Companies to fund new push for e-prescribing

A national coalition of large technology companies, employers and health plans is putting up more than $100 million to give a free Web-based electronic prescribing system to every physician in the country during the next five years, the most prominent effort yet to get doctors to adopt the technology.

Allscripts LLC, Dell Inc., Cisco Systems Inc., Microsoft Corp. and Sprint Nextel Corp. are among a dozen companies that have joined the coalition and agreed to contribute money or in-kind contributions or both. Participants also include WellPoint Inc., Aetna Inc. and Horizon Blue Cross and Blue Shield of New Jersey.

Those insurers have committed to offer financial incentives to encourage doctors to implement e-prescribing technology or use it to achieve certain pay-for-performance measures such as a certain generic prescription utilization level, Allscripts' CEO Glen Tullman said at Jan. 16 press conference in Washington D.C.

The National ePrescribing Patient Safety Initiative (NEPSI) has commitments for a majority of the $100 million and is talking with other large health plans and employers to obtain the remainder, Tullman said in a telephone interview with AMNews. None of the participants will make money off of NEPSI, he said.

However, he and representatives of Microsoft and Dell acknowledged at the news conference that they could reap a financial benefit in the long run if doctors upgrade from electronic prescribing to electronic medical records systems.

"We believe that this is a great investment in our future," Tullman said. "Electronic prescribing ... is the first step to an electronic health care highway and that electronic health care highway, which we think of as electronic health records, is something that Allscripts does sell."

Chicago-based Allscripts is driving the initiative and providing the e-prescribing software NEPSI is offering to doctors. NEPSI's goal is to improve patient safety, said members of the coalition and its supporters.

Allscripts got the idea for the initiative after the Institute of Medicine released a report in 2006 stating that at least 1.5 million Americans are injured and more than 7,000 people die annually from preventable medication errors.

Nancy Dickey, MD, president of the Health Science Center and vice chancellor for health affairs at Texas A&M University System, said at the news conference that NEPSI has removed the major hurdles that have deterred physicians from prescribing electronically. The software is free, it's easy to use, and secure, she said.

"That's a pretty unbeatable combination," said Dr. Dickey, a past president of the AMA. She was speaking for herself, not the AMA.

NEPSI estimates that between 5% and 18% of the country's practicing physicians prescribe electronically.

Based on similar initiatives that health plans have sponsored in the past few years, NEPSI will help increase but will not dramatically boost physician adoption of electronic prescribing, said Anthony J. Schueth, managing partner at Point-of-Care Partners, a health care consulting company based in Coral Springs, Fla.

Under those initiatives, insurers may provide hardware, software and service at no cost to doctors for one year and pick up the cost in subsequent years if doctors meet certain usage levels. But barriers to physician adoption from past e-prescribing initiatives have included questionable quality of the systems being offered, a lack of sufficient incentives and a general resistance to adopt the technology, analysts said.

The AMA does not endorse any specific e-prescribing product or vendor but believes "that e-prescribing is an important service for patients and physicians," said AMA President William G. Plested III, MD, a thoracic and cardiovascular surgeon in Santa Monica, Calif.

NEPSI was expected to begin rolling out the system on Jan. 31. To obtain it, doctors must have a high-speed Internet connection and sign up online to receive the technology (link).