Electronic Prescribing: The Time is Now

1. Electronic Prescribing: The Time is Now

2. Agenda • E-prescribing in the News • E-prescribing 101 • E-prescribing Incentives in the Medicare Bill • McKesson’s solutions for E-prescribing • RelayHealth eScript Overview • Q&A

3. E-Prescribing in the News National Roadmap and Practical Guides for Rapid Expansion of Electronic Prescribing Released (06/11/08) DEA proposes rules to allow e-prescribing ofcontrolled substances (06/28/08) SureScripts and RxHub merge (07/01/08) Congress passes Medicare Bill with ePrescribingIncentives for Physicians (07/15/08) CMS issues final rule to end fax exemption for e-prescribing beginning April 2009 (04/07/08)

4. Consider a few numbers… $5.00 $1,944 8.8 Million 150 Million

5. Nationwide adoption of E-Prescribingcould save $27 Billion annually Consider a few numbers… • $5.00 – Average cost to pull a paper chart • $1,944 – Average cost to a physician for prescription related callbacks and rework • 8.8 million – Ambulatory prescription errors annually • 150 million – Phone calls from pharmacies to physician offices annually for incomplete or illegible prescriptions Source: Electronic Prescribing: Becoming Mainstream Practice June 2008A collaborative report from The eHealth Initiative and The Center for Improving Medication Management

6. Consider refill workflow… • Handling refill requests is very time consuming for physician offices • Pharmacies call or fax office • Reception answers phone or retrieves fax • Nurse or assistant pulls chart • Doctor reviews • Nurse or assistant calls or faxes pharmacy back • Nurse or doctor updates chart • Can happen a dozen or more times per day for each physician

7. Only 6% of physicians use e-prescribing today E-Prescribing Adoption

8. Agenda • E-prescribing in the News • E-prescribing 101 • E-prescribing Incentives in the Medicare Bill • McKesson’s solutions for E-prescribing • RelayHealth eScript Overview • Q&A

9. What is E-Prescribing? • Using software to both generate and transmit the prescription (Rx) • Electronic receipt of, and response to, Rx refill requests • New Rx must stay in a Federally mandated digital form the entire time (NCPDP format) as it travels from the physician office through clearinghouses to the pharmacy • (Typically, the Rx is entered automatically into the pharmacy software)

10. What is E-Prescribing? • Usually includes the following clinical decision support to improve safety: • Drug-drug interaction checking • Drug-allergy interaction checking • Access to a current medication list • Optionally includes: • Drug–condition and drug-age checking • Drug dosage checking • Access to formularies and patient benefit information • Access to patient fill histories

11. E-prescribing can serve as a pathway to full EHRs, acting as a bridge that allows prescribers to become more technologically proficient with and comfortable using electronic systems to support patient care. What is e-Prescribing? • Software is available in two forms: • a stand-alone prescribing-focused solution • an integrated module within Practice Partner EHR or similar EHR

12. What is it not E-Prescribing ? • Computer-generated faxes • Computer-generated printed prescriptions • Scanned images • E-mail (is not secure nor in the required format)

13. Goal of E-Prescribing • Reduce medication errors and improve patient safety • Helps prevent wrong medication or dosage from being dispensed • Convenience for patients as the Rx arrives before they do • Save time for doctors’ offices and pharmacies • Can help reduce costs because formulary availability increases the use of less expensive medications

14. Value to Physicians • Improves quality of care because of clinical decision support • Improve patient compliance with medication recommendations (11% improvement according to a recent study) • Fill history helps monitor patients better (if available) • Convenient for the patients • Reduces “hassle factor” of call backs from pharmacies • Saves staff time on refill handling

15. Agenda • E-prescribing in the News • E-prescribing 101 • E-prescribing Incentives in the Medicare Bill • McKesson’s solutions for E-prescribing • RelayHealth E-prescribing Overview • Q&A

16. Congress Passes Medicare Bill with e-Prescribing Incentives • On July 15th, Congress overrode the President's veto of the bill that included: • The halt to a scheduled 10.6% Medicare physician pay cut • Financial incentives to physicians for using electronic prescriptions

17. E-Prescribing Incentives and Penalties • Medicare physicians who use e-prescribing technology will be eligible for incentive payments: • 2% in fiscal year 2009 and 2010 (starts January, 2009) • 1% in 2011 and 2012 • 0.5% in 2013 • Physicians participating in Medicare who do not e-prescribe: • 1% payment cut in 2012 • 1.5% payment cut in 2013 • 2% in subsequent years • Provision exempts physicians who infrequently use prescriptions

18. Additional Medicare Incentives • For Practice Partner EHR or similar EHR users: • PQRI (quality reporting) offers an additional 1.5% incentive payment (may be rising to 2%)

19. Agenda • E-prescribing in the News • E-prescribing 101 • E-prescribing Incentives in the Medicare Bill • CareTEC’s solutions for E-prescribing • RelayHealth eScript Overview • Q&A

20. CareTEC’s Solutions for e-prescribing • Practice Partner Patient Records • E-Prescribing is an integrated component of a fully functional electronic health record solution • Surescripts-RxHub certified • RelayHealtheScript • Standalone electronic prescribing solution • SureScripts-RxHub certified • Provides a starting point on the path to a fully functional EHR

21. Practice PartnerProven, Award-Winning Solution • Five Star Rating (5 is highest) EMR and Practice Management System 2008 (5 consecutive years) • Best EHR 2006, 2005, 2004 (no award given in 2007) • Best Integrated Clinical System 2004 • InfoWorld Top 100 IT Projects 2005 • AAFPSurvey 2007 High ratings in overall satisfaction, ease of use and functionality Fully integrated electronic health record and practice management solution Over 2,000 practices nationwide 21 FOR INTERNAL USE ONLY/PROPRIETARY AND CONFIDENTIAL 5/31/2014

22. Practice PartnerCertified Solution • Patient Records Version 9.1 and 9.2.1 from Practice Partner are CCHIT Certified products for CCHIT Ambulatory EHR 2006 & 2007. • SureScripts – focus on retail pharmacies • RxHub – focus on mail order pharmacies, offers real time formulary information, fill history

23. Practice Partner E-prescribing benefits • Writing an Rx automatically transmits to the pharmacy, updates the progress note, and updates the medication list • Thousands of included prescription templates speed creating prescriptions • Note templates can automatically generate prescriptions • Refills during a patient visit take a couple of keystrokes • Drug safety checks include drug-drug, drug-allergy, drug-condition, drug-pregnancy, drug-age, drug dosage • Dose Advisor and Dose Calculator included • Gives instant feedback on drug costs

24. Practice Partner E-prescribing benefits • E-prescribing refill requests enter normal message queue • Respond in a few keystrokes • Automatically compare to the original prescription • Automatically update the chart • Delegate to a proxy if desired

25. Agenda • E-prescribing in the News • E-prescribing 101 • E-prescribing Incentives in the Medicare Bill • McKesson’s solutions for E-prescribing • RelayHealth eScript Overview • Q&A

26. Electronic Prescribing: The Time is Now Questions?