Home Forums Discussions Problems E prescribing link

I have been using AC for about a month, and am going to start x-link.

Anyways, got a call from Medco offering a free Eprescribing solution for 1 year. This is not eRx but something like RxNT. I told them about AC, and they said they would provide a free interface.

I told them to call Bert for details!

Nice,
Hey Bert are you getting paid to be tech support for AC??? Moving up in the world are we? lol

But seriously, you should have them contact Jon and Carlos at AC for all the inner details of how to properly design their interface with AC.

A while back I spoke with Tom Galland who works for an EMR company near where I work and he told me about what it takes to make an EMR comply with the e-prescribing specs put forth by SureScripts. Think 9 months of focused work and lots of $$$$ to comply with the multitude of specs which make those found in CCHIT pale. In fact, as I understand, about 40 of the CCHIT criteria involve e-prescribing. Is it worth it? Probably not at this time. Is it going to be costly (and unweildy) to the end user? YES on the "costly", even with the initial "help" from Medco. YES on the "unweildy"- the FAQ to the PDF below states that it takes 15 seconds to print out one prescription. Heck, with the MS Access EMR that I use in my office, I can check and print out 20 prescriptions in about 10 seconds!

To be "fair and balanced", I went to the RxNT website and lo and behold, there is no pricing data, which is usually a bad sign. To get this data they offer a form where they ask all of your personal information. I found an email URL in the Physicians Practice website and I used that to email them for the pricing particulars- hopefully they will email me back tomorrow with a full direct quote, and I'll report here the true costs of e-prescribing through RxNT. There is one PDF which does give the cost per physician license: $1000, which is what you would have to pay after the first year, yearly. I'm not sure if this includes the HL7 interface. The link can be found here: http://www.erx2u.com/FAQ.pdf.

If you check HERE , you'll see that this company will throw in their own "EMR Lyte" solution FREE to work with their RxNT software, so most likely they are seeking to compete for AC users for their own supposedly "complete" EMR solution.

More later, when I get a reply...

Way to keep 'em honest Al. You keep right on asking those good questions.

24 hours- no reply. (Maybe my email was too direct about costs!)

Al,
Do you have a picture of sheered sheep to symbolize the fleecing of physicians? Or pictures of castrated goats to symbolize the neutering of our profession?
Roy

Roy, it's your money and it's your time that is being wasted by e-prescribing. I guess we both can differ on our opinions on this matter. Sorry- I have no bald sheep.

When something works in my office I personally find it offensive and repulsive to be forced to use something that will have absolutely NO affect on quality care or on patient outcomes, since my prescriptions are already typed and legible.

I have a problem with the "try it for free for the first year" after which they then throw you a hefty bill which is not presented openly and honestly.

Are you using e-prescribing? If so, do you see some benefit that I don't?

Cheers,
Al

What's strange is that they never answered my inquiry. Could they have been tipped off that I was asking on behalf of the curious on the AC forum and not to buy?

Hmmm... They have an audience here which they should take advantage of. They should try to sell the product like most vendors do- with honesty and openness. No "freebies"... just a simple good deal where everyone benefits (actually they still have to show a benefit to eprescribing ).

Al

Al, I think you misinterpreted Roy's comment. I may be wrong, but nothing in his post indicated he uses ePrescribing. I think he asked you because you post a lot of pictures.

Paul, you would be surprised how many calls I get about AC.

Actually Bert, no I would not. I would totally beleive it. And how many folks call or write back to say thanks??? But we still love ya Bert.

Actually Al, Roy does not use E-Rx's from what I understand. He is violently opposed to have such CCHIT shoved down our collective throats.... Right Roy?

Anyway, Al I get the impression that after what happened at EMRUpdate, your reputation in the "E" world of medicine probably proceeds you; if you catch my drift? These guys know who you are....

Yeah, I guess some do know me. Only the unscrupulous need to worry. I'm just one of them skinless sheep that Roy mentioned.

BTW, read this emrupdate thread where I look back over 2 years of lobbying against this stuff. Brendon (the CEO of eMedRec) stated that "Not because of Al's continous attacks on it here, which is very interesting but hardly going to move an entire political system and billion dollar industry one way or another."

I kind of set the record straight! Just reason # 3 where almost 5 billion dollars earmarked for P4P was deviated by Congress to pay for the rescinding of the 10% physician pay cut I think counts for moving a billion-dollar industry "one way or another". Hey, you'd be surprised what collective grumbling can do to politicians!

URL: http://www.emrupdate.com/forums/t/13717.aspx

Al,
Thanks for the picture. This is excellent. I think I'll use this picture when I make a presentation to a group of Employee-physicians to show that they are not only being fleeced but taken to the marketplace for slaughter and butchering.

And no... I won't do e-prescribing. My position is well stated if you google Roy E Gondo, MD where you will find a letter to Micheal Leavitt.

The AAFP recently tried to scare us into the idea that if we don't get e-prescribing we're breaking the law in 2009. What is really corrupt is that the AAFP offered a "check-up" to see if our EMR software is compliant for 2009, and then steered us to a SURESCRIPT website suggesting we get a VEEMR (very expensive EMR). One of the guys in that cartoon represents our medical societies supporting this CCHIT [censored].

Al,
Could you find some really good cartoons or photos of the OPEC meetings with all the headgear and stuff. Now, I don't want to be seen as doing anything the least bit racist here; Some of our best friends and collueges hail from such parts of the world and practice such religions, I really couldn't give a hoot, god bless them one and all.

BUT it finally dawned on me that the insurance industry with its Anti-Trust waiver, that controls and restricts our free access to our own end-retail customers of our services, is really just a legislatively created "CARTEL"!!! And so I would really love to start portraying them as such, using the cartoons and humor from the original oil crisis of the 1970's. This is all they really are... anti-free trade, protected by our bought and paid for government cartel.

It goes back to my having John Cleese do a ministry of messing up freetrade and healthcare routine. You couldn't make this more F'ed up if you intentionally tried. Give the large corporate side that naturally has lots of power simply in its wealth and access, an anti-trust waiver while maintaining and very actively enforcing and creating newer and even more restrictive anti-trust laws against the smallest of businesses, small and solo practictioners of healthcare who by their very small business nature have very little leverage in relation to the large corporate interests.

They are such a cartel that even very large employer groups have very little real leverage to negotiate good prices when they offer up thousands of covered lives in exchange for their business. We need to actively say it and paint them as such each and every chance we get... To the strongest cartel in the nation if not the world, the insurance industry which has our government, its enforcement agencies, and the courts in its hip pocket. CARTEL, CARTEL, CARTEL!!!

Good Night and Good Luck,
Paul

OPEC meeting? How about this one:

Then there is always the OPEC classroom:

Then there are the OPEC terrorists that we've caught:

Even the few Christians in the OPEC countries are armed to the teeth:

Ok- serious ones now:

Al,
Those are great. Most of the serious ones were just what I was thinking of. Now we need to caption them with BC/BS, UHC, Aetna, Cigna, and all the rest of the their gang with stinging commentary.

What do you folks all think? Are they not a legislatively created CARTEL, that then uses the same exact laws that they are now exempt from against us, the employers who buy the insurance policies as well as our patients and their free access to "ANY" provider of the their choice?

Come on now, repeat after me, Cartel, Cartel, Cartel. Very good, see you can do it. Wasn't that easy? Doesn't that feel better???

Good Night and Good Luck,
Paul

Here in Virginia the Board of Medicine specifically has been going after abuses by insurance companies. Two that they made laws for include:

- Separating products of these insurance companies, whereby if Aetna has a crappy HMO then a physician can join ONLY the PPO and not get barred from the program.
- Forcing all HMO patients to have a PCP from the getgo, not when they get sick. MDIPA was famous for floating patients without PCPs for years, thus not having to pay anyone for the monthly stipend for these well patients.

Alas, those are the only 2 that I can remember (and maybe the only 2 "wins").

Cheers,
Al

Could you get me a copy of the separate types of products law. Our largest Cartel member, Excellus BC/BS (really WellPoint!!!) here uses the all products crap on us all the time. They bundle HRA's and HSA's into standard PPO when we can't even know whether or not to collect allowable at time of service. A four thousand dollar deductable that I can't even know whether it has been met or not is not the same as collect a simple $20 copay and the rest of the claim shall be covered, there is a carrier behind this claim. Oh, just let 'em walk out the door and try to collect from the patient weeks if not months later.... Suuurrreee, right......

They have bundled all products other than traditional indemnity or state SCHIP like products and the new road to riches Medicare ones, under one entire bucket! So POS, PPO, EPO, HMO and all the rest are take it or leave it, no pick and choose what so ever. They call all of them now, "Managed Care" products. It seems they are even trying to package the traditional plans into the bundle soon.

But to me is the killer for all PCP's is just because someone may need a referal or prior auth later on, they are effectively barred from seeing any PCP who is not in network for fear of not being able to get their stupid paperwork thru the system sometime in the future if and when they may need it, be the referal to the specialist, drug approvals, tests and all the rest. Yes now we need to get all imaging other than x-rays or ultrasounds prior auth'ed before proceeding to "go". And we can't turf that to the specialist, because they are going to want to know what we already found out as to why we are sending them on.

I'm straining to remember which carrier right now, but just the other day, we looked up a patient's plan which was called "Whatever PPO". Now we all know what PPO means, "preferred provider", but that there should still be some method for patients to pay a modest amount more and still go out of network; RIGHT??? Well this plan clearly stated in the computer that there were NO out of network benefits at all!!! So how the hell are they getting away with calling it or charging for PPO type coverage while not providing PPO type coverage? Simply amazing.

They called it a PPO and it had no out-of-network benefits! That's a new low.

Paul:

Actually it was a Supreme Court issue, back in 2003, that allowed states to force HMOs to accept "any willing provider" and to prevent HMO retaliation against providers thus allowing providers to see more patients in order to make a decent living. Read more here-

http://query.nytimes.com/gst/fullpage.html?res=9A07E6DD1F39F930A35757C0A9659C8B63

This paper explains how Virginia took the "any willing provider" laws and made them broad-reaching:

http://findarticles.com/p/articles/mi_m3257/is_n5_v48/ai_15484887


If your state medical society hasn't used this ruling to enact a state law, then you should get on top of them to do so!

Cheers,
Al