That means that physicians and pharmacists could help make sure patients take medicines as prescribed.
Hutchinson acknowledged that the new capabilities will create new issues to be worked out. For example, some patients go to one doctor for certain health needs and go to another for more sensitive or personal prescriptions.
But, he said, patients have to give consent to let doctors see a medical history, and some states already have laws that block doctors from seeing that a patient is taking HIV medications.
But just blocking information is not an ideal solution. "The challenge with that is that these [drugs associated with mental illness and sex] are some of the most dangerous drugs that have the most dangerous interactions, so its enormously important that someone knows all those medications."
In any case, he said, the whole purpose of the pilot programs is to find and fix potential problems.
HHS awarded contracts to the following groups.
- RAND Corporation, Santa Monica, Calif., in conjunction with the New Jersey E-Prescribing Action Coalition, an industry-academic partnership involving RAND Health; Horizon Blue Cross Blue Shield of New Jersey; the e-prescribing vendors AllScripts, Caremark iScribe and InstantDx; Caremarks prescription benefit management plans; the electronic prescription routing companies RxHub and SureScripts; Caremarks mail-order pharmacy and Walgreens retail pharmacies will conduct the pilot in New Jersey.
In addition to testing the standards, the project will determine changes in drug use, clinical outcomes and patient satisfaction as a result of e-prescribing.
- Brigham and Womens Hospital, Boston, Mass., in conjunction with physician practices in Massachusetts associated with a hospital network, will use an existing community utility for e-prescribing called the eRx Gateway. The pilot will test the e-prescribing standards and will conduct needed research into ambulatory drug safety and the impact of e-prescribing on physician workflows.
- SureScripts, Alexandria, Va., partnering with Brown University and five vendors (Allscripts, DrFirst, Gold Standard, Medplus/Quest Diagnostics, ZixCorp.) will recruit physicians and pharmacies for participation in Florida, Massachusetts, Nevada, New Jersey, Tennessee and potentially Rhode Island.
The pilot will evaluate how the e-prescribing standards work in a variety of practice settings, geographic areas and e-prescribing technologies. In addition, the project will assess how prescriber and vendor characteristics influence e-prescribing adoption and what "best features" of vendor software improve medication-related safety outcomes.
- Achieve Healthcare Information Technology, Minnesota, in conjunction with nursing facilities in Minnesota associated with the Benedictine Health System and Preferred Choice Pharmacy will be the first program to evaluate how the e-prescribing standards work in certain long-term care settings.
The project also will assess the impact of e-prescribing on the workflow among prescribers, nurses, the pharmacies and payers.