By Patty Enrado, Editor

ALBANY, N.Y. — “Two thousand nine is going to be the year of e-prescribing,” declares Michael Van Ornum, consulting clinical pharmacist for the Greater Rochester Independent Practice Association, or GRIPA.

While all the elements are there to make it happen, many challenges will push a big bump in e-prescribing utilization and implementation to 2010, counters Patricia Hale, MD, deputy director of the Office of Health IT Transformation for the New York State Dept. of Health.

Despite these difference in timing, both say that e-prescribing’s future is bright.

Three areas will impact e-prescribing in 2009, Van Ornum said. The Medicare Improvements for Patients and Providers Act, or MIPPA, includes a two percent on Medicare fee-for-service incentive for physicians who use e-prescribing. “This is a meaningful incentive for a lot of physicians and large healthcare systems,” he said. “We’re going to see a huge upsurge in adoption.”

Besides the federal government, states and health plan and physician consortiums are also developing matching incentive programs, Hale said.

E-prescribing is undergoing a transformation and taking on an expanded new role, Van Ornum said. The traditional implementation has been practice centric, but it’s shifting to contribute to a patient-centric electronic record. “The desire to pull e-prescribing into electronic medical record systems, health information exchanges, or HIEs, and regional health information organizations is driving changes in the way information is being used by employers and payers,” he said.

Hale pointed out that CCHIT certification for standalone e-prescribing systems and the requirement for significant e-prescribing functionality for electronic health record, or EHR, systems will provide more confidence for providers to buy these products.

The transformation in clinical decision support, or CDS, will also impact e-prescribing, he said. CDS vendors are moving forward with new and innovative applications that provide more patient-adherence metrics and appropriate evidence-based drug-specific alerts.

“E-prescribing is a tool of education with respect to the alerts, but over time, it will help change prescribing behavior and then the messages themselves will change,” he said.

CDS and HIE vendors are partnering with e-prescribing vendors to broaden the functionalities of their products, Hale said.

Many pilots around the country, including those in New York State, have positively impacted uptake of EHRs and e-prescribing, she said. Most of the pilots, however, have been concentrated in urban areas and involve large physician practices.

“One of the really important distinctions between what we’ve done so far and the road ahead is in reach,” she said. A significant challenge in 2009 will be to broaden e-prescribing’s reach to inner-city, rural and small physician practices and clinics.

To succeed, health IT investments will need to be made, new paradigms must be created for implementation and physicians and pharmacists need to form partnerships, Hale said.

More planning will be done in 2009, she said. To that end, HIMSS09 will be featuring three e-prescribing education sessions: What’s New with E-Prescribing: A Federal Update, presented by Tony Trenkle, on Saturday, April 4, 9:00 AM – 10:00 AM; “DX on RX”: Pharmacy on Management Circles, Including In-Patient Indications, presented by Stuart Levine, PharmD, and John Brill, MD, on Saturday, 2:30 PM – 3:30 PM; and CCHIT Town Hall, presented by Mark Leavitt, MD, PhD, and Alisa Ray, on Sunday, April 5, 8:30 AM – 10:00 AM.