E-Prescribing Adding to the Squeeze

Hoping to find some (ahem) non-viral news, I wandered over to see our old pals at Medical Economics.  They have a kinda funny slide show about wondering whether office-based physicians are using electronic prescribing for controlled substances.  

The slideshow says that one-third of docs with EHR’s are electronically prescribing the good stuff. 

“Physician practices that were larger or owned by hospitals had the highest rates of electronically prescribing controlled substances.”  Yeah, because they are being forced to, no big revelation there. 

“Physicians in practices with four or more were significantly more likely to electronically prescribe…”  Also no mystery there, bigger practices are going to get a bigger bonus from Uncle Sugar by playing his game.  Also e-prescribing rates were much higher among hospital- and HMO-owned practices.  Same reason, plus the bigger groups are going know how to mine those patient satisfaction scores.  

There was no major difference in controlled substance e-prescribing rates between rural and urban areas.  So there’s pain in the hollers and the ‘hoods, but it seems like stories on the biggest candymen have all come from the flyover areas.  Street drugs are just as available rurally as downtown, so maybe higher population density encourages more market dispersal?  I don’t know.

I think the War On Drugs (Amen and Hell Yeah!) has caused far more harm than good, but I tend to think that of every government overreaction when the media declares a health crisis.  Given the chance I’d end the DEA five minutes ago, and let any adult ingest whatever they wanted.  The WOD has been a major impetus in the growth of mandated e-prescribing, and now has given major pharmacy chains a chance to help tighten the bonds on physicians.  Some chains actually limit what they will dispense based not on applicable state law, but on corporate policy.  Government at the federal and state level, along with Big Insurance and Big Pharmacy are all shoving individual physicians into ever shrinking therapeutic windows to the point where the poor ambulance chasers will have to allege that the doc off’d the poor patient with a single 10-count prescription of 5 mg hydrocodone. 

But our last slide offers safe harboring for the new generation of conforming med techs:  “Physicians participating in CMS Innovation Models had significantly higher rates of electronic prescribing of controlled substances (EPCS) compared to physicians that did not participate in those programs.  Participants in the Patient Centered Medical Home Program had the highest rates of EPCS:  42 percent of physicians participating in this program electronically prescribed controlled substances.”

The Patient Centered Medical Home Program??!  Don’t tell me Medical Economics has lost its sense of humor.

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