Medical Device Daily Washington Editor

WASHINGTON — Nobody who ever ran a company discounts the importance of marketing. And with information technology poised to hit healthcare en masse, those who have to depend on their marketing skills to put food on the table would not be surprised at some of the promotional efforts now rising to the surface.

Consider the all-star roster—including former director of the Centers for Medicare & Medicaid Services Mark McClellan, and former speaker of the House of Representatives Newt Gingrich, and e-health firm Allscripts (Chicago)—that pitched the National ePrescribing Patient Safety Initiative (NEPSI), at a meeting of the National Press Club (Washington) yesterday.

With a list of collaborators that includes software behemoth Microsoft (Redmond, Washington) and computer marketing whiz kids Dell (Round Rock, Texas), Allscripts and friends will provide free e-prescribing software to the nation’s doctors in an attempt to coax them into using the technology.

The next step is likely to coax these physician offices into buying related solutions, such as electronic health record systems.

The e-prescribing systems will require minimal training, the companies promised, with their essential benefit to be the reduction of medication errors and the deaths and injuries that such errors produce.

The numbers on medication errors are fairly familiar. According to the materials included in the briefing, prescription drug medication errors “injure 1.5 million Americans each year and contribute to the deaths of more than 7,000,” according to data reported by the Institute of Medicine (IOM).

Adverse drug reactions are blamed for more than 700,000 trips to the emergency room annually. The IOM report also indicated that the cost of errant medications to hospitals in the U.S. tops $3.5 billion a year, a figure not including lost productivity and other points of cost.

According to the Center for Information Technology at the National Institutes of Health, “national savings from universal adoption of electronic prescribing could be as high as $27 billion” a year.

Gingrich led off his comments by arguing that the use of paper “kills. You can use any analysis you want,” he said. Paper-based medication delivery results in 8,000-9,000 deaths each year in the U.S., according to estimates.

“Paper records,” he said, “are also stunningly disastrous because, as we found in Hurricane Katrina, they disappear,” with many of those affected by the hurricane fighting diseases such as cancer, and requiring re-evaluation to proceed with their therapies.

“In the long run, it’s clear that you have to have an all-electronic system,” Gingrich said. E-prescriptions are a key step toward healthcare information security, and will work, he said, because writing prescriptions is “a routine, repetitive behavior that happens over and over, every day” to the tune of 3 billion times annually in the U.S.

“The thing that is exciting about this launch is that you have the private sector coming together with the professional associations to devise the launch of a product,” Gingrich said. Best of all, it’s free, “which takes away any excuse for [not] e-prescribing,” according to Gingrich, now the president of the Center for Healthcare Transformation (Washington), a healthcare think tank. “After today, every patient in American should stop their doctor when the doctor is writing a paper subscription,” and ask for an e-prescription, he said.

Using aviation safety as a case study, he said “we’re relentless about aviation safety, and then we kill you in the hospital.” Gingrich also asserted that “[i]f aviation was killing 100,000 a year, it would be a national crisis.”

McClellan, who now works as a visiting scholar at the AEI-Brookings Joint Center (Washington), said that “2007 is the year when we finally stop talking about e-prescribing and finally start making it happen.” He also joined the chorus of public-sector skeptics in making the case that when it comes to e-prescribing, “government can’t do this alone . . . it really takes private sector leadership.”

“Not only is it free to physicians,” McClellan noted, but the software is available over the web and checks for formulary conflicts. “It works with interoperable standards that are emerging in our healthcare system,” the former CMS administrator said. “For those who are waiting for the tipping point, you do not have to wait any longer.”

Glen Tullman, CEO and chairman of Allscripts, called this an opportunity “to bring all the key stakeholders in healthcare together” and that his firm is not interested in patience, but in patients.

“NEPSI is really about making it happen, not a few years from now, but making it happen right now.” He added: “what is absolutely critical is not just that large practices taking a leadership role, but small practices take action,” and he noted that the software “has state-of-the-art privacy and security features.”

The firm said it will plow $100 million into the program over the next five years.

Hinting at his company’s motive for undergoing this expense, Tullman said that the initiative “is a great investment in our future because electronic prescribing is the first step to an electronic healthcare highway.” He added that “Allscripts will be a leading provider of those health records.”

In its 1999 report, IOM said as many as 98,000 die unnecessarily in the U.S. every year due to substandard care, but there are a number of serious difficulties with those numbers, including a high margin of error.

Medical Device Daily asked Gingrich if the projected numbers of fatality reductions due to e-prescribing were plausible, given that the IOM numbers are statistically problematic.

He replied, “[w]hen Piedmont Hospital [Atlanta] went to e-prescribing, medication errors went from 7 per 1,000 to 1 per 1,000. If you had a similar reduction in medication errors” in all hospitals, the impact would be enormous.

David Merritt, a project director at CHT, told MDD that the typical Medicare beneficiary “is on five prescription drugs and sees three doctors,” calling that “a recipe for errors.”

Regarding the e-prescribing initiative, Randy Boldyga, president/CEO of RxNT (Annapolis, Maryland), a company that publishes e-prescribing software, suggested that NEPSI is hardly a case of corporate altruism. “If you pull back the layers . . . you’ll find that it looks like a marketing ploy by Allscripts,” he told MDD, and that Allscripts is not the only company that gives away free e-prescribing software.

His company issued free licenses to use its software to 10,000 doctors in Michigan last year, he said. As to the impact of the Allscripts move on how other companies will operate in the future, he said, “I don’t know that this is going to change our business model.”