Groundbreaking eHealth Initiative Report Offers Good Medicine For Ailing U.S. Healthcare System

National Expert Panel Weighs In on Essentials of Electronic Prescribing Design and Implementation

Washington D.C., April 14 – The practice of electronic prescribing is increasingly touted in medical journals and by respected healthcare innovators as a promising way to improve the quality, safety and efficiency of patient care, but what changes need to occur before it can fulfill the promise? A new report produced by the eHealth Initiative (eHI) seeks to answer these questions and to transition electronic prescribing from a hot healthcare buzzword to an implementable reality across the nation.

The report, Electronic Prescribing: Towards Maximum Value and Rapid Adoption, reflects the collective wisdom of a diverse group of experts who began work in early 2003 with the objective of determining what action is needed to accelerate the adoption of electronic prescribing in ambulatory care. The Chair of eHI's Electronic Prescribing Initiative, Jonathan Teich, MD, PhD, explained the report’s historic importance: “This report is recommended reading for everyone in healthcare. It represents practical, comprehensive and consensus-based advice from more than 70 of the nation’s leading electronic prescribing authorities on precisely how to advance and support these technologies to serve patients better.” Teich is Senior Vice President and Chief Medical Officer, HealthVision; Assistant Professor of Medicine, Harvard University and Physician in the Department of Emergency Medicine, Brigham and Women's Hospital.

  “All of us have been grappling with how to reduce medical errors and increase cost efficiencies in our healthcare system,” said the co-chair of eHI’s Design and Implementation Working Group, Patricia L. Hale, M.D., PhD, FACP, Chair of the Medical Informatics Subcommittee, American College of Physicians; Chief Medical Information Officer, Glen Falls Hospital. “Electronic prescribing systems can do just that. Nationwide implementation of these technologies could prevent more than 2.1 million adverse drug events and 190,000 needless hospitalizations a year by reducing medical errors. And, electronic prescribing could save employers an estimated $39 to $74 per employee per year in medical care delivered. These improvements would be nothing short of revolutionary.”

“This report comes at a critical time not only for America’s patients but also for federal policy-makers” added Janet M. Marchibroda, Chief Executive Officer at the eHealth Initiative. “The new 2003 Medicare Modernization Act commits our nation to using electronic prescribing for improved healthcare delivery. eHI’s new report is the first document that tells health professionals and policymakers in detail how to get there — how to transition from paper-based to electronic prescriptions--and how to do so in a way that allows us to lay the groundwork for our migration to a truly interoperable, interconnected, electronic healthcare system which will mobilize health information to support better health and healthcare for patients.”

The report also highlights the challenges of making a transition towards an electronic environment and therefore the need for policy changes that will align incentives among those who bear the costs of implementation and those who benefit.  “Many, many stakeholders, including practicing clinicians, hospitals and other healthcare providers, pharmacies, health plans, pharmacy benefit management organizations, employers and other healthcare purchasers, and most importantly, patients, will benefit from the quality, safety and efficiency improvements that electronic prescribing will bring,” said Mark Frisse, MD, co-chair of eHI’s Incentives Working Group and Vice President, First Consulting Group.  “To realize these benefits, all of these stakeholders will have to be active participants in the change management effort required, and all must work together to support the short and long-term increased costs incurred by certain groups, such as prescribing clinicians.”

Jennifer Covich Bordenick, Director of Strategic Programs at eHI and Program Director for the Electronic Prescribing Initiative, discussed the unprecedented nature of cooperation and consensus that the report reflects. “Recognized leaders from every link of the electronic prescribing chain came together under the umbrella of the eHealth Initiative and volunteered their time to address the challenges and opportunities of electronic prescribing.  All involved understood the pressing need for a trusted, comprehensive resource on electronic prescribing.” eHI’s Electronic Prescribing Initiative brought together experts from a wide range of constituencies across every sector of healthcare. Covich added, “The importance of this effort and the unity reflected in the report cannot be underestimated, particularly given that stakeholders involved in and impacted by the prescribing chain often have strong competing interests. Speaking with one voice through the eHealth Initiative on what it will take to successfully design, implement and support electronic prescribing is a monumental leap forward.”

The report, Electronic Prescribing: Towards Maximum Value and Rapid Adoption, was unveiled today at an eHI conference in Washington. Electronic copies of the report are available at http://www.ehealthinitiative.org/initiatives/erx/.

The report:

• Outlines the graduated levels of electronic prescribing, from basic reference systems to advanced systems that integrate with electronic medical records.
• Features data on current electronic prescribing use and the demonstrated benefits, including improved quality, reduced medical errors, and potential cost savings for payers and employers.
• Recommends specific features and functions clinicians should seek in electronic prescribing systems, as well as priorities for clinical decision support.
• Reviews the state of the art of electronic communication between providers, pharmacies, payers, and patients, and considers steps that are needed to enhance and expand these valuable services.
• Reviews current options and critical needs in prescribing standards and vocabularies.
• Analyzes the needs and best possibilities for economic, legislative, and other incentives that can stimulate adoption.

Key findings of the report include the following:

Errors and adverse drug events in ambulatory care can be common, serious and preventable.

Electronic prescribing can improve safety, quality, efficiency and cost.

Despite the benefits of electronic prescribing, adoption is still modest.

Electronic prescribing systems are available in a variety of graduated levels—systems at the highest level of sophistication offer the most benefit.

The adoption and use of electronic prescribing should be encouraged through the deployment of appropriate incentives.

Continuing progress toward better-designed, usable systems is likely to help with adoption.

A number of enhancements in standards and vocabularies are needed to facilitate interoperability among systems, thereby further enhancing quality, safety and efficiency.

If implemented with longer-term goals in mind, electronic prescribing can be an important stepping-stone towards an interoperable, electronic health care system which will provide enormous benefits to patients.

About the eHealth Initiative

The eHealth Initiative is an independent, non-profit affiliated organization whose mission is to drive improvement in the quality, safety, and efficiency of healthcare through information and information technology.  It engages multiple and diverse stakeholders--including hospitals and other healthcare organizations, clinician groups, employers and purchasers, health plans, healthcare information technology organizations, manufacturers, public health agencies, academic and research institutions, and public sector stakeholders--to define and then implement specific actions that will address the quality, safety and efficiency challenges of our healthcare system through the use of interoperable information technology.

For more information about eHI, see www.ehealthinitiative.org or call (202) 624-3270.

About eHI’s Electronic Prescribing Initiative

The eHI Electronic Prescribing Initiative was launched in early 2003 to rapidly expand the adoption of electronic prescribing; in particular, to stimulate adoption of electronic prescribing by clinicians. The Initiative is comprised of a Steering Group and two Working Groups — a Design and Implementation Working Group and an Incentives Working Group, representing over 70 of the nation’s top experts on electronic prescribing, including practicing clinicians, hospitals and other healthcare organizations, medical societies and associations, payers, healthcare IT suppliers, pharmacies, manufacturers, patient and consumer groups, insurance providers, federal agencies, and connectivity providers. For more information on the Electronic Prescribing Initiative, go to www.ehealthinitiative.org.

Leadership and Steering Group of eHI’s Electronic Prescribing Initiative

The eHealth Initiative Electronic Prescribing Steering Group was chaired by Jonathan Teich, MD, PhD, Senior Vice President and Chief Medical Officer, HealthVision; Assistant Professor of Medicine at Harvard University; Physician, Brigham and Women’s Hospital.

The Design and Implementation Working Group was co-chaired by Patricia Hale, MD, PhD, FACP, Chair of Medical Informatics Subcommittee of the American College of Physicians and Chief Medical Information Officer of Glen Falls Hospital, and Bob Elson, MD, Vice President of Medical Affairs for RxHub.

The Incentives Working Group was co-chaired by John Glaser, PhD, Chief Information Officer of Partners Healthcare System and Mark Frisse, MD, Vice President, First Consulting Group. All three working groups and the Electronic Prescribing Initiative were staffed by Jennifer Covich Bordenick, MA, Director of Strategic Programs at eHI.

Members of the Steering Group included:

• Andrew Balas, MD, PhD, Dean and Professor, School of Public Health, St. Louis University
• Peter Basch, MD, Medical Director eHealth Initiatives, MedStar Health
• James P. Bradley, Chief Executive Officer, RxHub
• Sam Brandt, MD, Vice President, Chief Medical Informatics Officer, Siemens Medical Solutions
• Nancy Brown, Senior Vice President, Strategic Development, McKesson Corporation
• Bob Elson, MD, MS, Vice President Medical Affairs, RxHub (Co-Chair, Design and Implementation Working Group)
• Mark Frisse, MD, MBA, Vice President, First Consulting Group (Co-Chair, Incentives Working Group)
• Peter Geerlofs, MD, Chief Medical Officer, Allscripts Healthcare Solutions
• John Glaser, PhD, Chief Information Officer, Partners HealthCare System (Co-Chair, Incentives Working Group)
• Patricia L. Hale, MD, PhD, FACP, Chair of Medical Informatics Subcommittee, American College of Physicians; Chief Medical Information Officer, Glen Falls Hospital (Co-Chair, Design and Implementation Working Group)
• C. Martin Harris, MD, Chief Information Officer, Cleveland Clinic
• Yin Ho, MD, Director eBusiness, Pfizer Inc
• Kevin Hutchinson, Chief Executive Officer, SureScripts
• William F. Jessee, MD, Chief Executive Officer, Medical Group Management Association
• Kevin B. Johnson, MD, MS, Associate Professor and Vice Chair, Department of Biomedical Informatics, Vanderbilt University
• Ned McCulloch, Government Executive, IBM Corporation
• J. Marc Overhage, MD, PhD, Associate Professor of Medicine, Indiana University School of Medicine; Senior Investigator, Regenstrief Institute
• Thomas E. Sullivan, MD, Women’s Health Center Cardiology, Partners HealthCare System, Massachusetts Medical Society
• Jonathan Teich, MD, PhD, Senior Vice President and Chief Medical Officer, HealthVision; Assistant Professor of Medicine, Harvard University;

Physician, Department of Emergency Medicine, Brigham and Women’s Hospital; (Chair of the Electronic Prescribing Initiative)

• Robin Thomashauer, Executive Director, Council for Affordable Quality Healthcare
• John Tooker, MD, MBA, FACP, Executive Vice President, American College of Physicians and American Society of Internal Medicine
• Susan M. Welsh, MD