HOLLI W. HAYNIE

A national push toward health information technology (HIT) inspired Tennessee legislators to strengthen the capabilities of e-health in the state. The state network, TNII (Tennessee Information Infrastructure) established a place where physicians and colleagues can share patient data via a broadband internet network, regardless of the location of a practice, within all 95 counties. In an effort to further solidify connection on the state eHealth Exchange Zone, earlier this year TNII allocated $3 million in grant monies toward fostering the growth and usage of e-prescribing, a vital component of a medical information network. The grant money, available to primary care physicians, will encourage further HIT investment by physician practices and other key stakeholders in healthcare. E-prescribing can streamline the prescription process and cut down on errors.

The state will give $3,500 per physician or $6,000 per treatment site to allow physicians to develop the necessary infrastructure to connect to the eHealth Exchange Zone. This seed funding can go toward equipment and software purchases, as well as arranging suitable systems for a practice.

Ahead of the curve on electronic prescribing is Memphis Children’s Clinic, which began the process almost a year ago after TennCare insisted on a transition to electronic medical records (EMR). After implementing an EMR system, explained Scott Kloek, MD, they took the next step and added an e-prescribing program.

“The doctors needed a bit of work learning how to use it,” Kloek admits. Despite a few growing pains, “it’s a time saver. It’s really easy to refill medications, and at the push of a button you’ve sent the prescription.”

E-prescribing is much more reliable, and faster than leaving messages on pharmacy voicemails, not to mention the complete eradication of legibility issues. Prescriptions are ready by the time patients arrive at the pharmacy, added Kloek. “Patients love the convenience.”

Memphis Children’s Clinic applied for the e-prescribing grant retroactively and was accepted. All grantees, whether already using e-prescribing or practices interested in beginning a system, must agree to do e-prescribing for two years and have until January 31, 2009 to apply.

This program goes beyond sending prescriptions over the Internet, explained Jennifer McAnally, HIT program manager with QSource, a healthcare quality improvement organization. Pharmacies come on board and share information in the exchange, which includes insurance formulary lists, allowing checks for insurance eligibility. The system builds a prescription history. This, coupled with a patient’s medical history, can be invaluable for physicians.

Traditionally HIT and EMR tend to be adopted more readily by bigger institutions and networks. McAnally noted that, “smaller offices have low adoption rates, less than 20 percent and in some cases as low as 10 percent.”

“In my experience,” she continued, “pediatricians do extremely well with EMR adoption. They seem to be the easiest to get (programs) installed and running.”
The local pediatric community has whole-heartedly welcomed the grant. In fact, most of the primary pediatricians in the local pediatric IPA, PIPA, have applied and been accepted for grant monies, according to Bill Appling, president of J. William Appling and Associates, a healthcare consultant who manages PIPA.

“This large group of participating primary pediatricians is another important step regarding patient safety and clinical integration,” Appling said.
More incentive for physicians is a push toward national e-health connectivity. Beginning in 2009, doctors can also earn additional money from Medicare if they use e-prescribing systems. U.S. health officials have announced the bonus program will continue over four years, with doctors receiving a 2 percent bonus on top of their e-prescribing fee in 2009 and 2010. In 2011 and 2012, the bonus drops to 1 percent, and subsequently down to 0.5 percent in 2013.

Not only have pediatric practices jumped on board, but more primary care clinics as well. To further the reach of the information exchange, in addition to state funds going toward primary care providers, the contract has been amended, said McAnally, “to include anyone that prescribes.” This includes any mid-level provider, regardless of specialty, which can help underserved areas in rural counties.

Informed Medical Systems, a medical records and physician technology company, is generating the equipment and software assistance. The company supports practices in developing cost-efficient means of purchasing equipment and configuring communication.

“The data collection and information needed to better meet the needs of patients in West Tennessee will be further enhanced by the grant,” Appling emphasized, “and will actually be one of the more comprehensive data exchange and data repositories in the country.”


For more information about the TNII, e-prescribing grant program, visit: www.tnii.net
Informed Medical Systems: www.informedmedicalnetworks.com
QSource: www.qsource.org



August 2008