Evaluation of AHRQ- and CMS-Funded E-Prescribing Pilot Projects
In 2005, the Centers for Medicare & Medicaid Services (CMS) awarded grants to five pilot sites to test electronic prescribing (e-prescribing) standards. The testing focused on the interoperability of these standards with one another, their ability to delivery messages accurately and unambiguously, and their downstream effect on healthcare outcomes such as medical errors and clinical efficiency. The Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health IT (NRC) was then charged with compiling an evaluation report which summarizes and synthesizes findings across the pilot projects with the goal of advising the Federal Government on standards adoption and disseminating key data on e-prescribing outcomes among the policy community.
The inability for multiple systems to share information with a standard format and vocabulary has been a hurdle to effective implementation of e-prescribing. To address this situation, the Medicare Modernization Act of 2003 (MMA) directed the Secretary of Health and Human Services (HHS) to establish Federal standards that all e-prescribers must follow for patients enrolled in Part D.
When HHS promulgated rules proposing standards for electronic prescribing, the rules identified three well-accepted standards ready ("foundation" standards) for immediate implementation, and several other areas in which standards are needed. In these areas, HHS proposed six "initial" standards for pilot testing.
The five pilot sites are among the leading experts in the field of e-prescribing: RAND, Ohio KePRO/UHMP, Brigham and Women's Hospital, SureScripts, and Achieve Healthcare. A summary of their results as well as additional analyses and recommendations is included in the following reports.
CMS Report to Congress
As required by the Medicare Modernization Act of 2003 (MMA), the Centers for Medicare & Medicaid Services (CMS) produced a summary report for the United States Congress that highlights the key outcomes of the pilot testing collaboration project with AHRQ.
The NRC was charged with compiling an evaluation report to summarize and synthesize findings across the pilot projects with the goals of advising the Federal Government on standards adoption and disseminating key data on e-prescribing outcomes among the policy community.
Also available are individual reports from each e-prescribing pilot project. Each report describes the results of rigorous standards testing performed by one of the pilot sites. In addition, each report includes results of the pilot project's study of key issues in e-prescribing, such as reduction of adverse drug events, provider uptake (adoption), and potential gains in efficiency and effectiveness.
Download the Ohio KePRO/UHMP report (PDF, 1.01 MB; Text Version**)
Download the RAND Corporation report (PDF, 176 Kb; Text Version**)
Download the SureScripts report (PDF, 169 Kb; Text Version**)
*This version of the report is formatted for compliance with Section 508 of the Americans with Disabilities Act (ADA). **The Section 508 compliant version of this report will be available soon.
A computer-generated message generated when specific criteria are met; e.g., entry of a critically abnormal laboratory test value generates a warning message to the care provider who ordered the test.
The American Medical Association (AMA) is an organization of physicians which works on the most important professional and public health issues including health information technology (HIT).
The American Medical Informatics Association (AMIA) is an organization dedicated to the development and application of biomedical and health informatics in support of patient care, teaching, research, and health care administration.
Ambulatory medical record system (AMRS), which is a clinical information system that supports the functions of an outpatient clinic, generally including registration, appointment scheduling, order entry, reporting of results, clinical documentation, and billing.
The American Nurses Association (ANA) is a professional organization representing registered nurses with the goal of advancing the nursing profession by fostering high standards of nursing practice and lobbying Congress and regulatory agencies on health care issues affecting nurses and the public, including the use of information technology (IT) in nursing practice.
The American National Standards Institute (ANSI) oversees the creation, promulgation, and use and thousands of standards and guidelines, in nearly every sector of the economy, in order to strengthen the U.S. market in the world economy and to improve the health and safety of consumers.
A computer program designed to help physicians in the proper ordering of antibiotics.
The Arden Syntax standard, which is maintained by HL7, is a coding scheme which provides a standard means for writing rules designed to relate specific patient situations to appropriate actions.
Application Service Provider (ASP) is a type of client-server installation where a business hosts computer-based services for customers to access across a network, such as electronic health record (EHR) solutions accessed over the Internet.
A mode of communication in which exchange of data does not require both parties to be actively involved at the same time.
Asynchronous transfer mode (ATM) is a network protocol for sending small, fixed-length packets of data over network connections.
A record of all accesses and updates to medical data, which is generally maintained in chronological order, which is used to promoted accountability of access to the data.
A process for the positive identification of system users; this process is used to control access to the system.
A process for limiting user access and activities to only the actions deemed appropriate for that user.
The American Academy of Family Physicians (AAFP) is the national association of family doctors; its mission is to improve the health of patients, families, and communities which includes the introduction and use of health information technology (HIT).
A level of encoding of medical data which involves reviewing the data and labeling the data based on an item from a terminology.
A security function in which users are responsible for their access to and use of medical information. The users must have a right to know and a need to know the information they access.
Time between learning sessions when teams work on improvements within their organization. The teams are supported by collaborative faculty/staff.
An adverse drug event (ADE) is an unexpected or dangerous reaction to a drug.
Admission-discharge-transfer (ADT), which is a component of a health information system (HIS) designed to maintain and update the hospital census.
Computer software designed to operate with a degree of autonomy from its programmer (e.g., an agent may be used to search the Internet for specified information).
The American Hospital Association (AHA) is the national organization representing all types of hospitals, health care networks, and their patients plus communities. It strives to ensure that its members’ perspectives and needs are addressed in national health policy development, legislative and regulatory debates, and judicial matters; this includes issues related to health information technology (HIT).
The American Health Information Community (AHIC) is a federal government advisory body chartered to provide recommendations to the Secretary of the U.S. Department of Health and Human Services (HHS) on how to accelerate the development and adoption of health information technology (HIT).
The American Health Information Management Association (AHIMA) is a professional organization devoted to improving healthcare by advancing best practices and standards for health information management (HIM).
Agency for Healthcare Research and Quality (AHRQ) is the lead federal government agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. As one of 12 agencies within the Department of Health and Human Services (HHS), AHRQ supports health services research that will improve the quality of health care and promote evidence-based decision making.
This refers to the amount of data that can be transmitted over a communication channel in a given period of time.
A measurement obtained prior to an intervention and used for comparison to post-intervention measurements.
The College of American Pathologists (CAP) is a professional organization of pathologists which fosters and advocates excellence in the practice of pathology and laboratory medicine. It was responsible for developing the Systematized Nomenclature of Medicine (SNOMED).
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