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January 30, 2007

The NEPSI Challenge

Physicians who already signed up for the free Web-based e-prescribing software eRx NOW, provided by the National e-Prescribing Patient Safety Initiative (NEPSI), will begin receiving their free software tomorrow (January 31). According to their online FAQs, NEPSI  is a coalition of large corporations led by Allscripts and including Dell, Google, Microsoft, Intel, SureScripts, among many others. NEPSI sponsors are investing $100 million over the next five years to provide free Allscripts’ e-prescribing software to every U.S. physician as a way to jumpstart the use of e-prescribing software, and eventually electronic medical records, to reduce preventable medication errors and overall health care costs. NEPSI says,”We are not trying to lock providers into a one-vendor solution – we have a solution that works with any Electronic Health Record, Personal Health Record or practice management system from any vendor certified by the Certification Commission on Healthcare Information Technology (CCHIT).” For more information from NEPSI, see the press release from earlier this month.

From ”Coalition Offers Doctors Free Electronic Prescriptions,” an article posted two weeks ago on Ziff-DAvis’ eWeek: “The [NEPSI] system will be able to transmit prescriptions electronically to over 95 percent of the nations’ pharmacies. Two of the health insurance companies in the coalition, Aetna and WellPoint, said that they would provide incentives for physicians to write electronic prescriptions. Another coalition member, Sprint Nextel, is offering free pocket PC phones to doctors who sign up early…The initiative is offering a free Web-based system that would instantly check prescriptions for interactions with other medications (powered by a database provided by Wolters Kluwer Health) and would also check how much a patient or plan would have to pay for a drug. Google is providing a custom search engine to help physicians find relevant information for themselves or patients. Patient information will be stored remotely so that it will not be compromised if a doctors’ phone or computer is stolen.” 

This is not the first such effort. The article recalls how, in 2004, one coalition member—health insurer giant Wellpoint—invested $42 million in an effort to provide free e-prescribing software. “Doctors took the free stuff, but did not use it for the intended purposes. Since then, however, health IT evangelists have made large headways to create more positive attitudes toward health IT. ”

That same year, a second e-prescribing initiative involving many of the same NEPSI founders, Cafe Rx, also dissolved. Digital Healthcare & Productivity’s article, Free ePrescribing S/W Initiative Stirs Interest and Debate, goes into greater detail regarding Cafe Rx and quotes several competitors who speculate regarding NEPSI’s ulterior motives, along with replies from Glen Tullman, Allscripts CEO. “Tullman is clear that neither Google nor anyone else will mine data collected as part of the eRx NOW program and use the results for marketing purposes. ‘Patients and physicians will have unique access to all the information…Google will have no access to data we receive as part of the electronic prescribing process.’ Other questions raised about the e-prescribing program focus on accessibility of patient demographics and drug formularies. Notably absent from the list of NEPSI sponsors and supporters was RxHub, a joint venture of major pharmacy-benefit management companies that provides real-time electronic connectivity to patient-specific formulary and drug-benefit information. Tullman acknowledges that many users would have to find a third party to link the prescribing software to existing practice management and billing systems, but says that eRx NOW follows established standards to make the link. ‘We’re happy to interface with any practice management system.’ Tullman also addressed the formulary question by saying that Allscripts has access to eligibility and preferred-drug lists of more than 95 percent of payers nationwide via SureScripts and through the company’s own business relationships. He said that Allscripts was having discussions with RxHub and with practice management vendor Per-Se Technologies—now a part of McKesson due to an acquisition that closed last week—to find ways to pre-populate eRxNOW.”



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