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E-Prescribing Group Met with Cautious Optimism

Nine entities including tech and e-prescribing companies have banded together to educate physicians and health care payers about successful strategies, but physicians say they'll wait and see.Physicians are taking a time-will-tell approach to a new industry consortium dedicated to accelerating electronic prescribing. Nine well-recognized entities, including high-tech and e-prescribing companies, announced Tuesday that they had banded together to educate physicians and health care payers about successful strategies in e-prescribing and its potential to improve health care. The group, which calls itself Cafe Rx, says it will promote common standards and government support of e-prescribing.

Electronic prescribing transmits physicians prescriptions directly to a pharmacy from a point of care, eliminating errors caused by poor handwriting. David Brailer, the nations health IT czar, has promoted it as one way to reduce medical errors, and the Centers for Medicare and Medicaid Services is actively encouraging the practice.

Two California physicians contacted by called the formation of the group "intriguing" and "interesting," but werent sure whether Cafe Rx would be able to deliver on its rhetoric. But in an interview with, Steven Waldren, assistant director for health and IT with the Leawood, Kan.-based American Academy of Family Physicians (AAFP), seemed sanguine.

Waldren said e-prescribing could significantly reduce phone time for patients, pharmacists, physicians, health plans and PBMs. The biggest impact, he said, would come when e-prescribing was part of an electronic health record (EHR), where it could provide decision support in drug-drug, drug-allergy and other interactions. "If CafeRx stays true to e-prescribing as a step toward an EHR, I think they will be very effective."

Donald Gravlin, acting chairman of Cafe Rx and chief technology officer at Capgemini Healths payer practice, said in an interview with that while e-prescribing could function as a self-contained service, the group ultimately hoped to promote EHR and could help do so by promoting connectivity and interoperability standards.


But he said the first projects would involve mainly outreach, "just educating the average physician practice as to how e-prescribing actually works, what the use of the script standard actually means, helping them understand legislation in their state, and introducing them to the people working with retail pharmacies."

Another imminent focus is automating refill prescriptions, which would cut administrative costs at both pharmacies and physician practices. "There are 500 million refills that could be brought online very quickly," Gravlin said.

Electronic prescribing systems have been criticized for costing too much, taking more time than writing prescriptions by hand, insufficiently reducing medical errors and even introducing new kinds of errors.

To read about one study showing e-prescribing to have limited use, click here.

But Waldren said Cafe Rx might reduce these risks by promoting evaluation studies on e-prescribing and developing best practices for user interfaces.

AAFPs Waldren also said he thought Cafe Rx was more likely to shield against inappropriate commercial messaging than to promote it. "They want to increase adoption and use of e-prescribing, and if there is inappropriate commercial messaging, physicians will not use it," he said.

While he said Cafe Rx has so far been reaching out to other stakeholders, the group might not serve the general good if it does not represent all kinds of entities involved in e-prescribing. "If all the systems stakeholders interests are not incorporated in the directing of the consortiums action, then those actions may favor one stakeholders interest. This usually is not the best for the system as a whole."

To read about one study showing that e-prescribing reduces errors, click here.

Though he did not specifically mention any physicians groups, Gravlin said more than 10 groups had contacted Cafe Rx about joining the consortium and that there were "well more than 200 organizations that wed like to see participate."

But he said it made sense to start small and that many of the founding members had already partnered on e-prescribing projects. A group of nine was manageable at a dinner table at the National Council for Prescription Drug Programs in March. "We kept it focused so we could get some principles together," he said.

Members of the consortium include Allscripts Healthcare Solutions, Capgemini, Cisco Systems Inc., Hewlett-Packard Co., Microsoft Corp., the National Council for Prescription Drug Programs, NDC Health, ProxyMed Inc., RxHub and SureScripts.

Source:   E-Prescribing Group Met with Cautious Optimism
By M.L. Baker

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