Home Forums Discussions General Discussion Electronic Prescribing

This may be the idiot question of the day but is there some reason to be paying for Sure Scripts when eRx is free? Sure Scripts may run out of the same program, meaning AC but we have to manually update the patient’s record anyway and the latter seems like a much more user friendly interface. What am I missing here?

I believe Jon will have to write an interface.

We are in the process of getting interface with lab. It costs $5K from lab side and 0.5K from my side for this interface.

The question is who pays? If there are 2000 AC users, if we chip in $3.00 each, that may pay the interface. Is it a possibility?

Regards.

"I'd buy that for a dollar!"

But seriously, Joe how about a post in the wish list area here and a group of emails to Jon from the gang? I have been going back and forth with Jon, Roy, and Bert because Roy busted the AAFP supporting one E-Rx vendor over another and now they are backing down after getting caught. But Jon and Roy are pissed and rightfully so. So I think because Roy cc'd a few of us while writing to Jon to let him know about these shady things, I was able to have a front row seat watching and chimming in.

Now I've gotten a few responses from a few people from my own responses to Roy and Jon's first few exchanges with these folks; including this one guy who is supposedly one of the docs in charge of the AAFP's IT intitiative. Seems that we have stuck a cord here. Personally I don't think any of these new requirements or interfaces (on the portal side at least) should be ours to pay. Think about the lab interface, we don't make a dime on these labs, this is a referal to another provider to run the tests. Why should we have to pay anything so as to save the lab staff time, postage, messenger fees and all the like?

Let the labs pay for it all. This is their side of the business. Do we get to charge another doc when we refer the patient on for the notes and labs we have to copy and then mail or fax out? Hell no, so why should we have to pay for all these kind of things now? We were kind enough to send them the patient in the first place, now please send me my report at your expense. I'm sure that the relative value units for labs have calculated the cost of send these reports, right? Just like they have included all of our malpractice, cost of doing business and so on and so forth. Now we are just going to let them keep these fess while passing the expenses for their side of the business to us in the name of efficency and technology.... Think these things thru here people... (and Joe I am not yelling at you personally you know that, right?)

I feel the same about these Rx's. Who does it really serve? The government to track data and watch for abuse and the like, super large chain pharmacies who have chased our wonderful locally owned and operated ones off of Main street. Let Rite-Aid, and Walgreens, CVS pay for all of this. Let's finally hit big pharma with a windfall profits tax to fund some of this CCHIT. We on our side will benefit little if at all from most of this, so why should we be required to pay for all of this?

This is like the difference between Office Ally and all the other charge the providers clearinghouses. This will just be another life long, "taxi-meter" relationship for us providers to allow someone else to profit and take our dwindling money out of our pockets in another form of an un-needed parasitic drain for their own self betterment and gain. I am sick of all of these parasites glombing onto all of you folks, making bigger bucks than the docs who do the hard work in the trenches caring for patients all day.

But free is always nice. I would love to know how they are going to make any money on this. Is this more like office ally than we know? Do the pharmacies pay to use these systems and so these guys have decided that those fees are enough and they are going to give providers a break? Inquiring minds want to know.....

Good Night and Good Luck,
Paul

Hi Paul:

I think that with the AC 2000 user clout that Jon has, he could easily negotiate the cost of an interface with several labs- those that don't pay don't get the referrals.

An associate that used to sublease from me is constantly using both of our offices as clout to renegotiate new lab fees on a yearly basis. The lab also pays for a 20 hour-per-week employee to draw my bloods, for the computer, for all the related supplies, and they have told me that they would work with me on the interface anytime that I wanted to try it with my little old MS Access EMR (without me asking them to!). I just haven't found the time to take them up on it.

The e-Prescribing is turning out to be a serious war-in-the-making, though. To get that interface, Jon would have to have his programmers working overtime for the next 8 months (as is going on with a local vendor that I Skype with frequently)... it's d*mn hard to get the certification. In the meantime, you can see that the "players" are lining up for the kill-

-- A venture capital firm led by David Brailer, former national coordinator for health IT, has a company with a budget of $700 million to invest in health-oriented enterprises, but plans now to invest huge sums into e-Prescribing.
URL: http://www.ihealthbeat.org/articles...ost-From-Brailer-VC-Firm.aspx?topicID=52
-- See Joseph's thread on CMS' shenanegans here- http://www.emrupdate.com/forums/t/14330.aspx

At the end, it may depend on how angry we get about having to again double input information (like prescriptions) just because big government wants us all to use a handful of EMRs. BTW- today they announced that the Medicare P4P "initiative" will only go to those physicians that have purchased any one of 6 EMRs. I'm sure that AC is not on that short list...
URL: http://www.ihealthbeat.org/articles...ity-Reporting-Initiative.aspx?topicID=54

Al,
Only half a f'ing dozen! You've got to be CCHITTing me.... Sorry I couldn't resist. Awwh come on AC is the greatest little EMR since the learned how to slice bread. How many congressmen can you buy with your Health IT Dollars? Unbelievable... Simply AMAZING, right? But hey at only .015 percent of an increase in P4P from Medicare, the joke is really on the big guys who foot the tab for those expensive monsterous enterprise class EMR's for a spit in the bucket increase... They can take their 1.5% and stick it you know where.... Where all their CCHITT comes from.

So what about getting a group of us small and solo docs and staff in front of some meaningful congressional committee hopefully with some serious air time??? I'd try and pull off the press releases to get some attention. Keep up the good work on keeping us all in the loop. Keep the faith.
Paul

Damn, this is what is killing me and what I wrote to that collection if E'Rxing Nazi's. Funny how this rule only captures the minority of providers that were good enough to embrace EMR's in the first place. Meanhwhile the majority of offices that are still paper have nothing imposed upon them. So only us early adopters who have taken on the risk, the expense and hassle of attempting to go EMR are getting set-up for even more pain. Gee I guess we should just disconnect our EMR, print out all our old charts and encounters, and the hell with the new law. Unbelievable. Just set us do gooders up again for more pain.

Good Night and Good Luck,
Paul

Paul-

Some other BAD news- Hillary Clinton, in yesterday's Fox News interview, while posing with that sweet smile, and lovey-dovey talk with Bill O'Reilley, specifically stated that "electronic medical records" will be one of her cornerstones in her plan to solve all the ills of our health care system. I'm sure that she meant CCHIT-EHRs...

Now the GOOD news...
1) I've updated my "Hall of Fame" (or should I call it "Hall of Shame"?) to register than NextGen will NOT be going to TERP 2008. Historically, they've had a 3000 sq ft booth section. It'll be a big loss for the TERP folks. I guess that they can't afford it!
URL: http://s38.photobucket.com/albums/e103/alborgmd/?action=view&current=CCHITHOF.png
2) Also- Congress continues to be deadlocked on EMRs/P4P/physician pay cuts, which is great. This is one reason why I'm a McCain man- he's so old he probably thinks that a "laptop" is something that you get when you to into a red light district, which is GOOD. No HIT mandates from that guy. Obama? He'll probably get Rev. Wright to do the CCHIT thing... seriously, he's also into the HIT-is-cureall-for-all-ills camp.

What these vendors are trying to do is to bolster their sales, and thus their stock prices by manipulating the market, which as an industry have fallen an average of 20% in the past 6 months (see http://www.emrupdate.com/forums/p/13444/81270.aspx#81270 ). You can't force docs to buy into these bloated, 40% deinstallation rate, 20% CCHIT certified financially challenged vendor rate, non-AC systems. It just won't work; docs aren't that stupid.

Come on Al, our bitchin here among ourselves is OK. but we need to OUT these SOB's once and for all in Public. We need to compile a list of the politicos that have taken this dirty CCHITTy money too. And never forget the Big Brother civil rights aspect of all of this. Regular old Americans get that all too well.... Are ya game???

Paul-

Check out the Fox News interview here:
http://youtube.com/watch?v=L9X_nnEJmHM

We gotta go after these guys! My spy-in-Congress is going to send me an Excel spreadsheet about the under-the-table bribes that have led to this. Well- gotta go mail my office Virginia taxes!

I still think we'll win at the end, but it'll be a hard fight.

Cheers,
Al

Now deep thoat won't get her head cut off for leaking you this information? But it really is time to get some of us regular guys out in front to tell the truth in it's gory details. I think the honesty of it all would go a long way.... Personally, I can't wait to see that list... Go work my friend.

Christy,

Did you ever get an answer to your question about SureScripts vs. eRxNow? It's something I've been trying to figure out. I was ported over to eRxNow when the service I was using (ProxyMed) was acquired by Allscripts. I was paying $30 a month which I felt was worth the cost given the decreased faxes and employee time needed to process those faxes. I stopped paying the $30 a month when no one at Allscripts could tell me what I would get for paying for a service which is free (it may be the ability to refill controlled substances yet I'm not certain, AND I want those patients to come back to the office when their refills run out). A few days ago I was thinking it would be nice to have my Rx's linked with AC since one thing I dislike on the eRx site is the inability to see the past fill history very easily. Does anyone else have experience with the different e prescribing services?

By the way, I agree with the sentiment we should not have to pay to do this. Our business is so screwed up we have to pay for the privilege of being paid, and, with the mail order pharmacies, have to essentially rewrite/redo the prescription on their form after the patient mails in our nicely typed and personally signed Rx.