Anesthesia Billing & Management

Last summer, we mentioned data that suggested e-prescriptions are on the rise. Surescripts, which operates the nation’s largest e-prescription network, stated that about 36 percent of physicians file prescriptions electronically. However, that number increased by about 70 percent from 2009 to 2010.

That trend appears to be continuing as Surescripts just announced that over 52 percent of office-based doctors are now use e-prescribing.

E-prescriptions are seen by many as an important step in the evolution of our healthcare system. They make for a more accurate, reliable and secure electronic prescription system and also allow prescribers to access important information regarding their patients’ medications and health plan coverage.

Here’s the latest data from Surescripts regarding the growth of e-prescribing nationwide:

• 52 percent (291,000) of all office-based physicians now actively use e-prescribing compared with fewer than 10 percent three years ago

• There are 357,000 active prescribers on the Surescripts network (including office-based physicians, nurse practitioners and physician assistants)

• 94 percent of retail pharmacies nationwide are now connected and receiving e-prescriptions

And finally, here is the list of the top 10 states with the highest rate of e-prescribing:

1.  Massachusetts                
2.  Delaware                
3.  Michigan                    
4.  Connecticut                    
5.  Rhode Island                    
6.  Pennsylvania
7.  South Dakota*
8.  Iowa*
9.  Oregon*
10. North Carolina*

(*New to the top 10)

“In the next five years, we are going to see electronic health information exchange of all types – e-prescribing, clinical summaries, population health – become commonplace and become the rule rather than the exception,” said Dr. John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston.

There is some good news for Oregon hospitals and health care providers who serve Medicaid patients: there are federal grants available to support their efforts in implementing electronic health records.

On September 26, 2011, Oregon hospitals and eligible health care providers became eligible for these new grants. Those health care providers eligible for the program can receive up to $63,750 over a period of six-years. There will be various factors that determine the value of the grants.

Oregon’s Medicaid EHR Incentive Program is administered by the Oregon Health Authority’s Office of Health Information Technology, and moving forward, is set to help with better care and lower costs on behalf of Oregonians.

The Medicaid EHR Incentive Program is a part of the federal American Recovery and Reinvestment Act of 2009, which encourages states to make the switch to electronic health records. It’s not only intended to help hospitals and healthcare providers make the switch to secure EHR systems, but empower doctors and patients to work together to manage their private and up-to-date health records, increasing efficiency, and avoid redundant procedures.

Healthcare providers can apply now. There are a number of qualifying points, but if you are a provider with less than 90 percent of your services provided in a hospital, you may qualify for the program. For more information on the criteria for qualifying, go to the Medicaid Electronic Health Records Incentive Program website.

There are many reasons to advocate the transfer to electronic medical records. It has cost saving benefits and even can help improve the quality of care patients receive. However, if there is an improvement that needs to be addressed, it may be the privacy issues, something that opponents of electronic records often point out.

Veriphyr, a Los Altos, California-based identity and access intelligence solutions provider, conducted a survey of 90 healthcare IT managers. What they found should be a concern EHR proponent and opponents alike.

According to the survey, over 70 percent of healthcare organizations reported a breach of personal health information over the preceding 12 months. Most of these breaches were committed by nosy employees: 35 percent looked at the medical records of their co-workers and 27 percent accessed records of friends and relatives.

“While the loss of patient data on hard drives and USB sticks gets a lot of coverage, the top concern of compliance officers is the few employees who misuse the legitimate access to snoop on patient data,” says Alan Norquist, CEO of Veriphyr.

Norquist suggests that the focus on resolving the privacy problem should not be on digital security as much as tools that monitor who accesses the files. He goes on to suggest that healthcare organizations need identity and access intelligence tools that can monitor logs of employee access to patient data.

His reasoning is sound, because he points out that the main problem is not deviant outsiders hacking into the system, rather it’s employees who have access to the records.

“The problem is not authentication to keep the bad guys out, but monitoring the employees who have almost unrestricted access to patients’ data. The reason this data is greatly unrestricted is because in a life or death situation you would not want to prevent a doctor or nurse from getting the patient data they need right away,” says Norquist.

Google’s high-profile and bold mission has always been to organize the world’s information. Unfortunately (or fortunately depending upon your perspective), they haven’t been particularly successful in their health records business.

Last month, Google announced that it is folding Google Health, where consumers could organize their medical records. Starting in 2008, Google Health allowed users to manually input their health information or log in to their accounts with health services providers who partnered with Google. Some of the volunteered information included health conditions, medications, allergies, and lab results.

So what led to the demise of Google Health? For one, according to an IDC Health Insights study released last month, only seven percent of all Americans have ever used a personal health record (PHR). As more and more healthcare providers move toward electronic health records (EHRs) and health information exchanges (HIEs), the use of PHRs is expected to steadily rise. It’s just a little too late for Google Health.

“Experts say its untimely death is, in many ways, an extension of U.S. health-care providers’ failure to share data across institutions, or make it easy for patients to obtain it,” said David Talbot of MIT’s Technology Review.

Isaac Kohane, who directs the informatics program at Children’s Hospital in Boston, and co-directs Harvard Medical School’s Center for Biomedical Informatics, says that will be at least five years before data is flowing smoothly enough for something like Google Health to work. Beyond efficiency problems, some analysts feel that Google failed to create enough trust with people who may be wary about what would happen to their health records once they were loaded on Google’s servers.

Google Health will be shut down January 1, 2012, but people who currently use Google Health will be able to transfer their information to another PHR platform, such as Microsoft HealthVault, WebMD, or NoMoreClipboard, through January 1, 2013. Beyond that, they will be permanently deleted from Google Health.