PDAs: An Rx for Paper Cuts

PDAs help doctors reduce use of paper as well as prescription error.

A major health insurance company is providing PCS and networked handheld computers to thousands of doctors, hoping to cut down on paperwork and prescription error.

Launched last month, WellPoint Health Networks Inc.s $40 million program includes 19,000 physicians in California, Missouri, Georgia and Wisconsin. The majority belong to WellPoints network through Blue Cross and Blue Shield Association. An additional 170,000 doctors will be able to buy the equipment at a reduced rate, WellPoint officials said.

"Our goal is basically to improve the connectivity for the physician," said Ron Ponder, executive vice president and CIO at WellPoint, of Thousand Oaks, Calif. "We want to move them up in the electronic-connectivity world, and, most importantly, we want to improve patient safety."

The doctors can choose one of two options from Cap Gemini Ernst & Young Group, which is managing the project.

The Prescription Improvement Package includes Dell Inc.s Axim Pocket PC handheld computer, a wireless LAN access point from Cisco Systems Inc. and a yearlong subscription to an electronic prescription service. Doctors send the prescription information through a wireless connection from the Axim to the access point, which connects to the Internet.

Microsoft Corp. and its partners will supply the necessary software, which will include drug-interaction information. Doctors can choose to download the information wirelessly or through synchronizing when the device is in its cradle.

The Paperwork Reduction Package includes a Dell printer and a Windows PC that allow doctors to use the Internet to submit insurance claims. WellPoint officials said there are thousands of doctors who dont yet own computers. "More than a third of the claims we process from doctors come in through paper," said Anil Kottoor, vice president of application development at WellPoint. "It costs two and a half times more to process paper over a computerized claim."

The hope is that doctors who warm up to the PC will then be open to the idea of electronic prescriptions. While paper claims are merely a financial nuisance, paper prescriptions can be a safety hazard.

There are roughly 3 billion prescriptions written on an outpatient basis annually, officials said. Of those, 55 million are written in error. And between 7,000 and 10,000 deaths each year are caused by bad drug interactions. Studies have shown that computerized physician order entries would vastly decrease such errors.

"It is time to move out there and make a contribution that will jump-start the industry," Ponder said.

Prospective members are looking forward to the program because paper-based prescriptions can be unnecessarily complicated and time-consuming. In addition, patients sometimes lose prescriptions on the way to the pharmacy, which means lots of phone calls with the patient and the pharmacist.

"The most important piece Im looking forward to is the prescription refill," said Dr. Tom Long, senior partner and pediatrician at San Ramon Valley Primary Care Medical Group Inc., in San Ramon, Calif. Longs practice already files its claims electronically.

"What happens now is someone calls in the refill order, theres another order written and it has to be faxed back to the pharmacy. [Making that process electronic] is going to be huge. Clearly, it will minimize error rates. A few years ago, I participated in a trial using PalmPilot devices for prescription writing, and it was wonderful. The patients got clear prescriptions."

Long voiced concerns about integrating the prescription software with his practices existing database.

"If youre doing e-prescribing, you want that to be part of your medical records," he said. WellPoint officials said on-site consultants will help with any integration issues in the physicians office.

Working with the individual pharmacies is another issue. Just as not every doctors office has Internet access, neither does every pharmacy have a system that can handle electronic prescriptions.

"The interaction with the pharmacy could be complicated, but there are workarounds," Kottoor said. Faxing is always an option, and a faxed computer printout is generally easier to read than a faxed scrawled prescription.