Comments on: News 12/5/08

By: Al Borges MD

Al Borges MD — Sat, 07 Feb 2009 14:01:05 +0000

>>> There are studies out there through the IOM et al that demonstrate the benefits of eRx (saving lives, saving time on the phone for your office staff, etc).

Rustbelt, please post a reference, and I’ll discuss it’s flaws. Most references showing increased quality, decreased errors, and cost savings are flawed in that they:

– show an inherent reporter bias
– don’t compare e-prescribing to both handwritten prescriptions and to prescriptions sent to either a fax machine or to a printer- very different things, with the latter being as legible as the typical e-prescription, but at a lower cost
– at most show that EHR with e-prescribing is associated with increased organization and better outcomes, but have not been shown to be the cause-and-effect.

E-prescribing is a workflow killer and will not be accepted by the vast majority of physicians. It’ll be one more nail in the coffin of private practice as we know it and will end up damaging Medicare by diminishing participation as physicians find themselves unable to sustain further participation in this government run program gone astray.

The biggest proponent of e-prescribing is Glen Tullman, CEO of Allscripts, who is now President Obama’s personal HIT adviser. He, his company, and his coworkers have actually donated over $160000.00 to Obama and also paid $12000.00 on 8/2008 to Daschle in “speaker fees”, all part of a massive lobbying effort that has been the underpinning of e-prescribing which is being used by those in power to pick the pockets of this nation’s physicians. It’s sleazy, unethical, but legal and bipartisan. It will do nothing to increase quality, decrease errors, or decrease costs.

By: RustBelt Fan

RustBelt Fan — Sat, 06 Dec 2008 17:58:11 +0000

Hi Al Borges,
There are studies out there through the IOM et al that demonstrate the benefits of eRx (saving lives, saving time on the phone for your office staff, etc). I won’t comment about SureScripts because that wasn’t my point. Re: the pricing…I’m not saying you need EMR (you probably don’t), I’m talking about ePrescribing only which is virtually free. Check with your Physician Organizations in your state to see if you don’t qualify. Don’t know what specialty you are, but if you do Medicare business, in a few years you will receive decreased reimbursements if you don’t have TRUE ePrescribing. Up until then, you can actually earn bonus money doing so (I know, it’s not millions but every little bit helps). I would venture to say you could get ePrescribing (standalone) for about $1-2 per day. Check it out. You might actually like it! And I would agree with you that it’s time that your health plans poney up to the table and provide incentives for this. Again, check that out, because many do right now. Good Luck!

By: Al Borges, MD

Al Borges, MD — Sat, 06 Dec 2008 03:46:11 +0000

>>> Yes, I know. But, isn’t it really just a “cost of doing business”? <<<

Yeah- everyone seems to want for docs to pay for this cost, even though if there is a benefit, it will be for everyone but docs.

I personally can’t afford it. If you can buy it for me, then email me the cash…

By: Al Borges, MD

Al Borges, MD — Sat, 06 Dec 2008 03:43:15 +0000

Hi RustBelt:

Please quote me a study that shows that e-prescribing actually does result in “patient safety”. The closest thing I know of is one study, done at a childrens hospital that implimented a CPOE system and ended up with a higher death rate with the CPOE. Children DIED!!! Yikes!!!

I personally use Epocrates for not only drug interactions but for side effects as well as for insurance formularies. I don’t need an e-prescribing mechanism to tell me about the drugs that I write. If a sloppy, error-prone doc uses e-prescribing he still will be sloppy and error prone; the HIT won’t change that.

It is all $$$$- here we have one company (Surescripts) that has been annointed to set the industry standard which forces docs to purchase even more HIT, increasing the overall cost of doing business. It’s the patients that suffer at the end when they end up mortgaging their homes to pay off their medical bills.

By: RustBelt Fan

RustBelt Fan — Sat, 06 Dec 2008 01:01:00 +0000

“The e-prescribing is the same set of empty promises from CMS/Medicare. Nothing will change.”

Excuse me? Can we get back to Patient Safety as the main reason we should be moving to ePrescribing rather than $$$$. Yes, I know. But, isn’t it really just a “cost of doing business”?