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Mandatory E-Prescribing: Just Around the Corner?

April 28, 2008
by Mark Hagland
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In a speech last Wednesday to the World Health Care Congress in Washington, D.C., Health and Human Services Secretary Michael O. Leavitt urged his successor to continue with the “four cornerstones” initiative begun under his tenure, a drive that includes a call for the ongoing measurement of quality of care; better cost data; greater use of interoperable electronic medical records; and the development of incentives to promote better care. According to a report in Medical News Today, Leavitt told his audience that “Better information about quality and cost will not appear all at once, nor will the benefits of its use.” Instead, he said, “It will happen gradually over the next decade, but we will get benefits at every step in our progress.”

Among his priorities in the remaining nine months of this term? Requesting that Congress give HHS the authority to require physicians to electronically prescribe for their Medicare patients. Now, if you look at that specific priority in the context of HHS’s overall “four cornerstones” initiative, you’ll quickly notice that three of the four “cornerstones” will necessarily involve healthcare CIOs and the work they and their teams would need to be doing to help fulfill those federal government healthcare priorities (and of course the potential e-prescribing mandate will affect virtually every physician in private practice as well).

Meanwhile, in a blog posted on last month in the Wall Street Journal online titled “Cherry Blossoms and MedicareDoomMarkSpring in Washington,” Jacob Goldstein noted that “Federal officials told Congress yesterday [March 25] that the Medicare trust fund will become insolvent in 2019, as healthcare costs rise and Baby Boomers retire.” Keep that in mind at the same time you consider that Leavitt is making no bones about his contention that it is not the federal government’s responsibility to help pay for automation in healthcare.

So where does that leave us? Unquestionably, whichever national party generally prevails in the November presidential election and November congressional elections (or whether the Democrats and Republicans split the victories relatively evenly), providers will come under increasing pressure from the federal government to move forward as quickly as possible, and largely without significant financial aid, towards increased transparency and automation in healthcare. And when it comes to a relatively “easy” (well, for political leaders, anyway) step to take such as mandating e-prescribing for all Medicare-related prescriptions, there’s no question in my mind that the new president and the incoming HHS secretary, whoever those two individuals might be, could well make such a step one of the first ones taken to affect healthcare operations after the inauguration in January 2009. Such a move would be widely hailed by experts and the public, and largely uncontroversial. Given all that, my advice to CIOs is that if you haven’t already made e-prescribing a top priority for your organization—encompassing the needs of your office-based physicians and their practices—now is the time to do so. With the federal government heading towards Medicare insolvency in the foreseeable future and at the same time demanding a more efficient, cost-effective, transparent, and higher-quality healthcare system, you can expect a forward-thinking step like Medicare-universal e-prescribing to become a reality sooner rather than later.

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Mark Hagland

Editor-In-Chief

Mark Hagland

@hci_markhagland

www.healthcare-informatics.com/blog/mark-hagland

Mark Hagland became Editor-in-Chief of Healthcare Informatics in January 2010. Prior to that, he...