Saving Lives and Saving Money with Electronic Prescribing

November 16, 2007

By John Kerry and Newt Gingrich
(Originally published in The Wall Street Journal)

In 1799, doctors likely hastened the death of George Washington when they drained a third of his blood to treat a bacterial infection. Bleeding was a common practice, dating back to the Greeks and Romans. Nowadays, a doctor who promoted bloodletting would be barred from practicing medicine. But in the age of the Internet, is it any less inexcusable that we have yet to modernize and transform our health care system?

We have talked long enough about using technology to stem perpetually rising health care costs and poor quality. Now is the time to act— and the place to start is preventable medication errors. According to the Institute of Medicine, Americans average one medication mistake for every day they spend in a hospital, accounting for more than 1.5 million injuries each year. This year, medication errors will kill at least 7,000 Americans.

Of the more than three billion prescriptions written every year, doctors report that nearly one billion of them required a follow up between providers and pharmacies to clarify something. These inefficiencies cost our health care system billions of dollars a year.

One contributing factor to these egregious outcomes is that the vast majority of these prescriptions—95% of them—are transmitted using 5,000-year-old technology: pen and paper.

In this day and age, that is simply unacceptable. The deaths and inefficiencies of paper prescribing can be virtually eliminated by bringing to healthcare the kind of technology we treat as second nature in every other aspect of our lives. Electronic prescribing replaces the flood of handwritten, misread, and mismatched prescriptions with online, automated, and expert technology.

The benefits are clear and compelling. When a doctor “writes” an electronic prescription, a computer or handheld device warns of potentially dangerous interactions or allergies, preventing thousands of unnecessary hospitalizations each year. E-prescribing can also let a physician know whether a particular drug is covered by a patient’s insurance and whether a chemically identical generic alternative is available at a fraction of the price. One initiative led by Chrysler, General Motors and Ford to drive e-prescribing in the Detroit region has already generated more than one million prescription alerts that have saved lives and saved money.

The benefits of e-prescribing are so critical to modernizing health care that the Institute on Medicine has called for every doctor and nurse to prescribe electronically by the year 2010. Business and labor leaders, health insurers and consumer advocates—advocates with big differences on big issues—are unanimous in their support of this common-sense initiative.

Providers also understand the importance of electronic prescribing. According to a recent study of 400 physicians, 85 percent of physicians think e-prescribing is a good idea; 81 percent say it would reduce medication errors; and 65 percent say it would save time. They like a system that reduces their liability worries and allows them to focus on care giving—not paperwork.

The problem is that very few providers are currently using the technology. Of those 400 physicians polled, only seven percent actually transmit prescriptions electronically. And 63% say implementing the technology is not a priority. The main reason? It’s not always in their immediate financial interest to do so.

That must change.

The federal government can lead by ensuring that doctors who do business with Medicare convert to e-prescribing for our nation’s seniors. This can best be accomplished by using market forces and the federal government’s purchasing power to properly align financial incentives.

We should first offer bonus payments to Medicare physicians who already prescribe electronically or who adopt the technology moving ahead. These bonus payments will help providers—particularly small and rural practices without many patients—to cover the initial costs. Private insurers, like WellPoint, are also using this strategy to drive adoption of e-prescribing.

However, if a majority of doctors still don’t e-prescribe a few years down the road, the federal government should then require all doctors to adopt e-prescribing or face financial penalties. E-prescribing should become a condition of doing business with Medicare. This is no different than the requirements any other supplier would expect to see when they negotiate with their customers.

A newly-released study from the Department of Health and Human Services projects that if just 18% of doctors in Medicare adopt e-prescribing, savings will top $4 billion per year and one million adverse drug events can be prevented over the next decade. Imagine if every doctor in America did the same.

These results are something that all Republicans and Democrats can agree upon. While we continue to debate how best to cover the uninsured, improve quality, and lower costs, there is too little action is being taken to modernize health care right now. E-prescribing for Medicare providers is just the beginning of a much larger modernization and digitization that our ailing health care system urgently needs. A high-tech, healthier future is within our grasp. We just need creative leadership bold enough to reach for it.

John Kerry is a United States Senator representing the people of Massachusetts. Former Speaker Newt Gingrich is founder of the Center for Health Transformation. Chrysler, GM, Ford, and WellPoint are members of the Center.

Read about Speaker Gingrich and Senator Kerry's Capitol Hill briefing on e-prescribing here.