Blog | Wednesday, July 16, 2008

Amid Medicare debate comes mandatory e-prescribing

Included in this week's passage of Medicare payment updates was a carrot-and-stick mandate that doctors electronically prescribe drugs. Starting next year, physicians who do e-prescribe will recoup 2% of their entire Medicare billing component, which some back-of-the envelope math shows could average $4,000. By 2012, though, those who don't e-prescribe face penalties starting at 1% in 2012 and rising to 2% by 2014.

Prescription volume is expected to grow to 4.1 billion by 2010, according to a report by the eHealth Initiative. But the vast majority of docotrs don't e-prescribe today, with only about 2% of all prescriptions getting to the pharmacy electronically.

Doctors don't have good options when trying to adopt e-prescribing systems. Free systems are out there, but these have come and gone in the past decade, with the companies often going out of business. ACP recommends against standalone e-prescribing systems, saying the real benefits come from functions available to fully functioning electronic health records. But such systems cost tens of thousands of dollars per physician to implement, and setting up systems set back doctors for months, as article in Annals of Internal Medicine and ACP Internist point out.

One option that may become popular is hospitals that offer Web-based systems to doctors. The federal government has specifically exempted hospitals from Stark II kickback regulations when they offer EHRs. The systems can be Web-based, requiring no extra hardware or software, and hospitals can then extend tech support to users.

Has your hospital contacted you? Would you accept an offer if it came?