Washington - A coalition of insurers, technology companies and health care organizations is working to provide free electronic prescribing to every physician in America.

The National ePrescribing Patient Safety Initiative (NEPSI) is the first nationwide effort to prevent medication errors that kill 7,000 and injure 1.5 million each year, according to the Institute of Medicine (IOM) of the National Academy of Sciences. IOM has called on all physicians to adopt electronic prescribing by 2010.

"Electronic prescribing is clearly a tool that can dramatically reduce errors and improve patient safety," says Nancy W. Dickey, president of the Health Science Center, vice chancellor for health affairs at the Texas A&M University System and former president of the American Medical Association.

"Yet despite the many benefits of electronic prescribing, physician adoption is still modest,” says Dickey. “The situation calls for a solution that will overcome the barriers many physicians face in adopting this life-saving technology."

The challenge is that fewer than 1 in 5 of the nation's physicians process prescriptions electronically, according to the eHealth Initiative, a Washing-based group uses information technology to improve health care. Studies indicate that many have been deterred by the costs or by fears that the technology requires too much time to learn and install, the organization says.

NEPSI plans to help eliminate those barriers by providing simple, safe and secure electronic prescribing at no cost, advocates say.

A key element of the NEPSI initiative is participation by two of the nation's largest health benefits companies, Aetna and WellPoint, as well as influential regional payers such as Horizon Blue Cross Blue Shield of New Jersey.

The coalition's health benefits sponsors will provide incentives to physicians in their networks to encourage use of electronic prescribing technology. Their view is that electronic prescribing adds quality and efficiency to the patient care process, backers say.

"WellPoint views electronic prescribing as an essential tool in providing high-quality, safe and cost-effective care to our members," says Charles Kennedy M.D., Wellpoint vice president of health information technology. "We are excited about the potential of the NEPSI program to improve care when executed by our network physicians."

NEPSI is led by Allscripts, the provider of clinical software, information and connectivity that physicians use to improve health care, and by national sponsor Dell Computers Inc.
Other technology companies sponsoring NEPSI are Cisco Systems Corp., Fujitsu Computers of America Inc., Google Inc., Microsoft Corp., Sprint Nextel Corp., SureScripts Inc. and Wolters Kluwer Health Inc.

"The National e-Prescribing Patient Safety Initiative brings together a diverse group of technology companies, payers and physicians who share a commitment to one remarkable idea -- that providing free electronic prescribing for every physician will ultimately reduce errors and improve care,” says Glen Tullman, chief executive officer of Allscripts.

Tullman also calls electronic prescriptions an “on-ramp to a complete electronic health record" that could help consumers manage their health care and would follow employees from one job to the next.
Kevin Rollins, president and chief executive officer of Dell, says “information technology holds great promise as a means to help upgrade our nation's healthcare system technology."

"We believe that consumers will be the biggest beneficiaries of this technology adoption by physicians, enabling real-time access to the most relevant patient information,” says Steve Shihadeh, general manager of sales, marketing and partners for Microsoft's Health Solutions Group.

Craig Barrett, Intel chairman, who recently annou nced an initiative with employers to provide a personal health record system for employees, says: "Paper prescriptions are a key cause of cost, errors and inefficiency in U.S. health care. Which other industry could tell their customers it was OK to have a 15% imagine the airlines landing at the wrong destination 15 percent of the time.”

Electronic prescribing should be the rule not the exception, says Barrett. Electronic prescriptions, he adds, could provide timely and accurate information to employees through direct feeds to the Dossia lifelong health record. Dossia was announced in December by five big employers backing the project--Applied Materials, BP America, Intel Corp., Pitney Bowes and Wal-Mart.

NEPSI also includes more than a dozen academic medical centers, groups representing thousands of physicians across the country and integrated delivery networks Those organizations will serve as regional supporters of NEPSI, leading the delivery and support of electronic prescribing to physicians in their states and regions by providing education, training, incentives and local physician support.

Healthcare providers serving as regional supporters of NEPSI include Advocate Health Partners, Mount Prospect, IL; Brown & Toland Medical Group, San Francisco; Delta Health Alliance of the University of Mississippi Medical Center at Stoneville; George Washington University Medical Faculty Associates, Washington; Healthcare Partners Medical Group, Torrance, Calif.; Holston Medical Group, Kingsport, Tenn.; Louisiana State University Health Network, New Orleans; MaineGeneral Health, Augusta, Maine; Novant Health, Winston-Salem, N.C.; Sierra Health Services and Southwest Medical Associates, Las Vegas; University of Massachusetts Memorial Healthcare, Worcester, Mass.; and University of South Florida/USF Physicians Group, Tampa, Fla.

The backbone of NEPSI eRx NOW, Web-based software from Allscripts powered by the same engine used by more than 20,000 physicians to write millions of electronic prescriptions each year. Designed to appeal to physicians in solo practice or small groups, eRx NOW is available free to any healthcare provider with legal authority to prescribe medications, and requires no download, no new hardware and minimal training.

The product generates secure electronic prescriptions that can be sent computer-to-computer or via electronic fax to 55,000 retail pharmacies--more than 95% of all U.S. pharmacies. All prescriptions are checked for potentially harmful interactions with a patient's other medications, using a real-time complete medication database provided by Wolters Kluwer Health, as well as real-time notification of insurance formulary status from payers, plans and pharmacy benefit managers.

The product also allows physicians use a custom search engine from Google to search for health-related information. The NEPSI Custom Search Engine was created for medical professionals and when  used with eRx NOW can obtain search results tailored for the medical community.
eRx NOW offers physicians and patients the highest security available, with redundant layers of firewall, deep-packet inspection, SSL encryption, database encryption, intrusion detection, and virus, spyware and malware protection for the program's remote servers.

To ensure privacy, all patient information is stored on remote servers in a secure location, so information cannot be compromised even if a physician's computer or phone is stolen.
Similar programs have succeeded regionally, proponents say. Blue Cross Blue Shield of Michigan, for example, has worked since early 2005 with General Motors Corp., The Ford Motor Co. and DaimlerChrysler Corp. on the Southeast Michigan e-Prescribing Initiative (SEMI).

Detroit-based Blue Cross, which provides or administers health care benefits to more than 4.7 million members , also worked on the plan with Detroit-based Henry Ford Medical Group, Health Alliance Plan (HAP) and pharmacy b enefit manager Medco Health Solutions Inc.

BCBS of Michigan reported last year that more than 1,400 physicians had joined SEMI. Preliminary results showed improvements in generic drug prescribing rates and formulary compliance, as well as reductions in adverse drug events due to prescribing errors.

After writing a million e-prescriptions, more than 98,000 prescriptions were changed or cancelled because of drug-to-drug interaction alerts, and more than 63,000 prescriptions were changed or canceled because of formulary alerts, which increased the use of generic drugs.

Source: National ePrescribing Patient Safety Initiative

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