A series of tests designed to gauge the readiness of standards being developed for electronically prescribing drugs under Medicare have produced mixed results, according to a report on the tests issued yesterday.
Three of six tests of new standards were able to convey prescription information in the proper format for use in a Medicare Part D prescription drug benefit, according to the report, which was delivered to Congress by Health and Human Services Department Secretary Mike Leavitt. Three other standards need more work before they can be finalized, the report concluded.
Seeing the potential for electronic prescribing to cut costs and avoid adverse drug combinations, Congress required development of standard approaches for using e-prescribing in delivering Medicare drug benefits. HHS picked five sites to test these initial standards in its pilot project.
Although the tests showed the standards were technically configured to produce the needed information, difficulties arose in implementing three of six new standards.
“Electronic prescribing is still in its infancy,” the report concluded. “While the pilot sites have demonstrated the potential for effective standards-based implementation of three of the initial standards, there is additional work to be done on the three remaining initial standards in order to make them suitable for adoption for Part D.”
Successful implementations were performed for standards covering transactions that provide physicians with patients’ formulary and benefit information, medication history, and the fill status of their medications.
Standards that need extra work include those used to convey structured patient instructions; RxNorm, a terminology to describe clinical drugs, and messages that transmit prior authorization information.
In a statement, Leavitt was upbeat about the progress report: “The findings in this report, along with previously adopted foundation standards, demonstrate that HHS is effectively advancing electronic prescribing which will continue to help Medicare beneficiaries receive higher quality care.”
The report noted that the tests were affected by the limited amount of time to recruit contractors to run the tests, the small size of the test sites, and the ability of the contractor “to recruit the right set of participants to make the outcomes meaningful.”
The tests were a joint project of the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). They picked five test sites operating in eight states to test initial standards, including Achieve Healthcare Information Technologies, Eden Prairie, Minn.; Brigham and Women’s Hospital, Boston; Rand Corp., Santa Monica, Calif.; SureScripts, Alexandria, Va.; and University Hospitals Health System, Cleveland.
RAND focused on New Jersey physicians in an e-prescribing program sponsored by Horizon Blue Cross/Blue Shield of New Jersey. Brigham and Women’s Hospital worked in an academic medical systems setting with physicians from the CareGroup Healthcare System in Boston.
Achieve conducted a test site study implementing e-prescribing in facilities that had never used the technology, the report states.
University Hospitals Health System and Ohio KePRO, the Quality Improvement Organization in Ohio, teamed to study implementation of the standards in 300 primary and specialty care physician offices. SureScripts, the country’s largest provider of e-prescribing networking and certification services, worked with physician offices in five states.
Government Health IT will present Liesa Jo Jenkins, executive director of CareSpark, in an eSeminar at 11 a.m. Thursday, Oct. 16, where she will share her experiences and insight into building a health information exchange that enhances community health, rewards regional collaboration and drives economic progress.
