News Release

Pilot Project Launched to Expand Electronic Prescribing

HHS Secretary Mike Leavitt today announced the launch of a pilot project to test initial standards for electronic prescribing at the third meeting of the American Health Information Community. These standards may ultimately be adopted as the final standards that will create a robust system of electronic transmission of prescription information for the new Medicare Part D prescription drug program.

"The new e-prescribing pilot project represents a major step forward in our work to develop and adopt standards for electronic medical and personal health records," Secretary Leavitt said. "This pilot will help to create a new age in efficiency and safety in America's medical care industry."

Under the pilot project, four grantee teams will measure the impact of electronic prescribing data transmission systems on patient safety and quality of care, such as whether and how they reduce adverse drug events and improve the appropriate use of medications. The project involves testing several systems of electronic data transmission standards and determining how efficiently and effectively prescriptions and prescription related information can be sent to and received by the providers and pharmacies that are participating in electronic prescribing for Medicare Part D beneficiaries.

"With Medicare's new drug coverage program, we are providing help with drug costs as well as new support for a more effective electronic health care system," said Centers for Medicare & Medicaid Services (CMS) Administrator Mark McClellan, M.D., Ph.D. "We expect that electronic prescribing will help improve quality, prevent medication errors, and reduce costs."

The standards that will be tested are termed "initial standards." They will also be tested for interoperability with three "foundation standards" that were adopted in the regulation issued on Nov. 1, 2005 and published in the Federal Register on Nov. 7, 2005. These initial standards involve transactions that will support not only the electronic prescription itself but also will provide additional related information to help improve quality and lower cost. For example, the standards in the e-prescribing pilot will enable physicians to obtain formulary information and medication history. It will also test new standardized ways of naming clinical drugs and their ingredients, and of providing instructions for patients on how to take their medications.

The pilot project will assess resulting changes in workflow in pharmacies and physician offices that may demonstrate a return on investment resulting from e-prescribing.

The project will be administered jointly by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ).

"We want to be sure that e-prescribing works as intended and that health care personnel are prepared to use it effectively," said AHRQ Director, Carolyn Clancy, M.D. "This project will help ensure that we achieve positive results as we implement health information technology."

The project is being conducted through competitively awarded cooperative agreements totaling nearly $6 million and will run during calendar year 2006. The awardees are:

• RAND Corporation, Santa Monica, Calif., in conjunction with the New Jersey E-Prescribing Action Coalition, an industry-academic partnership involving RAND Health; Horizon Blue Cross Blue Shield of New Jersey; the e-prescribing vendors AllScripts, Caremark iScribe, and InstantDx; Caremark's prescription benefit management plans; the electronic prescription routing companies RxHub and SureScripts; Caremark's mail-order pharmacy and Walgreen's retail pharmacies will conduct the pilot in New Jersey. In addition to testing the standards, the project will determine changes in drug use, clinical outcomes, and patient satisfaction as a result of e-prescribing.

• Brigham and Women's Hospital, Boston, Mass., in conjunction with physician practices in Massachusetts associated with a hospital network, will use an existing community utility for e-prescribing called the eRx Gateway. The pilot will test the e-prescribing standards and will conduct needed research into ambulatory drug safety and the impact of e-prescribing on physician workflows.

• SureScripts, Alexandria, Va., partnering with Brown University and five vendors (Allscripts, DrFirst, Gold Standard, Medplus/Quest Diagnostics, ZixCorp.) will recruit physicians and pharmacies for participation in Florida, Massachusetts, Nevada, New Jersey, Tennessee, and potentially Rhode Island. The pilot will evaluate how the e-prescribing standards work in a variety of practice settings, geographic areas, and e-prescribing technologies. In addition, the project will assess how prescriber and vendor characteristics influence e-prescribing adoption and what "best features" of vendor software improve medication-related safety outcomes.

• Achieve Healthcare Information Technology, Minnesota, in conjunction with nursing facilities in Minnesota associated with the Benedictine Health System and Preferred Choice Pharmacy will be the first program to evaluate how the e-prescribing standards work in certain long-term care settings. The project also will assess the impact of e-prescribing on the workflow among prescribers, nurses, the pharmacies and payers.

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Last revised: January 18, 2006