MICHELE NORRIS, host:
In ancient Babylon, healers wrote some of the earliest known prescriptions for medicines by carving instructions into clay tablets. Two and a half millennia later, most doctors use pen and paper. Now Congress wants doctors to make the next technological leap - filing prescriptions for Medicare patients electronically.
NPR's Julie Rovner reports some doctors are a little wary.
JULIE ROVNER: Andrew Warner may be a very a good gastroenterologist, but when it comes to handwriting, well, here's how he puts it.
Dr. ANDREW WARNER: When I was in fourth grade, I got my first B in penmanship. My mother, who believed in honesty, actually called the school to see if that was legitimate grade. My penmanship's god-awful.
ROVNER: So when the Lahey Clinic in Massachusetts, where Warner practices, moved from handwritten prescriptions to electronic prescribing a few years ago, it was a big relief. Now, he says, pharmacists don't have to wonder whether he's written a four or an eight.
Dr. WARNER: The pharmacist gets exactly what we want them to get. The numbers of call backs we've gotten from pharmacist have gone from multifold down to zero.
ROVNER: And because the prescription goes directly from the doctor to the pharmacy, e-prescribing say it's a step for patients. The prescription is ready and waiting when they arrive at the pharmacy counter. But Warner says the real value of e-prescribing is its ability to reduce medication errors and save money. He prescribes straight from his handheld computer, he taps on the screen, and, basically, a prescription pad pops up.
Dr. WARNER: It has a list of all the drugs your patient is on, so you know everything they've taken. And if there's a particular medication you want to give your patient, you go ahead and just tap on it. If there's an interaction between that drug and some drug the patient's already on, a big, red box will appear. It'll say, safety alert, and tell you what that is. If there's no safety alert then the drug will appear plus a bunch of other drugs which are alternatives. And these are color coded. If they're green or black, it means that the patient will have a low code payment. If it's red or blue, it means they have a high code payment.
ROVNER: While electronic prescribing is growing rapidly, it still represents only a tiny fraction of prescriptions written each year about, about 2 percent of the one and a half billion that were eligible for electronic routing this year were actually filed that way according to SureScripts, which runs the industry network that allows doctors and pharmacies to exchange electronic prescribing information. So now Congress wants to give e-prescribing a bit of a kick-start.
Senator JOHN KERRY (Democrat, Massachusetts): We have the technology, we have the interoperability, we know how to make this happen, but not enough people are embracing it rapidly enough.
ROVNER: Massachusetts Democratic Senator John Kerry is sponsoring a bipartisan bill that would initially give doctors a bonus in their Medicare payments if they start e-prescribing. If they don't adopt the technology by the year 2011, though, they'd have their payments reduced.
But now is not the time for any type of mandates on doctors for new technology says the American Medical Association. Dr. Joseph Hayman is the AMA's chairman elect.
Dr. JOSEPH HAYMAN (Chairman-elect, American Medical Association): We worry that there's such frustration out there right now with Medicare payments that adding a mandate would be something that would cause some physicians to just throw in the towel.
ROVNER: Hayman himself, an obstetrician gynecologist in solo practice, uses both an electronic medical record and an e-prescribing program, and he doesn't plan to ever go back to paper. But he also says the technology is not as simple as advocates suggest. For example, in his system…
Dr. HAYMAN: You have to leave one program to go to the other. And you're entering data in a duplicate fashion, so that when I write a prescription for a patient on my e-prescribing programs, I also have to write the prescription in my electronic medical record. So it's twice as much work.
ROVNER: Hayman says he's recently found a way to synchronize his electronic medical record and e-prescribing programs, but there have been more than a few glitches along the way.
Dr. HAYMAN: We've been working on it for weeks. You can imagine that in a busy practice, a solo practitioner or a small group practice, the frustration level could get pretty high. Doctors are already frustrated with Medicare; unless Congress acts in the next two weeks, they're facing a 10 percent pay cut starting January 1st. But it's possible the same bill that will prevent that cut will also implement the e-prescribing mandate.
Julie Rovner, NPR News, Washington.
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