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TECH: Free eRx from Allscripts and friends, with UPDATE

Allscripts, backed by a cast of friends, is going to let any physician in America sign up for its ASP-based eRx system (which links into Surescripts) for free. The coalition is called the National ePrescribing Patient Safety Initiative (NEPSI) and it has its own website and press release and everything!

Also in on the deal are two biggie health plans, Wellpoint and Aetna, several tech companies (Dell, Cisco, Fujitsu, Microsoft, Sprint, & Google), Surescripts (connection to pharmacies) and Wolters Kluwer (drug databases). I assume there is some money flowing around (presumably from the health plans) to cover the costs, but it’s not clear how much or to whom. I’ll endeavor to find out.

The old joke is that for physicians to adopt technology, free isn’t cheap enough. I guess that we’re about to find out.

UPDATE: Well I actually listened to the whole webcast (yes, my life is pretty sad!). The most interesting thing is the Glenn Tullman (Allscripts, CEO) said that the 5 years commitment was $100m. That’s real money, and the only real place that they can expect to get (most of that) is from the health plans—unless Glenn’s got the negatives of Bill Gates or Larry and Sergey with the goats. And it’s probably a similar amount that Wellpoint and the others have already spent on these initiatives, much of that with Allscripts—so there’s probably a migration of those regional projects going on.

The other thing mentioned was that the system would have interfaces with practice management systems—what that means in reality remains to be seen of course.

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8 replies »

  1. I have worked with four different EHRs.
    Now six months into Allscripts, I advise any other system.
    I hate Allscripts.
    If your hospital is exploring EHR, get involved and experience actual visits at Allscripts installed sites.
    Talk to the users and victims and avoid salesmen and administrators.
    Did I mention I hate Allscripts?

  2. I come from a family of pharmacists but realized that my three uncles, aunt, and older brother all hated being pharmacists. I quit pharmacy school my junior year and switched to biochemistry when I realized I didn’t want to spend the rest of my life counting pills in multiples of 12 or 20. The catalyst was the pharmacy professor who “explained” that the required two years of calculus was to control and reduce the number of pharmacy graduates.
    Ironically, I ended up as a “detail man” selling pharmaceuticals for six years when I got out of the Army (remember Vietnam?). However, I also came to the conclusion that half of the doctors in my territory I would NOT trust to use a rectal thermometer.
    The problem with Allscripts is NOT the technology, but the pseudo-priests in white coats who don’t want to give up the mystique that creates the illusion that they are Doctors or Pharmacists rather than (biological) plumbers or stock clerks. What scared ME about pharmaceutical sales is when I discovered the documentation that 40% of the “good to excellent” results of almost all pharmaceuticals is the placebo effect. This (lack of information) is the “magic dust” that gives most doctors and pharmacists a secure living. To make their activities transparent terrifies them because it holds them accountable.
    Any online prescription service will succeed only when medical insurance providers require that all approved prescriptions be transmitted online. Much like “Approved Provider” lists have provided some control for medical costs, only that type of oversight will provide the pressure for the medical and pharmaceutical “professions” to be held accountable for the thousands of people who are killed each year and tens of thousands who are severely injured each year by mis-prescriptions.

  3. Who’s responsible if instead of writing a electronic prescription you hand a paper one to a patient and while in the parking lot the wind grabs it and they chase it into the street and get hit by a car? You for writing it or them for running into the street?
    How about if your car manufactuer installed 2 gas pedals instead of a gas and brake and you went flying into a wall – you responsible or the car manufactuerer?

  4. Gary,
    Your comments are very insightful. We experience similar pains. We installed Quests 360 for free and the only thing our staff uses it for is calling up lab results. To my knowledge, no one has ever used the free prescription software and now that we have decided to switch lab vendors the installation cost and staff training is lost.
    I did have some experience with AllScripts too when I join an IPA and a Medical Group in California. Both signed up with AllScripts in order to qualify for health plan incentives. It took months to install and after we received training, no one used it. I think we really tried, but everyone hated it and it became the office joke for months, and as you would expect, we never saw a dime from the health plans.
    Thanks to BCC we also received NextGen and new Dell PCs. Now they are collecting dust and wasting space too.
    Coincidentally, I used to attend the California IHA Stakeholder meetings and regularly attend the various medical conferences. Colleagues of mine at HCP and Sharp in CA recently told me that their groups have been trying to install AllScript for years and they still can’t get it going, nor do they want to. A college buddy who is at Facey told me they finally installed Allscripts which took more then a year and no one is using it.
    I did hear about a company that Pacificare bought that was installed in several CA groups but I don’t recall the name. The word among my peers was it worked well. I remember a good friend from UCLA and his wife who worked for a large group in Southern California love it. She told me all their doctors used it all the time and they were squashing AllScripts. She was obviously overstating her enthusiasm because I haven’t heard anything about it since, and I know she is not using it any more because it was a big deal when it was turned off. I would guess that United now owns it. Maybe they are going to use it to compete with WellPoint, Aetna and AllScripts.
    Personally, I would like to use something reliable that did not take so much time to learn and use. Coding is becoming a nightmare to manage and Medicare is not helping with the new change that is for sure.
    I can see the value of some automation if it worked, but I can’t see any of my peers using something from WellPoint or Allscripts. They just don’t trust them and what happens if Allscripts has a bug that kills a patient. Who is responsible? Me for trusting the software and not sticking with something I can control, or them for the screw up?
    But who care is the product is crap, I just wish I had purchased their stock a few years ago and cashed out now that is for sure. Someone is making money here…just not us anymore.

  5. Regarding you comment, “The old joke is that for physicians to adopt technology, free isn’t cheap enough. I guess that we’re about to find out.”
    The North Shore University Hospital Medical Staff IPA I am president of has already painfully proven this point. Our IPA paid for licenses for docs to e-prescribe using DrFirst’s Rcopia, paid for the Palms AND the wireless modems, paid a $1,000 honorarium to those docs who wrote 200 scripts in the first few months–and we still couldn’t get more than half of the docs to sign up. One year into the program, we’ve had a majority of those docs who earned the $1,000 stop using the program.

  6. Emdee, I’m with you.
    I don’t trust corporations or insurance companies with my private medical data. I want only the federal government to have access to my private health information. Federal health workers will be reliable and honest; private citizens working for profit are inherently unreliable and dishonest.

  7. OK, so no one likes to be a party pooper! Therefore, I was glad to see that I am not the only skeptical person to comment on this announcement.
    Personally, I seriously doubt the ability for these companies to pull this off. Are people supposed to believe that AllScripts is altruistically giving this away? Come on, consumers and physicians know a Trojan Horse when they see one. Not to mention the integrity of the Health Plans….
    There is also the real issue of security and the HUGE privacy risk to consumers. Don’t believe me, just look at the VA, the banks and all the other “secure” monolithic companies getting their data ripped off or hacked. The FTC reports that most security breaches are inside jobs, and at 1.8% of the nation’s fraud, medical record fraud is one of the fastest growing and most costly types for fraud.
    But let’s not dwell on the negative. These companies know what they are doing, right? Oh I forgot, are’nt these same companies who teamed up before on several different occasions and failed miserably, and isn’t this CaféRx, under a different name? And didn’t AllScripts, WellPoint, Microsoft and Dell give us a bunch of computers a few years ago with essentially the same deal.
    Who are you trying to kid now? Don’t count on my group’s support that is for sure. You are wasting our time.

  8. I can’t help it.
    No group of corporations like these is in it for the good of it. Newt? Yeah, he’s a real compassionate guy and isn’t thinking only of the dollars .
    No, they’re in it because they smell value.
    What’s in it for them? Data mining. Don’t worry. Trust us. We’ll never deny you coverage, or a job, or a security clearance, or housing, or financing because of the health records we dipped into. What’s that? The agreement says they won’t share your data except with authorized recipients? SURPRISE! WE’RE ALL AUTHORIZED.
    Got I hate this stuff.

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