When the subject of potentially adding an electronic prescribing mandate to pending Medicare legislation arose on Capitol Hill late last month, a chorus of protests rose up among physician groups. One group that didnt join in is the American College of Cardiology, which strongly favors such a mandate.
The cardiologists stand apart from many of their physician colleagues on this issue because they say theyve moved quicker to embrace e-prescribing. Cardiologists are ready to move faster than other physicians on implementation, as many are in larger practice groups and have already adopted the technology, said Jack Lewin, chief executive officer of the group.
Since installing an e-prescribing system, weve quickly realized the benefits to patients, said Doug Weaver, president of the ACC and a practicing cardiologist at the Henry Ford Health System, Detroit. For example, its much easier to find duplicate prescriptions and it automatically flags any drug-to-drug interactions, he said.
The cardiologists may get their wish. Washington sources say that a Senate Medicare bill in the works, while intended to roll back pending cuts to physician reimbursement, among other things, is likely to include a financial penalty for those doctors not using e-prescribing. Whether the bill and the provision make it into law is an open question (May 26, p. 8).
But the e-prescribing issue is a sticking point with other influential physician organizations such as the American Medical Association, Medical Group Management Association and American College of Physicians, which argue that such a requirement needs to follow the establishment of standards and incentives before issuing financial penalties. (The American Hospital Association isnt taking a stance on e-prescribing, according to a spokesman.)
The concern is that the provision would be enacted as an unfunded mandate, and would impose huge punitive measures on doctors who dont adopt the systems. If done right, e-prescribing could meet goals for patient safety, said Robert Doherty, senior vice president for governmental affairs and public policy with the ACP. But there are questions about how a mandate will be set, Doherty said. Will there be exemptions if people cant comply? And can pharmacies universally accept the mandate?
While the American College of Cardiology also supports boosting reimbursement as opposed to cuts, the group in a recent letter to the Senate Finance Committee nevertheless recommended that Congress enact a specific date for e-prescribing adherence: Dec. 31, 2011. Weve learned from those early adopters that were seeing actual cost savings, in addition to improving patient safety, Lewin said.
I dont think cardiologists differ too much from internists and primary care in volume of prescriptions, he said. We will all benefit though, from being able to see what other doctors are prescribing via e-Rx. That could save timeand time is money.