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Seniors to Try EHRs

An 18-month pilot project will give some Medicare beneficiaries access to electronic health records (EHRs), according to the Centers for Medicare & Medicaid Services. The program will give participating seniors a personal health record they can access online. The data contain information on medical conditions, hospital stays, physician visits, and medications as part of the overall drive for Medicare-wide adoption of EHRs.

The agency explained that the records will be updated automatically using Medicare data, and beneficiaries can add their own information and choose whether to share the record with health care providers. At the end of the project, Medicare will collect data on which features beneficiaries like and strategies to get seniors to use the record. Medicare is partnering with 4 private plans that already offer the records: HIP USA, Humana, Kaiser Permanente, and the University of Pittsburgh Medical Center.

RFID Heading to California

Cardinal Health has announced that it will integrate radio-frequency identification (RFID) technology into its Sacramento, Calif, pharmaceutical distribution center by the fall of this year.

The integration is being done to prepare for the state's recently passed pedigree legislation. The bill requires pharmaceutical manufacturers to originate itemlevel pedigrees for drugs distributed within the state's borders. The legislation also requires companies within the pharmaceutical supply chain (including companies that distribute drugs) to update item-level drug pedigrees with each change of ownership.

As the company incorporates RFID technology into its California operations, Cardinal also said that industry standards and technology issues need to be discussed by the health care industry before RFID technology can be adopted across the health care spectrum. The California law calls for product serialization to be initiated by the manufacturer, at the unit level, to allow tracking from the beginning to the end of the supply chain. For this action to take place, Cardinal explained that the health care supply-chain industry must first agree on a standards-based approach and a single RFID protocol and technology.

Company officials added that the technology and process improvements are needed to consistently achieve acceptable read rates at all packaging levels. Industry adoption also is needed for standard practices, such as accepting bar-code technology as a complementary and redundant technology to RFID.

Electronic Rxs Slash Medication Errors

A review of 12 studies found a 66% drop in medication errors when hospitals switched from paper prescriptions to computerized drug-ordering systems. Experts said that unreadable handwriting on Rxs and transcription mistakes cause as many as 61% of drug errors.

As reported recently in Health Services Research, nearly 25% of US hospital patients experience medication errors, such as getting the wrong dose, the wrong drug, medication at the wrong time, or no medication at all. Medication errors injure or kill >500,000 hospital patients each year.

The researchers found that hospitals with the highest rate of medication errors (>12%) showed greater improvement when they started using computerized drug-ordering systems. Overall, the use of computerized ordering systems reduced medical errors. Prescribing the wrong drug, however, did not decrease.

E-prescribing Will Save Medicare Billions, PCMA Finds

Medicare could save as much as $29 billion over the next 10 years and prevent nearly 2 million medication errors with the use of electronic prescribing (e-prescribing), according to a July 11, 2007, report released by the Pharmaceutical Care Management Association (PCMA).

The report recommended that Congress require physicians who participate in Medicare to use e-prescribing and that the program offer bonuses to physicians valued at $7 billion over 10 years to help offset the cost and to maintain the computer hardware and software needed. The report indicated that implementation of those and other recommendations could expand the use of e-prescribing to cover almost 80% of Rxs by 2017.

The association also released a survey of 407 physicians, which showed that only 1 in 10 reported using e-prescribing on a regular basis. Of the respondents, two thirds said that e-prescribing was not a priority mainly because of the cost burden and administrative concerns.

PCMA President Mark Merritt said that implementing the recommendations could help move forward a proposal to prevent a scheduled 10% reduction in Medicare physician reimbursements next year. Joseph Heyman, MD, an American Medical Association board member, argued that, although physicians "are eager to adopt new technologies that have the potential to increase patient safety and quality of care?, hitting doctors with an unfunded e-prescribing mandate at the same time the government plans to cut Medicare physician payments 10% next year is untenable."

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