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ACP Critical of Mandatory Electronic Prescribing in Medicare Prescription Drug Legislation

College Releases Principles to Guide Development of e-RX

WASHINGTON, DC - (August 20, 2003) The American College of Physicians (ACP) expressed concern about electronic prescribing (e-RX) provisions included in the House and Senate Medicare prescription drug legislation, H.R. 1 and S. 1, in a letter sent August 15 to congressional conferees.

ACP has developed its own preliminary principles to guide the development of effective, patient-centered e-RX technologies and systems as an alternative to the proposals currently under consideration.

"ACP believes that e-RX offers the potential of reducing medical errors, improving patient safety and compliance, and reducing administrative costs," said ACP President Munsey Wheby, MD, FACP. "However, a federal mandate to require that within three years all prescriptions be written and transmitted electronically, as H.R. 1 proposes to do, forces unproven systems and technologies on patients and clinicians."

ACP's principles stress the need to:

  • involve physicians and stakeholders in all aspects of the design of e-RX technologies, systems and standards;

  • perform pilot-tests of such systems before they become standard;

  • make resources available to the private sector to support such activities rather than imposing unfunded mandates;

  • preserve and support the physician's role in making patient care decisions;

  • accommodate the needs of communities that lack high-speed Internet access; and,

  • assure that e-RX systems can be dynamically/bi-directionally linked to office management and electronic medical record systems.

ACP supports the Senate provisions calling for the development of standards for e-RX that would be used by those who voluntarily choose to incorporate such technology into their practices.

ACP believes the Senate language would be improved by:

  • testing such standards on a demonstration project basis before they are adopted by HHS;

  • delaying the implementation date of such standards to January 1, 2008 to allow for such demonstration projects;

  • requiring that the standards be developed by an appropriate private sector group that includes adequate participation of physicians and other stakeholders; and,

  • authorizing a program to provide federal financial resources to assist the private sector in the design, testing, and adoption of e-RX technology.

"We are directly participating in several groundbreaking private sector initiatives to design, test and encourage the use of effective, patient-centered e-RX technologies and systems," said Dr. Wheby. "We recommend, however, that the conferees reject the House mandate for use of e-RX technology and instead accept the Senate language, with consideration of our proposals to modify and improve it."

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include more than 115,000 internal medicine physicians (internists), related subspecialists, and medical students.

[Note to editors: A full copy of the College's "Preliminary Principles to Guide the Development of Effective, Patient-Centered e-RX Technologies and Systems" can be obtained on ACP Online.]

Jack Pope, (202) 261-4556, jpope@acponline.org

Page updated: 11-03-03

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