The National ePrescribing Patient Safety Initiative

When the Institute of Medicine released its Preventing Medication Errors report in July 2006 estimating 1.5 million adverse drug events per year (www.iom.edu/ CMS/3809/22526/35939.aspx), as a practicing physician, I dreaded the inevitable list of abbreviations banished from appearing again in patient’s notes and charts. Others, however, reacted by taking a more constructive approach. Glen Tullman, CEO of medical software giant Allscripts (www.allscripts.com), came up with a revolutionary plan. He set about to provide all physicians with free electronic prescribing capabilities. He challenged his board to answer the following questions:

• How can we give every physician this software for free?

• How do we make it as easy to use as Google?

• How do we make it so easy that even someone who doesn’t know anything about medicine can use the program to write a prescription within fi ve minutes?

• How can we enlist the large payers in this country to step up and provide incentives for using electronic prescribing?

Tullman then assembled a dream team of technology firms, insurance companies, and clinicians to design the system and provide the best opportunity for this project to succeed. The resultant conglomerate, the National ePrescribing Patient Safety Initiative (NePSI), launched in late January.

What Program Is Used? NePSI is built around Allscripts’ eRx NOW™, a standalone electronic prescription-writing program that may be used on any device with Internet access, including desktops, tablet PCs, PDAs, and smartphones. Since the vast majority of physicians probably already own and operate one or more of these devices, using NePSI does not require physicians to invest in any additional technology. The program enables prescription writing and submission to the patient’s pharmacy from any location with Internet connectivity. All data submitted is fully secure and HIPAA compliant. Like other top-of-the-line ePrescribing programs, eRx NOW™ provides dosage verifi cation, formulary adherence, and drug—drug interaction checking at the point of patient care.

Who Is Expected to Use NePSI?

Physicians who are not currently ePrescribing by means of a more comprehensive electronic medical record (EMR) are the NePSI target audience. Given the existence of an inverse relationship between medical practice size and technology adoption, this program is targeting the large percentage of physicians that practice in groups of less than 10 practitioners.

How is This System Superior to Other Products?

A tremendous amount of thought and planning has gone into producing an ePrescribing software solution that combines an easy-to-learn interface with the ability to rapidly generate prescriptions. With NePSI, a new prescription can be produced in about 30 seconds. This speed of prescription generation is facilitated by the following unique features:

• The ability to interface with an existing practice management system. Once in place, such an interface will automatically update patient demographics so that the ePrescribing system will contain current information.

• An embedded Google search engine that allows users to populate patient data simply by entering the patient’s phone number. A reverse number lookup provides the rest.

• Automatically populated patient medication profi les. eRx NOW™ has the capacity to retrieve prescription data from multiple pharmacies, as long as the prescriptions were purchased under insurance coverage.

• eRx NOW™ allows users to associate an indication (diagnosis) with each medication prescribed. Medications may be searched by diagnosis, and NePSI reminds physicians of what they usually prescribe for a given diagnosis.

• Physician ease-of-use for every step of prescription writing. This physician bias will be apparent to users who are familiar with other ePrescribing systems.

• Allscripts plans to “close the loop” on prescriptions sent via the SureScript Network (www.surescripts.com). They realize that it would take a very small number of unsuccessful prescription transmissions to sabotage the program. NePSI is dedicated to ensuring a positive physician experience each and every time.

Allscripts and its technology consortium are offering a cutting-edge product that succeeds in eliminating two of the barriers to technology adoption: expense and ease of implementation. I recommend eRx NOW™ and applaud NePSI for their vision and commitment to improving the quality of medical care by off ering this program. For further information or to sign up for this service, go to www.nationalerx.com.

Dr. Zuckerman is a solo-practice neurologist in Baton Rogue, LA, and a juror for the Certification Commission for Healthcare Information Technology.