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Toledo area physicians say good-bye to prescription pads: Computerized approach designed to avoid errors, boost patient safety
(Blade, The (Toledo, OH) Via Acquire Media NewsEdge) Jan. 4--Dr. Shalini Singh doesn't go through piles of prescription pads anymore.
The Maumee family practitioner is among a growing contingent of doctors nationwide who are electronically sending their patients' medication orders straight to pharmacies.
And, starting this month, Medicare will reward such doctors who are routinely using e-prescription software with bonus payments, part of a federal carrot-and-stick program that will culminate in 2012 when payments could be cut to those who have not converted.
Roughly 10 percent of U.S. doctors use e-prescription software, which helps promote patient safety by eliminating doctors' notoriously sloppy handwriting and the corresponding possibility for error at the pharmacy.
Plus, Dr. Singh said, there are no more yellow sticky notes in paper patient files with notations that could be rewritten in error since she and her staff tote laptop computers around the office and enter information into them.
"That not only helps with time efficiency, but the error of recording and rerecording is taken away," said Dr. Singh, an employee of St. Luke's Hospital in Maumee whose office is being converted to all electronic medical records, of which e-prescribing is a part.
"In a couple of years or so, it's going to be mandatory," she said.
Avoiding injuries from prescription errors could save Medicare as much as $156 million over the bonus program's five years, according to the U.S. Department of Health and Human Services. Converting to electronic medical records also is part of President-elect Barack Obama's health-reform plans to improve safety and efficiency.
Eligible e-prescribing doctors will get a 2 percent incentive payment in 2009 and 2010 from Medicare, followed by 1 percent payment in 2011 and 2012, and a half-percent payment in 2013. Those not successfully e-prescribing by 2012 could be subject to a 1 percent penalty, followed by a 1.5 percent penalty in 2013 and 2 percent in 2014, according to the Department of Health and Human Services.
Not all Medicare prescriptions must be ordered electronically for doctors to get bonus payments, and, by law, some cannot be. E-prescribing of controlled substances, such as narcotics, is prohibited, although the Drug Enforcement Administration is working on rules to allow it under certain conditions, according to Health and Human Services.
Various local doctors are using e-prescription technology.
Vision Associates in Toledo, which converted to electronic medical records several years ago, started trying out e-prescribing last month. The practice has long printed out prescriptions for patients, which is not considered e-prescribing.
Some problems with e-prescribing have surfaced, such as patients who do not want to designate a pharmacy for all of their medications and businesses that are not yet accepting drug orders electronically, Vision Associates doctors said. Figuring out the exact address of the chain pharmacy's store where patients want to have their prescriptions sent, when several are on the same street, also is troublesome, they said.
"People just don't want to commit or don't know," said Dr. Gerald Striph of Vision Associates.
Vision Associates is converting to e-prescriptions with Medicare patients first, then others will follow as issues are worked out, said David Sobczak, executive director of the 12-doctor practice.
Said Dr. J. Gregory Rosenthal of Vision Associates: "You don't think of a lot of things until you're in the midst of it."
The University of Toledo Medical Center, formerly the Medical College of Ohio, is in a multiyear effort to convert to a digital campus. Part of that includes e-prescribing at doctors' offices and in the hospital, said Dr. Jeffrey Gold, UT provost of health sciences, executive vice president for health affairs, and medical college dean.
"We're doing this to decrease medical errors, to improve patient safety, and enhance patient satisfaction," Dr. Gold said.
Besides providing electronic medical records technology to employed doctors, St. Luke's is helping other community physicians put it in their offices. Under federal law, the hospital is allowed to donate up to 85 percent of the cost for certain items, such as software, to nonemployed doctors.
Dr. Singh of St. Luke's started using e-prescription software nearly two months ago. Patients whose prescriptions are sent electronically no longer have to keep track of multiple papers, and the software alerts doctors and pharmacists to potential problems with medications, she said.
"That's really a nice check," Dr. Singh said.
Contact Julie M. McKinnon at:
jmckinnon@theblade.com
or 419-724-6087.
To see more of The Blade, or to subscribe to the newspaper, go to http://www.toledoblade.com.
Copyright (c) 2009, The Blade, Toledo, Ohio
Distributed by McClatchy-Tribune Information Services.
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