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45 Comments
- gardnmi, on 03/17/2009, -0/+10Think of the trees you will save.....Listen dumb dumb, money invested now will ultimately in the future make healthcare cheaper, faster, and more reliable. With your logic horses would be the popular mode of transportation and computers wouldn't exist.
- inactive, on 03/17/2009, -0/+9My doctor uses paperless prescriptions all the time. It cuts down on pharmacy errors and my pills are waiting for me when I leave the docs office. I love the system. And where does it say all the money is going for the e-prescribing system? There are TONS of other applications that would benefit from IT upgrades. Medical images can be requested and received faster, medical histories updated much faster, emergency info gotten faster. This isn't frivolous spending.
- frontaxle, on 03/17/2009, -1/+7Old doctors can't find the Any key. We got troubles.
- davdev, on 03/17/2009, -0/+5as opposed to the current system of sending a fax and having it sit on the machine until one of the Pharm techs decides to look at it?
- roddack, on 03/17/2009, -2/+6Those drugs should be avaliable without a prescription because the government has no right to tell you what you can and can not put into your body.
A prescription should only exist in so far and insurance requesting one before they decided to shell out money for a drug but that should be a private matter between individuals. Government needs to back the ***** off from private life. - Chapman9110, on 03/18/2009, -0/+3I just wanted to poke my nose in here. I worked at a fairly large private practice for a number of years, the current system used to prescribe and refill prescriptions is horribly inefficient. In the interest of saving money anyway we can on health care costs in this nation, I am all for e-prescriptions and e-medical records.
- jcsoc, on 03/17/2009, -0/+3Where can I can my ecstasy prescription?
- jcsoc, on 03/17/2009, -0/+3you're friends with Rush Limbaugh?
- chesterogilvie, on 03/17/2009, -0/+3I'm sorry but we can't fill your prescription. The computer is down.
- cplusplus, on 03/17/2009, -0/+2Does anybody know how this work? Does the doctor just login to https://example.com (or something) and direct the pharmacist to do the same?
- crawfishsoul, on 03/17/2009, -0/+2My wife followed her doc's instructions to ask the pharmacy to contact them for a refill on her muscle relaxers for recent back surgery. The request was made Wednesday. Today, 6 days later, we finally find out that the pharmacy had the wrong fax number.
I mean, the technology is 30 some years old. Can we get out of the freaking stone ages already? - roddack, on 03/17/2009, -1/+3404 error: Prescription not found.
- foofightrs777, on 03/17/2009, -0/+2With ATM systems working so well I can't see anything going wrong with this idea!
- slayermet420, on 03/17/2009, -0/+2I like it. The military has been doing it for years. Everything is stored electronically, and your information is accessed by the doctor. He then makes the request, and the pharmacist pulls up your info by social security number.
- shanelw24, on 03/17/2009, -2/+4I love it when my personal information is stored to a server. Just dont let Comcast have it please.
- jamin, on 03/17/2009, -0/+2Even if you only have prescriptions filled via paper, that's still stored in your med history on the various networks (SureScrips/RX-Hub).
- davdev, on 03/17/2009, -1/+3With an electronic system, the MD would most likely be pulling the drugs out of a lookup into the hospital/practices Pharmacy dictionary with predefined dosages, so error's there would be rare. You could also have the system check for dangerous interactions or patient allergies before the drugs are ever sent to the Pharmacy, thus eliminating possible delays or deadly errors.
Also, at our hospital, all MD's are given individual user id's, passwords and esignature Pins. Giving these to a nurse so she can enter them in the system would be a gross violation of electronic medication policies and could easily lead to the MD losing his Hospital Credentials (essentially firing the MD) and the nurse would be fired. Most nurses, at least in a hospital setting, will refuse to do these sorts of things, as it puts their license on the line, a small PCP practice with LPN's or PCP's instead of RN's may be another story though.
More likely is an attending would have their residents do it, but at least the residents are also MD's. - jcsoc, on 03/17/2009, -0/+1see? I can't spell, I need my E!
- RealmDown, on 03/17/2009, -0/+110th Street and Peachtree. Don't forget the $120 co-pay.
- rollin03, on 03/18/2009, -0/+1Federal spending for Pharmaceutical Drugs.... O'Rlly?
http://tinypic.com/view.php?pic=1zdile&s=5 - hokie47, on 03/17/2009, -2/+3This will really help to stop the problems with prescription fraud. A good number of people I know are addicted to pain killers.
- nesagwa, on 03/17/2009, -1/+2Doctors already have their nurses write prescriptions for them.
A paperless system is ESSENTIAL. The way it is now the pharmacy has to call the doctor because he scribbled something that doesnt make sense or wrote the wrong drug. This costs a lot of time in a busy and over worked system and creates many many many drug errors.
Clearly typed electronic paperwork sent directly to the pharmacy's system eliminates a good portion of the human error (unless the doctor writes the wrong dosage/drug, which happens a fair amount, but thats what the pharmacist is there for.) - davdev, on 03/17/2009, -0/+1Yes, we will be using surescripts and a couple others (I believe, I am not working on that part), and we are converting our PHA dictionary to populate via FirstDataBank, we previously used 3M.
- InfiniteNothing, on 03/17/2009, -0/+1This should help correct problems caused by messy hand writing. It should also help those who want to order their prescriptions online.
- nanded, on 03/18/2009, -0/+1As a physician, I can tell you that the good pain medications require a signed paper script and can not be called by phone or computer. Weak stuff like vicodin however can be refilled like crazy.
- davdev, on 03/17/2009, -0/+1Don't tell me, you work for MEDITECH.
If so, yes, you have lots of issues - Nifab, on 03/17/2009, -1/+2Well this is going to cause my job to be more of a pain in the ass. I work for a pharmacy software company as part of software and hardware support. E-prescribing has been somewhat broken for a while and causes issues when the main switching company's server updates according to GMT even though it is located in EST. That or it is just that our software has a lot of issues. I am leaning towards option 2.
- davdev, on 03/17/2009, -0/+1We just switched over to a Bed Side med verification system, where the nurse needs to scan a bar code on both the patient and on each med before giving it to the patient. What we found is that on average, the Bar Code system catches between 5-10 errors a week. Meaning, before the bar code, the patient could have received the wrong med, or the wrong dose of the correct med.
Anyone who works in healthcare IT can easily demonstrate the need to increasing move towards a more Electronic system. - jamin, on 03/17/2009, -0/+1The CMS approved standard is NCPDP Script. http://ncpdp.org/
Typically you don't actually interface with individual pharmacies but with a clearinghouse, the largest of which is SureScripts: http://surescripts.com/
We've come a long way. This stuff actually works now. - hokie47, on 03/17/2009, -0/+1I forgot this is digg not reality. The reality is that these drugs are harmful and addictive and destroy countless lives. Oh sure that is the persons fault, but the fact remains it is still destructive. Weed is not addictive and barely harmful. I think many drugs should stay regulated.
- mooninite, on 03/17/2009, -0/+1Hahaha.... Until the "old school" doctors die from old age, we won't see a boom in ePrescribing. So I bet it will take about 10 years instead of 5 years. My guess should be pretty accurate seeing as I'm in the pharmacy software industry.
- 2of8, on 03/18/2009, -0/+1I'm sorry for your death but the doctor scribbled illegibly.
- otbeverly, on 03/17/2009, -0/+1Ummm, how is it going to help? A law banning so-called on-line pharmacies from operating is supposed to go into effect in April. Whereas before a prescription could be acquired via tele-medicine and a script mailed or filled by a "middle man." Now you'll be able to find unethical doctors, pay them and have them enter the script into "the system" and go wherever you want to pick it up.
Your friends who are hooked will learn to exploit this system pretty fast as will doctors looking to make a quick buck. Ten years ago, the internet was like the Wild West as far as pain meds go, and it's gotten legislated progressively since.There has been some loophole for every new law, but people always found a way around it.
I'm a recovering addict so I should know. - jamin, on 03/17/2009, -0/+1In many cases the doctor will have an ePrescribing system they purchase (either client/server or ASP model). It may even be built into their EMR. So they could be accessing the system through a web browser, yes...or through a client running on a PC or tablet. In the case of the fully integrated suite, your demographics are already in the system along with your chart...they would then go to the ePrescribing "module" of the system and often it will pull up a list of medications appropriate to the diagnoses the doctor has attached to your visit. This is usually all automated through the use of databases such as the ones provided by First Databank (http://www.firstdatabank.com/). The doctor will select the appropriate medication for you, the system will typically check for DDI (drug-drug-interaction) and ADR/Allergies (Adverse Drug Reactions), then allow the prescription to be sent electronically to SureScripts (the clearinghouse which connects to the participating pharmacies). If your preferred pharmacy is not in the network (the list is obtained through a web service, by the way), you will have a fallback of faxing the prescription (electronically) or printing.
Additional SureScripts interfaces allow retrieval of your medication history (for the purposes of having as complete a record as possible for DDI/ADR), and formulary/benefit/eligibility checking.
In the case of the doctor using a standalone ePrescribing system, your demographics may be automatically added to this system from your EMR through an interface using a standard such as HL7, or there may be manual entry required in the external system prior to prescribing for the first time. - davdev, on 03/17/2009, -0/+1When we first moved over to an Electronic Order Entry system, we got a ton of pushback from the older MD's (surgeons especially). Many outright refused to use the system. That's when the Chiefs stepped in, and told all medical staff they could either use the new system, or lose hospital priveleges. Most jumped on board, but a few didn't. Those few left the hospital, and honestly haven't been missed.
The key to implementing this stuff is a strong management team who, once they decide on a system, go headlong into it, and don't back down. Once they back down and let one doc get away with not using it, you will lose the whole house.
Now, that probably won't work in a small PCP office, but in a hospital setting it is vital. Personally, I won't see any MD who fights the PC's because it automatically throws a question in my head wondering what other advancements and technology they haven't been keeping up with. Give me a Resident backed by a capable Attending anyday. - circuitworx, on 03/17/2009, -0/+1I completely agree with you roddack. In fact, drug regulation is unconstitutional.
- davdev, on 03/17/2009, -0/+1We are working on this in my hospital.
The way it will work, is the MD will be working in the software we currently use and when the Patient gets discharge, the MD will fill out all the discharge orders, as they currently do. However, now instead of manually writing the script on a pad, and then typing it into our system, they will just type it in, and the computer will automatically send the script out to the correct Pharmacy via various interfaces we have with the other systems.
The biggest obstacle now, is there are no real standards for the systems, and each interface can be drastically different. If the government does step in, and establishes some standards for data transfer, it will be a lot more efficient and accurate. - davdev, on 03/17/2009, -0/+1Of course, if implemented, you should also be able to track what the MD's are prescribing and to who. So in theory, it should make it a lot easier to find the Dr's who are participating in this scam
- GaltShrugged, on 03/17/2009, -1/+1This article has come to an amazing conclusion. Did you know when the Pepsi invented Pepsi, more people drank Pepsi?
- RealmDown, on 03/17/2009, -1/+1"I bet good money the doctors will be having their receptionists going on the computer and keying in the prescriptions"
No bet here. What could *possibly* go wrong ? - shanelw24, on 03/17/2009, -0/+0It was clearly a joke.
- Pawnd, on 03/17/2009, -0/+0***** e-prescribing! Anger face.
I'm mean seriously?! I'm all for technology but this is going a little too far, this is just along the lines of iHigh... the electronic high schools, too much isolation. - endersadvocate, on 03/17/2009, -5/+3it will, of course, be tamperproof!
- BooksOfBokonon, on 03/17/2009, -7/+2With electronic voting systems working so well I can't see ANYTHING going wrong with this idea.
Note-to-self: Learn to hack e-prescription system within 5 years - DirtyVicar, on 03/17/2009, -13/+5Getting rid of paper prescriptions and replacing it with a client/server system sounds like yet another way to drive up health care costs and give unscrupulous companies more information for marketing, insurance denial, and other purposes.
If paper prescription errors are an issue, it sounds like that's a problem with medical schools not instilling the importance of accuracy and good handwriting and with the state licensing board not imposing harsh penalties on doctors who are careless and sloppy. A multibillion dollar IT project will just introduce other kinds of errors.
For instance I bet good money the doctors will be having their receptionists going on the computer and keying in the prescriptions -- that won't be good.
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