To prepare for e-prescribing and the Medicare payment incentive of 2% in 2009, the Hoskins Center has compiled resources to help in your selection.
Minimum Functional Criteria for E-Prescribing
The American Academy of Ophthalmology's Committee on Medical Information Technology has developed minimum functional criteria recommended for an e-Prescribing program, to help provide guidance in selection. Click here to view the criteria. (PDF 59K)
A Clinician's Guide to Electronic Prescribing is available from the eHealth Initiative Foundation, in collaboration with the American Medical Association, the American Academy of Family Physicians, the American College of Physicians, the Medical Group Management Association, and the Center for Improving Medication Management.
The Academy also has a site where you can learn more about e-prescribing and take an assessment: www.getRxconnected.com/AAO
The e-prescribing solution does not need to be specific to ophthalmology; they usually draw upon a database of commonly prescribed drugs, and should have the ability to add drugs readily for the office, as needed. If you already have an electronic health record, e-prescribing is probably available. If you are looking for a standalone solution, certified solutions are described below.
To help you integrate pharmacy connectivity into your practice with ease, Best Practices have been compiled. This information can help in your initial start of e-prescribing. Find out how to participate in the 2009 incentive program with a new CMS fact sheet. The CMS has a website dedicated to e-prescribing: http://www.cms.hhs.gov/ERXIncentive.
SureScripts-Rx Hub operates the Pharmacy Health Information Exchange™which facilitates the electronic transmission of prescription information between physicians and pharmacies. To utilize e-prescribing through a stand-alone solution or an electronic medical record (EMR) system, the system should be certified to connect to the Pharmacy Health Information Exchange™. SureScripts GoldRx™Certified Solution Providers meet an advanced certification that focuses on benchmarks that signal a vendor's commitment to interoperability, customer support and successful implementations. The AllScripts E-prescribe program (by itself) is provided free of charge. DrFirst and RxNT are standalone products; Allscripts Enterprise EHR, eClinicalWorks and NextGen EHR are electronic health record products. You and your office will want to compare products on features, ease of electronic prescribing, availability of technical support and training, how it can interface with your existing practice management systems, etc.
In presenting this product summary, the American Academy of Ophthalmology affirms that it receives no revenues, grants, or royalties from any company listed herein.
GoldRx™ Certified Solution Providers (PDF 64K)
Companies: Allscripts, Allscripts/National E-prescribing Safety Initiative (NEPSI), DrFirst, eClinical Works, NextGen® and RxNT
Ask about compliance with standards when you evaluate devices and software
Health information technology standards should increase the quality of care. The Hoskins Center and the Academy recommends you factor in standards
when you evaluate devices, equipment and information systems for your practice. A list of companies participating in the Academy-sponsored standards initiative is available.
An open standards approach gives you flexibility to select systems that meet your needs today and in the future as the digital landscape evolves. Single vendor, proprietary interfaces between devices and software in your office are not standards-based, and do not provide the same assurance of data integrity that standards-based interfaces do. The issue is connecting the right data to the right patient, whenever and wherever you may be viewing it. A standards-based approach enhances quality: you won't lose data in the future, and the right data is connected to the right patient.Standards Approach - Why you should care about standards?
Why does the Hoskins Center and the Academy think that you should care about standards? Single vendor solutions tie a physician to the success of their selected vendor. Multi-vendor solutions, on the other hand, require a practice to become a "systems integrator," coordinating and problem solving. To have multiple systems connected to support the needs of the practice, systems need to be "interoperable" or talk to each other. This can be done either through an open standards approach or a private, proprietary approach.
Standard-based approaches relevant to eye care include:
- Digital Imaging and Communications in Medicine (DICOM) for digital images and data
- Integrating the Healthcare Enterprise (IHE) Eye Care for exchange of information between different systems within your practice
The Integrating the Healthcare Enterprise (IHE
) Eye Care initiative brings together modality vendors, Electronic Health Record (EHR) vendors, image management system vendors, physicians, hospitals, departments of ophthalmology in hospitals, etc., to define the actors and transactions that are required to capture, store, retrieve, process, communicate, etc., information in support of the delivery of medicine and the business activities essential to the economic survival of those organizations.
The most fundamental benefits expected from integrated healthcare enterprises are economic reductions in the total cost of service delivery and quality of care improvements available from the accessibility of EHR information used to optimize care and the utilization of resources required to deliver that care. Plug-to-plug compatibility and interoperable product alternatives should assist decision makers in selecting instruments, EHR systems, etc., that work together seamlessly without the need for special customized efforts and costs for installation and support.
IHE Eye Care Technical Co-Chairs: Rick Butler (Medflow, Inc.) and Imran Chaudhri
IHE Eye Care Planning Committee Co-Chairs: Jim Riggi (Medflow, Inc.) and Linda Wedemeyer (Veterans Administration)
Find out more information about The Electronic Office:
The Digital Imaging and Communications in Medicine (DICOM
) is a standard for the communication of medical images and associated information. This standard has been developed to meet the needs of manufacturers and users of medical imaging equipment for interconnection of devices on standard networks.
Systematized Nomenclature for Human and Veterinary Medicine (SNOMED) was conceived from the start as a system for representing clinical information. Unlike ICD-9 and CPT4, it is not used for billing in the U.S.
Electronic Health Records
If you would like more information or are interested in being involved in IHE or DICOM, contact Flora Lum
Clarification that CCHIT Certification does not apply for any Eye Care Electronic Health Records
Currently, there is no eye care specialty CCHIT certification. The current process for testing is not designed for eye care only EHR vendors, and they cannot participate in the process unless they adapt to including ambulatory care elements. A lack of current CCHIT certification does not have significance for eye care specialty needs. Current CCHIT certification means that the system satisfies basic ambulatory care needs. Practices need to look at different systems and how they best meet your needs in delivering eye care services.
At the current time it is problematic to ban the sale of non-CCHIT certified EHRs because not all specialties have CCHIT EHRs available to them at this time. Under the current CCHIT timeline for eye care certification criteria development, it will be virtually impossible for eye care providers to purchase certified systems that are designed for their specialty until 2011. Since most of the remaining surgical specialties are not yet on CCHIT's roadmap, and it is not clear when CCHIT will open its "environmental scan" process where groups can approach CCHIT about expanding certification to other areas, there is a concern that any other specialty approaching CCHIT with the same request is not likely to have certification criteria developed for their specialty until after 2011. If providers must purchase primary care focused EHR systems, they have to make significant and costly modifications to certified primary care focused EHR systems to make them feasible for managing their specific patients. Quality of care and reduced costs will be lost if this is mandated.