, and transmit it to the pharmacy of the patient's choice. It also enables you to have access to clinical sufficient support information at the time of prescribing."

Berry spoke about the infrastructure and industry adoption of e-prescribing. "Ninety-five percent of the nation's retail pharmacies are using certified software today," Berry said. "So, about 75% to 80% of the pharmacies nationwide are enabled on the network and are able to receive electronic prescriptions today and send renewal requests electronically as well. The gap in the pharmacy readiness is really around the independent pharmacies."

A personal experience of e-prescribing implementation was presented by Cindy Maddox, MD, FACS, director of glaucoma services and vice chairwoman at the New England Eye Center, Tufts University School of Medicine, Boston and member of the American Academy of Ophthalmology's (AAO) health policy committee.

Dr. Maddox discussed some of the steps to implementing the software program for e-prescribing. Steps included the physician creating a list of all of their commonly used prescriptions, transferring patient information to the e-prescribing system, and collecting information about the patient's preferred pharmacy.

"The response from patients has been amazingly good," she said. "Patients absolutely love the concept that they don't have to now get a piece of paper from you.

"What I like about it is that now I know that prescription has gone to the pharmacy. I know that even though my patient might forget that they need their medication, chances are, their pharmacy is going to contact them," Dr. Maddox said.

Cherie McNett, director of health policy for the AAO, discussed why Medicare is offering an incentive for e-prescribing and how the program is being implemented. According to the Institute of Medicine, 7,000 deaths occur in the United States due to medication errors. According to McNett, the goal of e-prescribing is to reduce this amount of errors.

Starting in 2009, physicians who e-prescribe through their Medicare program will receive a 2% bonus. In 2011 and 2012, the bonus will be reduced to 1% and in 2013 it will be reduced to 0.5%. Although in 2009 it will not be mandatory, starting in 2012, physicians will be penalized by minus 1% for not e-prescribing, McNett said.

To qualify for this bonus, physicians must make sure that 10% of allowed Medicare charges for the year come from eye-visit codes, a practice must have a qualified system, and the practice must report on a minimum of 50% of patients.

"You should be able to access the patient's medication history, what you've prescribed, what other providers have prescribed for that patient," Berry said. "You should be able to have access to the patient's formulary and pharmacy benefit information so that you are able to make a decision upfront that it is going to be covered by that patient's drug plan. And, furthermore, your electronic prescribing system should be able to alert you to drug and allergy interaction."