Ever since CMS passed the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) e-prescribing has been a hot topic in medical facilities all across America. MIPPA adds a 2% incentive over current payments for e-prescribers today. Additionally, ever since the “Meaningful Use Guidelines (draft)” confirmed that e-prescribing will be a requirement in the future, medical facilities have been getting very excited to implement this technology.
But it isn’t all about the money. E-prescribing allows physicians to quit guessing about what drugs are covered by the patients formulary. Instead of constant phone calls between provider, patient, and pharmacy, the physician can KNOW what is approved by the insurance company automatically. In an integrated environment, much of the back office abstracting can also be removed as the response and correspondence information from pharmacies can be automatically processed back to the physician’s inbox. E-prescribing has many advantages both financially, and in the way of process improvement.
With e-prescribing in mind I had the opportunity recently to interview Rohit Nayak, vice president , Physician Technology Solutions with Quest Diagnostics . Rohit and I were able to discuss many facets of the Care360 e-Prescribing application.
Care360 is one of the core HIT solutions from Quest Diagnostics, that encompasses lab orders, physician diagnostics, and lab transactions , and is used by over 140,000 physicians in the U.S. The e-Prescribing component is currently 5 years old and has had 85 percent growth since the start of 2009 in the number of medications prescribed using Care360 ePrescribing.
Upon seeing Care360 I was quickly impressed by the easy usability and interface.
All that was necessary was to go to a secure website in Internet Explorer and all functions were available (after the install of a plugin or two). Seeing patient demographics and basic information was simple and quick to learn. Overall the interface was very clean. I asked Rohit what the learning curve was on his product. He told me on average providers were able to be completely trained in two hours. Given the ease I was able to view everything in the application, I am fairly certain I could navigate and prescribe properly after only two hours.
Care360 is easy to use, but how accessible is it really? Care360 is also available on iPhone (much to my delight) and is currently supported on Safari. Care360 ePrescribing from the iPhone is expected to be available for download from the Apple Apps store later this month. Accessibility is assured from any location that has web access, as Care360 is fully deployed “software as a service” (basically give us an Internet connection, and we are off!). Between the high mobility on the iPhone, and the easy accessibility via Internet Explorer, I was convinced that if I needed to get to Care360, I could find a way.
IT time is something I am keenly interested in. Given demand management is increasingly difficult in a world with unlimited demand and limited resource, we have to be aware of the needs any application puts on today’s health information technology team. I had already seen that the application was deployed via Internet Explorer but how many IT hours will be necessary to keep it running? What about user maintenance? How customizable is the app? High availability? Security? Integration? All easy to answer questions for Mr. Nayak.
User maintenance is very straight forward. A super user can handle normal user rights and access. Additionally the super user can handle the addition of new pharmacies and verify connection to the Sure Script / RX Hub pharmacy networks. Care360 is ~20% customizable (actually quite high compared to most health IT solutions). The app is meant to be a “best for many” application but it is nice to know that changes can be made on a case by case basis if necessary. Rohit surprised me when he said Care360 takes 3 or 4 updates per year. It seems that Quest Diagnostics is really putting a lot of work into the product and is very concerned about making sure work flows are efficient.
Another large plus for Care360 is the “Data Exchange Engine”, aka THE HUB. The HUB is basically an enterprise service bus that allows for a great number of EMR/EHR vendors to integrate and interoperate with Care360. I asked specifically about integration to systems like Meditech, Cerner, Epic, AllScripts, etc and Rohit pointed out that the HUB is currently supporting over 100 applications and systems integrated with Care360. That is a great many interfaces, but make sure you double check yours during your request for proposals.
Overall the only negative I really walked away with was the lack of a test environment. Care360 currently doesn’t support an integrated test environment. If you are using Care360 as a standalone app, you really have a small risk with this issue. However, if you are a fully integrated medical environment, you may want to look into engaging MedPlus, Quest Diagnostics’ health information technology subsidiary, for an internal test environment to make certain there are minimal disruptions to your clinical practices.
I must say I walked away from the Care360 discussions very happy. The product is quick, slick, and easy to use! That is just how I would expect software to be and is so rare in today’s health care application base. If you are in the market for an e-prescribing solution, Care360 is certainly an app that you should compare in your vendor matrix.
EAR to the ground…. rumor has it that Quest Diagnostics is going to be releasing the “Care360 EHR” in September….I am very interested to see this app. It has a huge mountain to climb against the older, much more mature, folks in the EHR field, but I am looking forward to seeing that is coming out….
Screen shots from Care360:
