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Docs, stop whining, start e-prescribing

The whining is getting old.

Per Surescripts, in 2012, the latest year for which statistics are available, about 69 percent of physicians nationwide used e-prescribing technology in one way or another, and 44 percent of all prescriptions written nationwide were routed electronically. (That report came out in early May 2013, so expect some new numbers soon.) Both are up substantially from the previous year, probably due in no small part to the Meaningful Use EHR incentive program, which does require a minimal level of e-prescribing.

But what about the holdouts? A recent article in the journal Perspectives in Health Information Management found that cost remains the No. 1 reason why physicians still haven’t ditched the paper prescription pad in favor of electronic prescribing.

“While e-prescribing offers many benefits, not all providers have been excited about implementing e-prescribing systems. A major barrier, reported by more than 80 percent of primary care physicians, has been lack of financial support. New technology requires training and information technology support for installation and upkeep. A practice must take these costs into account when deciding whether to implement an e-prescribing system and also when choosing a stand-alone system or one that is integrated into an EHR system. According to the Health Resources and Services Administration, in a 2007 study the total cost of implementing an e-prescribing system was found to be $42,332, with annual costs after implementation of about $14,725 per year, for a practice of 10 full-time equivalent psychiatrists,” the authors reported.

Yes, but the paper also says this: “E-prescribing improves the efficiency of the prescribing process. Though the actual entering of a new prescription takes about 20 seconds longer per patient than writing a prescription, this time is offset by the time saved because of the fact that less clarification is needed for electronic prescriptions. Prescribers spent more time on the computer, on average an extra 6 minutes per prescriber per day or an increase of 20 seconds per patient when seeing 20 patients per day. If implemented correctly, e-prescribing should cause little disruption in the workflow of ambulatory care settings.”

In other words, those resisting the switch are being penny-wise and pound-foolish.

Besides, e-prescribing systems don’t have to cost that much. In fact, they don’t have to cost anything. Allscripts offers a free, standalone e-prescribing system online, while PracticeFusion, DrChrono and Kareo have e-prescribing modules in their free EHRs. A startup named ScriptPad has an e-prescribing app for Apple iOS that’s free to prescribers; transaction fees get billed to pharmacies. I can’t vouch for the efficacy of any of this software, but cost doesn’t have to be an issue.

I think the real problem here is intransigence. Some doctors simply don’t want to get with the times, and the only losers are patients.

April 24, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

DrChrono and Sermo, what are you thinking?

Free, mobile ambulatory EHR developer DrChrono made a minor ripple of news this week, claiming to be the first vendor to release an EHR for the new Apple iOS 7. But that’s not why I’m writing this post. I’m calling out DrChrono co-founder and COO Daniel Kivatinos for this tweet:

I was quick to respond on Twitter.  


Indeed, the HITECH Act and Meaningful Use are about the Triple Aim of producing safer care, improving population health and lowering overall healthcare costs. The incentive money isn’t supposed to make physicians rich or even cover the cost of the typical EHR. (Yes, “free” EHRs have costs in terms of changing physician workflows and interfacing with practice management systems, and the advertising may cause patients to lose trust in their doctors, as John Lynn seems to have found with Practice Fusion.) Frankly, I don’t want to go to a doctor who views Meaningful Use as “cashing in.” That’s not “meaningful” in the spirit of the incentive program.

I’m making a big deal out of this because this is not the first time DrChrono has made misleading and hyperbolic statements. As I wrote a couple years ago, the company claimed its patient check-in app was “groundbreaking,” despite a lot of evidence to the contrary. The same post also had a video from DrChrono in which the vendor explained to physicians how they could qualify for Meaningful Use “tax breaks.” The incentive payments aren’t tax breaks. In fact, the money counts as taxable income.

The video is still up on YouTube, and it’s been viewed more than 57,000 times. That’s 57,000 times people have heard a patently false statement. DrChrono, stop misleading clients or you won’t have any clients left to mislead.

Also from the “what were they thinking?” department, physician social network Sermo marked the start of the NFL season this month with the launch of the “Pro Football Injury Challenge.” I know this because I received this e-mail:

Sermo injury challenge

Yes, I know I’m not a doctor. Sermo sent a follow-up a few days later saying that I received the invitation in error. But actual physicians still are competing against each other in kind of a fantasy football injury pool. Do you find this as tasteless as I do?

 

September 20, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.