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Project Overview
e-Prescribing Gateway | e-Prescribing Education
December 2006 - The project to develop and deploy the Rx Gateway community e-prescribing utility has achieved considerable success in 2006. More than 1,000 Beth Israel Deaconess Medical Center physicians are registered for e-prescribing with SureScripts, and more than 100 of them are using BIDMC's online medical record system, webOMR, for e-prescribing, with more to come online over the next several weeks. Approximately 10,000 electronic prescriptions have been transmitted, and several of the early adopters have proven to be high-volume e-prescribers, with hundreds of electronic prescriptions created over the course of several weeks.
Testing is under way to begin a live pilot with Partners Healthcare/Brigham and Women's Hospital in March, RxHub certification for eligibility and formulary is complete, and work is in progress to integrate Harvard Pilgrim Health Care formulary.
With the community utility live and expanding its offerings, MA-SHARE is seeking to partner with other organizations to integrate e-prescribing capabilities and expand the availability of Massachusetts community data. Discussions are under way with several Massachusetts payers, hospitals, and EMR vendors to understand the community benefits of Rx Gateway integration.
Organizations interested in learning more about MA-SHARE's e-prescribing program may contact Gail Fournier, gfourni3@csc.com, 781-290-1356, for more information.
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Vision
The Project's goal is to improve the speed of adoption, accuracy
and value of e-prescribing applications by electronically linking
them with all major payers, prescription benefit managers, and
prescription dispensing locations, including retail pharmacies
and mail order services.
Ultimately, the Rx Gateway will serve as the prototype for a broader
clinical data exchange.
Objectives
- Provide 24 by 7, single access and distribution point to support
end-to-end e-prescribing that shares the cost across the community
- Meet privacy and security requirements along with contractual
obligations related to data access and distribution
- Provide measurable value to stakeholder:
Prescribers/Provider Organizations
- Provide a complete service to support end-to-end e-prescribing
regardless of the patient's payer or PBM
- Improve patient safety (legible prescriptions, dispensed
drug history for drug-drug interaction manually or via embedded
logic in the point of care system)
Health Plans, Payers and PBMs
- Increase formulary compliance and e-prescribing adoption
- Reduced costs through reduced adverse drug events
Vendors
- Streamline connectivity through the use of standards-based
interfaces and centralized contracting for access and distribution
rights
Pharmacies
- Create two-way communication between pharmacies and prescribers.
- Reduce administrative costs associated with prescriptions
(e.g., calling clinician to verify prescription, requesting
a prescription change due to formulary issues or drug-drug
interaction)
- Establish a sustainable business model for ongoing delivery
of Rx Gateway services including expected revenue contributions
from each of the stakeholders
- Offer a migration strategy for MedsInfo ED by including dispensed
drug history in the data stream
Project Description
The Rx Gateway will be a traffic manager, NOT an e-prescribing
solution. Rx Gateway will provide a single point of access to eligibility,
Rx history and formulary data. Rx Gateway will route prescribing
transactions to payers, PBMs, pharmacies and mail order houses.
E-prescribing tools (e.g., ePrescribing, EMR or internally developed
systems) will use the Rx Gateway for prescription writing, E&B
confirmation, formulary validation, presentation of Rx history,
improve drug utilization, and two-way connectivity to pharmacies
and mail order companies.
Rx Gateway will connect to all Stakeholders, and will contract
with data sources and data users to establish terms in governing
access and distribution rights. Rx Gateway users only need to build
one interface and negotiate a single contract with MA-SHARE, saving
time and money, and increasing the value of their initiatives.
Customers include provider organizations, e-prescribing software
vendors, Rx connectivity "wholesalers" like RxHub and
SureScripts, as well as retail pharmacies, PBMs and mail order
companies.
Rx Gateway will provide 24/7 access to Rx information. Standards-based
interfaces facilitate connectivity and provide e-prescribers with
flexibility to choose the right e-prescribing software solution
for their situation. When an e-prescribing solution needs to be
upgraded or replaced, users will not be tied to proprietary data
access and distribution agreements.
MA-SHARE's Rx Gateway will provide a community solution to accelerate adoption of e-prescribing by providing a single point of access to comprehensive prescription related data from multiple data sources, and using standards-based interfaces to route prescription data between stakeholders.
Rx Brief is attached which is a one pager describing the Rx Gateway and its expected value propositions by stakeholder.
Related Information
- Massachusetts Medical Society
- Surescripts: Needs Assessment
Contacts
Activities to date
- June 9, 2006 - the first production release of the Rx Gateway was deployed in a live production environment. This community utility allows prescribing physicians at Beth Israel Deaconess Medical Center, using BIDMC's electronical medical record system, webOMR, to send new prescriptions electronically to retail pharmacies via the SureScripts Messenger Service. BIDMC subsequently demonstrated the production implementation of the new prescription functionality to Blue Cross Blue Shield of Massachusetts to satisfy a pay for performance contract.
In early August, approximately 130 BIDMC physicians will begin using the new electronic capability in support of a grant from AHRQ and CMS (RFA HS06-001/NGA: 1 U18 HS016377-01). Under the grant, a research team from Brigham and Women's Hospital Division of General Medicine will study the clinical and business impact of implementing electronic prescribing in a mature CPOE environment.
Later in August, the second release of the Rx Gateway will introduce handling of eligibility and formulary data from RxHub as well as electronic processing of new mail order prescriptions.
Subsequent releases will expand the community utility to support additional provider organizations, expand the scope of data offered through the Rx Gateway, including eligibility and formulary data from additional payers, and expand the functionality of the Rx Gateway, including the introduction of medication history, prescription renewals, and prior authorization.
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Spring 2006 - Article published in JAMIA. John Halamka, MD, MS, Meg Aranow, MPH, Carl Ascenzo, BS, David W. Bates, MD, MSc, Kate Berry, BA, MA, Greg Debor, BS, Jessica Fefferman, MPH, John Glaser, PhD, Jerilyn Heinold, MPH, John Stanley, BS, MPA, Diane L. Stone, MBA, Thomas E. Sullivan, MD, Micky Tripathi, PhD and Bruce Wilkinson, MBA
"E-Prescribing Collaboration in Massachusetts: Early Experiences from Regional Prescribing Projects"
JAMIA (May /June 2006)
Subscription Required, or contact Dr. Halamka for reprints (see article abstract for contact information)
- April 6, 2006 - The Consortium's MA-SHARE joined the Connecting for Health press conference on April 6, 2006 in Washington to publicly release the source code and implementation guides for the clinical data sharing work to date. MA-SHARE, as a Connecting for Health "prototype team", contributed to the technical and policy components of the Common Framework report, published by Connecting for Health and available for free on their web site at www.connectingforhealth.org/commonframework/.
- January 2006 - The Department of Health and Human Services
(DHHS) via the Agency for Healthcare Research and Quality (AHRQ)
awarded funds to a partnership of three organizations:
- MA-SHARE which will implement e-Prescribing Gateway* architecture
for the state which will connect providers to payers, pharmacy
benefit managers and service providers such as RxHuband SureScripts;
- Beth Israel Deaconess Medical Center will implement
e-prescribing among its owned practices;
- Brigham & Women's Hospital will evaluate the
quality and workflow impact of the MA-SHARE and BI Deaconess
implementations.
* The ePrescribing Gateway (also
know as RxGateway) provides a single 'front door' for hospitals
and physician offices to easily access the four major functions
of e-prescribing - eligibility checking, formulary enforcement,
prescription routing, and dispensed drug history review.
- February 2005 - The Consortium is attempting to determine
the relevant e-Prescribing standards that will be incorporated
into the Rx Gateway. In accordance with the Medicare
Modernization Act (MMA), CMS has issued a Notice
of Proposed Rulemaking (NPRM) on e-Prescription Transaction
Standards and invited
feedback. Responses are due back to CMS by Tuesday, April
5th. As it has done in the past, MHDC will assume the role of
coordinating a Massachusetts community response to the NPRM.
To that end, a
meeting was scheduled at MHDC offices in Waltham on Tuesday,
March 8th, 8:30-10:30am. The objectives of that meeting were
to review the NPRM and to develop a process for soliciting and
synthesizing comments from concerned parties in our healthcare
community.
This page last updated December 20, 2006
For further information regarding the MA-SHARE initiative and
its projects, please contact Gail Fournier, Partner, CSC Consulting, via
e-mail. We welcome your further questions & look forward
to your participation in our work and our events!
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