Under DEA regulations that took effect June 1, e-prescribing of controlled substances is now permitted in the United States. All the dust has not yet settled, however; APhA joined with other pharmacy associations to suggest ways that the process could be improved. In addition, software developers may need at least a year  to make the updates to computer systems that will allow prescribers to transmit scheduled medication orders, intermediaries to process the prescriptions, and pharmacies to receive them.

DEA has been moving for years toward allowing e-prescribing of controlled substances. The latest push began in June 2008 when the agency announced its intention to create an alternative to manual prescriptions. After the February 2009 economic stimulus act created incentives for increased use of health information technology by physicians, pressure increased for DEA to offer a structure for e-prescribing.

As pointed out in the article, pharmacists may not have to opportunity review a electronically submitted controlled substance prescription for 6-12 months, until this new process has sufficient time to be implemented. However, this is a long overdue - and welcome - policy change.

For additional information from the DEA, navigate your browser to the following site: http://www.deadiversion.usdoj.gov/ecomm/e_rx/index.html

Nice high-level slideshow from Medscape [Registration required (free)]

Clinical Pharmacy Services

Specific to clinical pharmacy services, the law provides for:

MTM Grant Programs. The new law establishes a stand-alone grant program to ensure pharmacist-provided MTM services as defined by the pharmacy profession’s consensus definition on the Core Elements of an MTM program. The program ensures the testing of practice and care delivery models, such as patient-centered self-management programs, that improve patient outcomes through team-based collaborations between prescribers and pharmacists.

Integrated Care Models. The law also includes provisions to ensure that providers with expertise in pharmacotherapy, including pharmacists, are fully engaged in integrated, collaborative, team-based approaches to delivering care, including medical homes, accountable care organizations, community health teams, and home-based chronic care programs.

Transitional Care Activities. The law recognizes the gaps in care coordination and communication that often occur when patients are transferred from one care setting to another. Problems arising from inappropriate medication use are a primary reason for hospital readmissions. Pharmacists—by helping manage pharmacotherapy as part of a transitional care team—will be able to play major roles in preventing these events. Transitional care activities might include medication reconciliation, improved use of personal medication records, and discharge planning that may include MTM services.

Medicare Advantage Plan Incentives. The law provides bonus payments to Medicare Advantage plans that conduct care coordination and management activities. In particular, it acknowledges the need for MTM programs to address medication use issues such as poly-pharmacy through medication reconciliation, periodic reviews of drug regimens, and integration of medical and pharmacy care for chronically ill, high-cost beneficiaries.

Workforce. The law establishes a National Health Care Workforce Commission that will study health care workforce supply issues and make recommendations to Congress.

A nice summary from the American College of Clinical Pharmacy (ACCP) regarding the clinical pharmacist provisions in the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872).

Keep Pharmacy-Related Provisions in the Final Version of Health Care Reform Legislation

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Thank you for your advocacy on behalf of your profession and your patients!

 

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Act now to make sure that the interests of our patients, and profession, are protected in this historical legislation.

Senate Bill 1046 RSS feed for this bill

Relating to prescriptive authority for licensed psychologists; declaring an emergency.

Authorizes Oregon Medical Board to issue certificate of prescriptive authority to certain licensed psychologists and sets forth requirements and procedure for issuance of certificate.

This bill has passed the House and the Senate. Please contact Oregon Governor Kulongoski to express your concerns with this bill: http://governor.oregon.gov/Gov/contact_us.shtml

Under pressure from out-of-state interests, our Legislature is about to consider passage of Senate Bill 1046, enabling psychologists to prescribe medication. This bill would jeopardize the safety of our citizens while creating unnecessary costs. The work group proposing the bill held only five sessions, without public testimony. Remarkably, one member of the work group was from California (and required a temporary Oregon license to participate) and heads a distance-learning post-doctoral psychology training program in clinical psychopharmacology that stands to benefit from the bill's passage. I hope that the Legislature will defer judgment on such an important issue to a regular session during which full and open testimony can be offered.

I am not in favor of this kind of legislation, which I think sets a dangerous precedent. I agree with the author of this editorial that it would be interesting to see if this actually expands care into rural and undeserved populations.

Instead of increasing the scope-of-practice for this profession, I feel a better option would be to encourage the expansion of professionals already credentialed to provide medication therapy.

World Cancer Day 2010, led by UICC, its members and with the support of the World Health Organization (WHO), will raise awareness of cancer prevention. 

Each year, over 12 million people receive a cancer diagnosis and 7.6 million die of the disease.

The good news is that approximately 40% of cancers are potentially preventable. We invite you to join us in marking World Cancer Day on 4 February by promoting our exciting new campaign and spreading the message that cancer can be prevented too.

This coming February, UICC will launch the campaign “Cancer can be prevented too”, focussing on how the risk of developing cancer can significantly be reduced through simple measures:

• Stop tobacco use and avoid exposure to second-hand smoke
• Limit alcohol consumption
• Avoid excessive sun exposure
• Maintain a healthy weight, through eating healthily and exercising regularly
• Protect against cancer-causing infections

February 4, 2010 is World Cancer Day. Please educate and share!

Everyone talks about the capacity of cloud computing to transform government and reduce costs (one study estimates that federal agencies could eventually save 85% of their IT budgets by moving to the cloud). But the vast majority of the federal government's IT spending today is spent on traditional desktop or client-server computing. And until that changes, the federal government won't have the ability to tap the true potential of cloud computing.

That's why the inclusion of cloud computing in the Obama Administration's new FY 2011 budget is a big deal. Check out page 42 of the budget overview which identifies the problem:

"Under the leadership of the Federal Chief Information Officer, the Administration is continuing its efforts to close the gap in effective technology use between the private and public sectors. Specifically, the Administration will continue to roll out less intensive and less expensive cloud-computing technologies; reduce the number and cost of Federal data centers; and work with agencies to reduce the time and effort required to acquire IT, improve the alignment of technology acquisitions with agency needs, and hold providers of IT goods and services accountable for their performance."

Later on page 321 of the Analytical Perspectives section, the Administration writes that

Adoption of a cloud computing model is a major part of the strategy to achieve efficient and effective IT. After evaluation in 2010, agencies will deploy cloud computing solutions across the Government to improve the delivery of IT services.

And on page 327, the Administration says that it will, among other things

[...] initiate pilot projects in cloud computing to transform how the Government provides computing services while taking steps to improve the security of Federal information and systems.

Interesting post on Google's Public Policy blog regarding cloud computing and its potential for cost savings for the federal government. This post stimulated some neuronal activity for me, regarding the potential for this to impact clinical informatics.

I would be interested to read your thoughts on this issue - will this impact pharmacy informatics? Help push PHRs forward?