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New Federal eRx Incentives

11 Responses

1. Darrell, on January 4, 2009 at 5:48 PM said:

   On eDRs [Dentists are Different]

   I haven’t sent you anything since the opening combinations I hailed down on Dr. Marty Jablow regarding the difference in eDRs from whole body medicine and eHRs. If you haven’t been following my exchange with him on DrBicuspid, let me say it got weird. I left him bleeding. Marty just would not take a dive like most do.

   Then I tangled again with Valerie Powell PhD. She is currently trying to dodge me, but I have her penned against her own buzzwords and I won’t let her squirm free. If you are interested, these little skirmishes are occurring on DrBicuspid.
   http://www.drbicuspid.com/forum/tt.aspx?forumid=2

   Seriously now!

   I posted the following on both DrBicuspid and PennWell. It’s an important one.

   The “Conscience Rule” and eDRs

   David Templeton, a reporter for the Pittsburgh Post-Gazette, posted an article on their website this morning titled “Conscience can now be guide for reproductive health workers.”
   http://www.post-gazette.com/pg/09003/939386-85.stm

   He describes the last-minute push by the U.S. Department of Health and Human Services [DHHS] to support healthcare providers in their decision to withhold treatments from patients if doing so is against a provider’s conscience. Specifically, it is about abortion.

   “The proposed regulations will reinforce and reaffirm existing federal laws which prohibit recipients of certain federal funds from coercing individuals in the health care field into participating in actions they find religiously or morally objectionable,” said John M. Haas, president of the National Catholic Bioethics Center in Philadelphia. “If you do not believe in performing an abortion, you want to be protected from being forced to do that. Others may disagree with us, but we are not forcing them to violate their conscience.”

   Since this “conscience rule” will go into effect the day before Barack Obama is sworn in as our next president, do you think a dentist say in Fort Worth might stretch the envelope of the law and declare he or she morally objects to forcing dangerous and expensive electronic dental records on his or her patients?

   I smell a fight. Maybe this Rule will eventually mean that the NPI number will no longer be required for a dentist to participate in CHIP in Texas – treating the poor. CHIP, of course, receives federal funds. This could get exciting.

   Facing overwhelming odds, ADA President Dr. John S. Findley and others gave up the fight for moral sovereignty long ago. In September, Dr. Findley stated in an interview that “The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’”
   http://www.ada.org/members/resources/pubs/adanews/081006_findley.asp

   Wanna bet on it, John?

   D. Kellus Pruitt; DDS

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2. Don, on June 22, 2010 at 3:25 PM said:

   More on eRxing

   The Drug Enforcement Agency [DEA] recently released its much-anticipated Interim Final Rule (IFR) on electronic prescribing of controlled substances. While additional clarification is needed from DEA, the rule opens the door for electronic transmission of controlled-substance prescriptions to pharmacies and removes a significant barrier to the overall use of electronic prescribing.

   http://www.govhealthit.com/GuestColumnist.aspx?id=74035

   Don

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3. Ann Miller RN MHA, on May 10, 2011 at 10:28 AM said:

   UPDATE: On Electronic Prescribing

   Physicians say systems are often too difficult to use and don’t provide useful data, diminishing potential safety and cost-savings benefits.

   http://www.informationweek.com/news/healthcare/CPOE/229402957

   Ann Miller RN MHA
   [Executive-Director]

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4. Ann Miller RN MHA, on June 1, 2011 at 11:14 PM said:

   E-Prescribing Penalty Could Hit Up to 109,000 Clinicians

   The Centers for Medicare and Medicaid Services (CMS) is proposing more exemptions to an electronic prescribing requirement that could penalize as many as 109,000 physicians, nurse practitioners, and other prescribers who do not adopt the technology.

   The penalty is the flip side of a Medicare program created in 2008 that gives clinicians a bonus if they transmit prescriptions electronically to pharmacies, using approved software. The bonus is 1% in 2011 and 2012, and 0.5% in 2013; it disappears the following year. Meanwhile, clinicians who do not report at least 10 electronic prescriptions on Medicare claims during the first 6 months of 2011 will experience a 1% pay cut in 2012 that grows to 1.5% in 2013 and 2% in 2014 with continued non-compliance.

   Source: Robert Lowes, Medscape Medical News [6/1/11]

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5. D. Kellus Pruitt DDS, on June 30, 2011 at 2:47 PM said:

   e-Prescribing selling point busted!

   Doctors’ handwriting discovered to be not so bad after all!

   An article by Michelle Fay Cortez was posted yesterday on Bloomberg titled, “Errors Occur in 12% of Electronic Drug Prescriptions Matching Handwritten.”

   http://www.bloomberg.com/news/2011-06-29/errors-occur-in-12-of-electronic-drug-prescriptions-matching-handwritten.html

   “As many as 12 percent of the drug prescriptions sent electronically to pharmacies contain errors, a rate that matches handwritten orders for medicine from physicians, researchers said.” Oops!

   Taxpayers should be furious.

   As Congress decides whether they should take a few days off for the 4th of July before radically cutting spending to keep the US financially afloat, consider this:

   “The U.S. paid more than $158.3 million to doctors and hospitals in the first half of 2011 to encourage adoption of electronic health records, which President Barack Obama has advocated as a way to lower health- care costs and reduce medical errors.”

   In other words, all the money taxpayers and patients spent on e-prescribing did nothing more than benefit healthcare IT stakeholders. Is it any wonder why healthcare costs so much in the land of the free?

   Even though Obama once said that HIT is a “panacea” for the nation’s financial problems, illness is not a natural resource that can be tapped to improve the economy through software companies like Allscripts (MDRX).

   D. Kellus Pruitt DDS

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6. Darrell, on July 1, 2011 at 2:57 PM said:

   Busted!

   It turns out that e-Prescribing is a bust. Will the FWDDS Board be any more honest with members this time?

   One thing I’ve noticed about the Fort Worth District Dental Society, its Board members have always had a soft spot in their hearts for struggling electronic dental record stakeholders – perhaps even more than for struggling dues-paying members who are encouraged to e-prescribe. Why the favoritism?

   In August 2009, former state dental board investigator Sharalyn Fichtl was generously provided a couple of pages in the Twelfth Night to promote her new HIPAA consulting firm, Dental Compliance Specialists, LLC. I thought the ad was an article until her naive bias became evident when her partner, Travis Criswell – also not a dentist – reasoned that even dentists who have no digitalized records must be HIPAA/HITECH compliant (and therefore, ALL dentists should purchase DCS’s fine HIPAA compliance products to help navigate through the tedious requirements – or risk terrible HIPAA fines. “It’s the law”).

   Over the next week, as a concerned FWDDS member, I did what I knew had to be done in light of his egregious deception. I engaged Fichtl, Criswell and the FWDDS in an exchange of emails about how so very wrong Criswell’s harmful statement was. In the end, Fichtl couldn’t or wouldn’t explain her position on Criswell’s misstatement.

   It got nasty. The last email the Board and I received from Fichtl, she said “We will no longer entertain your unprofessional remarks and are forced to ask you to refrain from further harassment.” Unprofessional remarks? Harassment? Remember, Ms. Fichtl is a former investigator with the Texas State Board of Dental Examiners. Fun is fun, but FWDDS Board members and I need our dental licenses….

   The FWDDS appeared to be fine with her explanation as well. Nobody felt it was at all necessary to publish a retraction in the next issue of the Twelfth Night or to mention it at all ever, ever again. Well, I’ve actually mentioned it a couple of times.

   Would it be unprofessional for me to point out that almost 3 years after I was accused of harassment, it’s clear that Criswell was conveniently ignorant about the very purpose of HIPAA? I would add that what appears to be his self-serving lie still stands as fact to naïve FWDDS members through the Twelfth Night, their monthly newsletter. I’m not even sure and no longer care if Fichtl was ever charged for the misleading ad. But she no longer intimidates me. I’ve been called unprofessional by more important good ol’ boys in Texas dentistry than her.

   The reason I bring up this esoteric story is because recently, the FWDDS sponsored some HIT stakeholder who promoted electronic prescribing at a monthly meeting. Whoever it was, I’m certain he told FWDDS members that eliminating errors from bad handwriting is one of the principle reasons for e-prescribing in dentistry. It’s a common, discussion-halting argument that until very recently could not be challenged. However, recent research suggests that the bad-handwriting myth is as bogus as Travis Criswell’s ignorance of HIPAA. (See: “No decrease in errors for digital prescriptions,” by Deborah Kotz, Globe Staff).

   http://www.boston.com/Boston/dailydose/2011/06/decrease-errors-for-digitial-prescriptions/cHNYY1LsN9waPxdtLVqmWM/index.html

   Should I waste my time warning FWDDS Board members that they might have once again become unwitting stooges in the deception of local dentists concerning EDRs? Or let them always wonder why nobody trusts them like they used to?

   D. Kellus Pruitt DDS

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7. Ann Miller RN MHA, on July 4, 2011 at 1:04 PM said:

   eRx Errors [One in Ten Prescriptions]

   Electronic prescriptions are as likely as handwritten ones to contain errors, according to a study from a group of Boston-based researchers.

   The study, “Errors associated with outpatient computerized prescribing systems,” is published online in the Journal of the American Medical Informatics Association. The report is based on a retrospective study of 3,850 computer-generated prescriptions received by a commercial outpatient pharmacy chain in three states in 2008.

   A clinician panel reviewed the prescriptions to identify and classify medication errors, potential adverse drug events (defined as those that might cause patient harm) and the rate of prescribing errors by prescription type and by system type. The researchers found at least one error in 11.7% of the prescriptions reviewed.

   “About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm,” the researchers wrote. “This is consistent with the literature on manual handwritten prescription error rates.”

   Source: Joseph Conn, Modern Healthcare [6/30/11]

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8. Hope R. Hetico RN MHA, on November 3, 2011 at 4:27 PM said:

   CMS Extends Deadline to File for ePrescribing Hardship Exemption

   After learning that some physicians were having difficulty accessing the CMS Communication Support Page recently, the AMA was able to work with CMS to secure an extension.

   The new deadline to file for an e-prescribing hardship exemption is Tuesday, November 8th, 2011.

   Source: CMS

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9. Faith, on December 9, 2011 at 1:41 PM said:

   Study Exposes Electronic Prescribing’s Flaws

   According to this article, communication gaps, transmission barriers, and software problems plague the rapidly growing field of online prescribing.

   http://www.informationweek.com/news/healthcare/CPOE/232200183#disqus_thread

   And, there are [too] many more reports of healthcare e-commerce snafus on the web:

   • Consumer Interest In Health Information Wanes
   • Medicare Delays HIPAA 5010 Enforcement
   • Doctors Slow To Embrace Telemedicine, Cloud Computing

   Faith

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10. Hope R. Hetico RN MHA, on April 13, 2012 at 10:23 AM said:

    CMS Backlog Shortchanges Doctors on e-prescribing Exemptions

    Some physicians are reporting that the Medicare payments they’ve received for their services in 2012 are being reduced for a failure to prescribe enough electronically in 2011, even though the doctors filed waiver requests seeking special hardship exemptions. The Centers for Medicare & Medicaid Services could not process all hardship application requests before starting to levy the 1% penalty for non-compliant physicians in 2012, officials said.

    The agency said it since has approved or denied all of those exemption requests, requiring contractors to reprocess claims for physicians unfairly penalized earlier in the year. CMS now is accepting hardship requests from physicians looking to avoid the 2013 e-prescribing penalty, which will grow to 1.5%. The agency reopened the application website on March 1, and physicians seeking waivers will have until June 30 to file their requests.

    Source: Charles Fiegl, AMNews [4/9/12]

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11. Hope Rachel Hetico RN MHA, on July 11, 2012 at 3:54 PM said:

    CMS proposes new eRx hardship exemptions, Physician Compare reports

    As part of proposed changes to its physician fee schedule, the Centers for Medicare and Medicaid Services (CMS) has proposed changes to its health IT programs, including the electronic-prescribing incentive program, the Physician Quality Reporting System (PQRS) and the Physician Compare website.

    Hope Rachel Hetico RN MHA

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