Free e-prescribing software on the Web

A new national coalition called the National ePrescribing Patient Safety Initiative (NEPSI) is offering physicians free, Web-based e-prescribing software (to sign up, go to www.nationalerx.com). ERx Now, as the program is known, comes from Allscripts, the software vendor that's leading the effort with Dell Inc. While ERx Now is similar to the prescribing module in Allscripts' full EHR, the company says it's interoperable with other EHR systems. In addition, interfaces with leading practice management systems are available, according to Allscripts Chairman and CEO Glen Tullman.

The coalition that's sponsoring this initiative includes, besides Allscripts and Dell, technology companies like Microsoft, Cisco, Intel, Sprint, and Google, insurance companies Wellpoint, Aetna and Horizon Blue Cross Blue Shield of New Jersey, and 13 multispecialty groups, integrated delivery systems, and academic medical centers. The provider organizations will help train physicians and staff on the software. Other sponsors are supporting the initiative financially. Health plans will pay NEPSI a "transaction fee" for each electronic script written, and Allscripts is donating its software. If 100,000 doctors use eRx Now within the next five years, the company says, its contribution will be worth about $55 million.

Standing at the intersection of commerce and do-goodism, the coalition hopes to jump-start e-prescribing to prevent medication errors and save lives. "With this initiative, 2007 can be the year when we stop talking about e-prescribing and make it happen," said former CMS chief and current think-tanker Mark McClellan, MD, at a Washington, DC, press conference on Jan. 16.

In addition, some coalition members regard the NEPSI initiative as a commercial opportunity. "We see it as a great investment in our future," stated Tullman, noting that eRx Now will be a stepping stone to EHRs, including Allscripts' products. Similarly, Dell, which is providing the infrastructure for eRx Now, wants to demonstrate its ability to host software on the Web "in a mission-critical environment," said Scott Wells, vice president of marketing and online for Dell's Public Business Group. Microsoft views health care—and particularly, personal health records—as a major arena for expansion, noted Steve Shihadeh, general manager of sales, marketing and partners, for Microsoft's Health Solutions Group.

Health plans stand to benefit directly from increased e-prescribing. Aside from the cost savings that a reduction in medication errors might produce, the insurers anticipate that e-prescribers will increase formulary compliance and the use of generic drugs. That's how Wellpoint, which has made a "seven-figure" commitment to eRx Now, expects to recoup its investment, said Charles Kennedy, MD, the company's vice president of health information technology.

Wellpoint earlier failed in a much-publicized attempt to give away e-prescribing software to physicians, discovering that "free is not cheap enough," in the words of Wellpoint CEO Leonard Schaeffer. But Tullman said that new health plan incentives will help cover physician e-prescribing costs that the coalition doesn't, including those for computers, high-speed Internet access, and wireless networks. It remains to be seen whether even the three plans involved so far will invest enough, and many more plans must get involved to have a real impact, say observers. But as former House Speaker Newt Gingrich pointed out at the conference, the availability of free software removes a major excuse for physicians who've held off on e-prescribing.