As part of ACC’s ongoing series on e-prescribing, ACC staff interviewed South Denver Cardiology CEO Brenda Lambert, RN, AACC, and Amy Hurley, RN, Director of Clinical Services at South Denver, about their experiences with e-prescribing and how it has affected their practice. The deadline to demonstrate successful e-prescribing under the Medicare E-Prescribing Incentive Program is June 30, 2011. Health care providers who cannot demonstrate successful e-prescribing by June 30 will have their 2012 Medicare payments penalized by 1 percent.

1.      What does e-prescribing mean to you? What are some of the benefits you’ve seen?

Lambert: We embraced e-prescribing as soon as we could with our electronic medical record (EMR) system. It’s been up for a year and was quite easy to do. So for us it was an easy implementation.

Some important things it’s meant to us: We always had a difficult time when patient called in for a prescription to make sure they had been seen in our office in the past year. We now know when their last visit was and if we can go ahead and e-prescribe or need to have them make an appointment.  If a patient or pharmacy contacts us we know if they’ve been seen all in the matter of less than a minute. We’ve increased efficiency and maximized patient care.

It has also help with legibility – I’ve personally experienced poor signatures or poor writing and the pharmacy would have to call back and double check what the prescription says. With e-prescribing it does improve patient safety as well.

We’d like to see a bidirectional piece added where we can see if the patient hasn’t picked up the prescription yet so we can do some follow-up, but that’s not in place at this time.

Hurley: It is also very convenient for the patient; if they’re in the office their prescriptions are ready for them at the pharmacy by the time they get there. Also, there’s a large database in our e-prescribing system that allows us to have access to all of the pharmacies in our area, so if the patient doesn’t know the information, we have it.

2.      Are there any downsides? What challenges have you had to overcome to implement e-prescribing?

Lambert:  More on our EMR side, there are times when meds aren’t used as much as others and you have to tweak dosages but it’s just a matter of identifying that and having it changed. Just like any system there are things that have to be improved.

We have had some problems for in-person pharmacy pick-up in terms of liability for payment. For example, if we e-prescribe to Walgreens and the patient decides between here and there they don’t want the medication, then that’s the end of it – they haven’t paid anything.

With mail in, once we click that button, the patient is liable for paying for the meds and can’t return it. Because of e-prescribing we’ve had multiple problems with patients saying they don’t want to take the medication anymore and wondering who will pay for what was delivered. We tell them they do.

3.      Are there any stories or reasons why e-prescribing has worked for you and your practice?

Lambert: There are many comments from patients saying how nice it is that they don’t have to wait at the pharmacy when they get there: once they arrive, the prescription is there and it’s correct. It’s been a huge patient-pleaser. It’s funny how you get used to it – I went to the doctor and he didn’t e-prescribe and I was surprised. I thought our physicians would resist, but it went as smooth as silk. Our physicians took to it immediately.  

Hurley: It’s a lot more efficient and more organized and cuts down on paper. We all know patients who lose a piece of paper no matter what it is – this is a slick, efficient way of doing things.

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Resources are available at cardiosource.org/HealthIT to help ACC members learn more about e-prescribing.