I think that the one that has to comply is Obama with a federal law called the Hobbs Act (18 U.S.C.A. § 1951 [1994]) which makes it a felony for a public official to extort property under color of office. Trading campaign contributions for promises of official actions or inactions are prohibited under this act.

There are a lot of angry folks out there: “Obama, Tullman- are you listening?” If President Obama is going to take on lobbyists, then he should start in his own back yard.

Al

What she did not mention is that if you use and EMR and NEPSI, then you’re relegated to double entry- writing the script once in NEPSI and then again, recording it in your EMR. You see, Allscripts purposefully did not provide a bidirectional EMR interface with the software. Does Allscripts have the expertise to do that? You would certainly hope so. So while the tone of her note depicts Allscripts as altruistic, there is no altruism in their corporate offices.

>>> Physicians don’t have to pay for e-Prescribing. This is a free service available to any physician who signs up online, as outlined at the National E-Prescribing Safety Initiative (NEPSI) website

As long as Allscripts does not integrate with the vast majority of EHR systems, it is not really free. The way it is being promoted, it is more of a demo of Allscripts than a real workable solution. It’s a marketing ploy to get physicians accustomed to using the full, expensive, “enterprise” level Allscripts software which most docs in small offices would find to be overkill.

If a physician does not buy the Allscripts EHR, then he or she will have to pay to get software to integrate e-prescribing with his current EMR or be forced into an unworkable double-entry situation, which will intrinsically increase the chances of making a prescription error.

>>> Electronic prescribing (ePrescribing) is a viable solution to counter shortcomings of the current paper-based prescribing processes that are in large part responsible for these errors.

First of all, there are many like myself that have an EMR that sends prescriptions either to the printer or to a fax machine, so I don’t turn in hard to read handwritten prescriptions.

For drug interactions I use a truly free software- the Palm-based ePocrates. It even gives me price comparisons, formularies, adverse effects, etc. I don’t need an EMR to immerse my Win XP screen with pop-ups that are annoying and which may slow me down.

Privacy is ensured as the patient takes the prescription to the drugstore of his/her choice. There are no intermediaries to deal with. Narcotics? No problems.

>>> There are 1.5 million adverse patient incidents each year due to handwritten prescriptions that can be avoided with the use of electronic prescribing

Again, my prescriptions are NOT “handwritten”, but Mr. Tullman’s advice to President Obama is to simply send everything through Allscripts, I guess to maximize his profit.

That aside, if you look at the US Pharmacopedia’s 5th annual study of medication errors, it’s true that there are a lot of medication errors with handwritten prescriptions, and in fact they found that illegible or unclear handwriting accounted for 2.9% (6,134) of reported mediation errors, and it ranked as the 15th leading cause of these errors. That’s high, but pales to computer entry errors, which accounted for 13% (27,711) of the medication errors reported in 2003, which ranked as the 4th leading cause of errors.

So that translates to a 4.5 fold increase in errors if one chooses to use e-prescribing as per the results of that study. I have yet to see a sound, scientific study that actually demonstrates an increase in quality, a decrease in errors, and/or decrease in costs associated with e-prescribing OR with the use of a certified electronic health record (c-EHR), yet President Obama and Mr. Tullman want to ram these initiatives down the throats of hard working people- this nation’s physicians.

On 12/8/2008 the Joint Commission (JACHO) that certifies hospitals issued an alert and warned that “implementation of technology and related devices is not a guarantee for success, and may actually jeopardize the quality and safety of patient care.” They also stated that “…any form of HIT can have a negative impact on the quality and safety of care if it is designed or implemented improperly or is misinterpreted.”

These HIT initiatives send a chilling message that Mr. Obama really doesn’t care about the “working class”. The abusive issue of forced unproven costly mandates, of penalties and of other cutbacks in reimbursement will only work to make certain vendors that have donated to his cause richer and will eventually destroy the busy small businesses that make up 75% of the clinical system in the USA. President Obama and his HIT adviser Mr. Tullman are jeopardizing the very existence of Medicare.

All of the URLs can be found in my (REALLY FREE) downloadable PPT presentation, “HIT in the USA Under President Obama” located here: http://msofficeemrproject.com/Page3.htm

Al