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Electronic prescribing and Medicare: Let the doctor decide

Don't force physicians to buy and use unproven e-prescribing systems.

Editorial. Nov. 3, 2003.

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When it comes to electronic prescribing, the federal government should not shoot off mandates first and ask questions later.

Yet that is what the House of Representatives is proposing as part of its Medicare reform bill. The bill contains a measure that would require Medicare officials, with help from an advisory panel, to establish electronic prescribing standards by Jan. 1, 2006. Then starting in 2007, physicians would be required to write electronic prescriptions for all Medicare patients, except in emergencies or certain other cases.

The idea of setting technological standards is commendable. After all, it's much easier to adopt a technology if everyone is comfortable that information can transfer from point to point without glitches. But requiring use of a technology that may not be ready for prime time, even in four years, is not so laudable.

That's why the AMA and numerous medical societies are pushing for adoption of the Senate's version of the electronic prescribing measure as House and Senate conferees meet.

The Senate bill would require standards by the same date as the House bill, but it would allow physicians to choose whether to prescribe electronically.

There are many reasons that this is the wiser course. The first is that developing and implementing any technological standards is a difficult, time-consuming process.

In an Aug. 26 letter to House Ways and Means Committee Chair Bill Thomas (R, Calif.), the AMA and 46 specialty societies pointed out that Congress passed the Health Insurance Portability and Accountability Act in 1996, yet transaction standards had yet to be fully implemented. That's seven years.