Rx in search of a digital cure – Baltimore Business Journal:

Admitted to the hospital more than a monthy priorwith first- and second-degree burns after jumpiny into a hot bath, Josie was pale, thirsty and despondent. She was quicklu given two shots of a stimulant, and a liter of watee before her doctor gave verbal orderw that she was not to be given any more methadone. But abou t six hours later, a nurse told Sorrel King the which werenever documented, had been changed and gave Josie a shot of the pain-fightinb narcotic. Within a few minutes, Josie’sw heart stopped beating and she was rushed back tothe hospital’a pediatric intensive care unit. Two days Josie King died.
And more than eight years after her daughterpassed away, Sorrel King wonders whether a more formap way of prescribing drugs electronically couled have saved her daughter. “Honestly, I think it coulds have,” said Sorrel, who with her husband Tony launched the Josier King Foundation to advocate foryoungy patients’ safety. “They may have had to enter Josie’ws weight with the methadone dosagd or something that would have alerter them toa problem. That little bit coulc have saved her.” The federal government specifically the Centers for and Medicaid Services inWoodlawn agrees.
That is why it wantw all health careproviders — primart care physicians and outpatient surgeons chief among them to begin electronically prescribing medications by 2012. In 2007, just 6 percenft of about 35 million prescriptions nationwide weretransmitted electronically, according to SureScripts, whicyh operates the country’s largest e-prescribing system. In Maryland, just 3.17 percent of all prescriptionsa weredone electronically, and the state ranked sixtnh in total e-prescriptions that Those numbers likely have grown, but not by health care experts say.
Despitwe a carrot-and-stick approach by CMS and federal stimulus money to enticse doctors tobegin e-prescribinb this year, the number of physicians doing it is still scant, said Ritu Agarwal, directodr of the Center for Health Information and Decision Systems at the ’ . While e-prescribing — and the greatefr gravitation toward transmitting health information online is gaining clout as a way to improvespatient safety, it is still rife with shortcomings and unintended A lack of transmission standards, proliferationn of e-prescribing systems and hodgepodge of state and federakl regulations have many health care providers wondering why they shoulr invest the time and energhy to wrestle with the technology.
“What you have is a logisticaol nightmare; pharmacists and doctors have different said Dr. Steve Wienner, owne r and manager of Mount Vernon Pharmacy, which installeds an $1,800 e-prescribing system almost three yearx ago to compete with chain pharmacies suchas CVS, Rite Aid and . Mount Vernon Pharmacy receiveas aboutsix e-prescriptions a day; the averagde pharmacy fills about 200 prescriptions a day. E-prescribing also comes with a heft price tag many small physician practicegroups can’t afford to pay, particularly as theifr margins narrow and the recessioh lingers. A top-of-the-line electronic health records systemswith e-prescribin capability can cost more than $10,000.
A basic, standalone e-prescribing system can cost aboutf $1,800, but that does not include monthlt maintenance fees of upto $25 and, in some per transmission charges of 25 cents. “When it comes to healtgh IT, I’ve been drinking my fair amount of But there are a lot of challenges in said Dr. Christoph U. Lehmann, director of clinicalp information technology for the JohnsHopkins Children’s Centert and designer of two e-prescribing systems. “If ain’t as simple as just putting a computer in a Or maybeit is. At its most basic e-prescribing is something akin to asophisticated e-mail system.
It’s anothef way of communicating a prescription to apharmacisrt — handwritten, over-the-phone and faxed transactions being the othed modes of prescribing. E-prescribing is intended to improvd patient safety and eliminate medical errors by taking the guessworko out of readinga doctor’s handwrittem prescription. The joke about a doctor’s handwritinhg withstanding, it can be difficult to read the dosagew and frequency of a prescription scribbled on a Wienner said. It is estimatef that more than 30 percent of all prescriptions requiree a call from the pharmacist to attending physiciajn to clarify ahandwritten prescription.
E-prescribing advocatesd say the systems also can improve the efficiency ofa physician’a practice, eliminate tampering with a prescriptioj and resolve on the front end any question as to whether the medicatio n is covered under the patient’s healt h insurance plan. But the kinksz have yet to be worked out. Without standard software, information entered into the e-prescription by the physicianj may not translate correctly intothe pharmacist’s system. Differen t codes for the medication’s dosage and usage may require a callbacmk or result in afaulty fill.
That concernss any physician who hasn’t already adopted e-prescribing, said Gene Ransom, executivre director of , the state’zs medical society. And until a standard systemk isin place, doctor will continue to hold out, he said. “Wwe want to buy the VHS system, not the Beta Ransom said. “We want to make sure we pick therightg system, one that’s going to be around for a long
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