January 04, 2004

Electronic Prescriptions

I have been a bit busy to continue my reading of the new medicare act at the pace I would have liked. One thing that popped up at me was the section on electronic prescriptions.

This is a tremendous cost saving measure for physicians on several fronts. First, physicians gain the ability to simply enter the prescription once and the data will be able to automatically go to:

  1. The patient file

  2. The insurance company if there is a need for pre-clearance

  3. The pharmacy

  4. The practice accounting software

The last is probably the most significant from a cost containment point of view. If you can, with zero additional human input, calculate and create a report on how much it costs to do an action by health insurance carrier, you can measure and find out where you are enduring the greatest costs, both by patients and by insurance carriers. Instead of vague claims that can be disputed by effective lobbying associations that "the insurance industry" is slow paying and purposefully throwing bureaucratic roadblocks in the way of effective treatment care as cost containment for them, individual doctors will be able to measure exactly who are their "problem children" in terms of insurance carriers and take quick and effective action to solve the problem.

Patients can be "problem children" too. The current practice is simply to drop them when they get too bad but if the cost of keeping track of who they are is reduced to almost zero, it would make sense to have something of an education alternative for them to be taught exactly what they're doing wrong and seeing if they'll shape up.

This has nothing to do with the severity of the illness a patient has. It is much more about routinely calling at two in the morning and asking for an antibiotic prescription over the phone (as a freebie) for an illness that could have been properly treated during business hours (which would have cost out of pocket the copay for an office visit). Doctors know who's taking them for a ride and when that cost exceeds the cost of dropping a patient, the patient's got to find a new doctor, a pretty expensive proposition all around. The more information is entered electronically, the easier it will be to create alternatives that improve patient behavior short of dropping them.

Posted by TMLutas at January 4, 2004 12:00 PM