Panel weighs competing views on federal e-prescribing standards

Physicians call for a workable system that protects patients' interests.

By Markian Hawryluk, AMNews staff. June 14, 2004.

Washington -- Patricia Hale, MD, an internist from Glen Falls, N.Y., wants the ability to prescribe electronically.

Several years ago, she test-drove several commercial e-prescribing systems in her rural practice in the Adirondack mountains. But none of them were viable.

They didn't operate well with her practice management software, forcing her to re-input patient information. Formulary information from insurance companies, if available at all, was quickly out of date. And though Dr. Hale knew local pharmacies wouldn't be able to accept electronic prescriptions, she thought she could at least fax the prescriptions. But the pharmacies that had fax machines were unwilling to commit to checking them on a regular basis.

"It turned out because of all those things, it wasn't worth using," she said. "It took longer to do it than it did writing them by hand with no real reward to it."

The federal government is now working to resolve many of the problems Dr. Hale faced in trying to bring electronic prescribing to a small-practice setting. But myriad competing interests and a high level of complexity has left government officials with a lot to accomplish in a short amount of time.

The Medicare Modernization Act of 2003 directed the Dept. of Health and Human Services to develop standards for electronic prescribing by Jan. 1, 2006, and then to pilot-test them and have them ready for voluntary adoption nationwide by 2009. That would allow systems developed by different companies to interact with each other.