PHARMACY

Companies collect, analyze prescription information

BY Drew Buono

WASHINGTON The next step in the switch from hand-written medical records to electronic health records is companies offering their service in collecting and analyzing patients’ prescription information and then helping insurance companies decide whether to offer clients insurance through their companies and determine price, according to the Washington Post.

Companies offering the service, such as Ingenix and Milliman IntelliScript, say they follow Health Insurance Portability and Accountability Act procedure and ask for patients’ authorization before giving their information to insurance companies.

The companies create patient profiles with information from pharmacy benefit managers’ prescription drug history databases. Ingenix has servers in the PBM data centers updating the drug files as frequently as once a day, John Stenson, senior vice president of consulting for Ingenix, told The Washington Post.

Once the analysis is completed, the companies provide the insurance companies with a score that determines whether a patient constitutes a high risk, for whom care will cost more, or a low risk.

One of the biggest problems seems to be multiple uses of a drug. A patient could be taking Prozac for menopausal hot flashes, but insurance companies might think she is using it for depression and won’t offer her a life-insurance policy even if her doctor explains the reason for the drug’s use.

But the biggest factor is patient confidentiality. Companies like Milliman and Ingenix do not have to obey HIPAA, even though they say they do. There is a health privacy proposal pending in Congress would expand federal officials’ ability to regulate such “downstream” organizations, audit their activities and impose civil fines.

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?
PHARMACY

Sanofi-Aventis, NSF launch sleep education program

BY Drew Buono

WASHINGTON Sanofi-Aventis, which manufactures the insomnia drug Ambien, and the National Sleep Foundation are launching a new campaign called Sleeping Smart which is designed to educate the millions of Americans who suffer from sleeping problems about the importance of a good night’s sleep, proper sleeping habits, the consequences of insomnia and the safe and appropriate use of prescription sleep medications.

As part of the campaign, results of a new survey of over 1,000 American adults aged 18 and over released yesterday showed that while nearly 60 percent of those at increased risk for insomnia say that their symptoms affect their daily activities at least a few days a week, only about half of those at increased risk for insomnia have actually initiated a conversation with their healthcare professional about their sleep issues.

One key note of the survey according to Helene A. Emsellem, MD, FAASM, medical director, The Center for Sleep and Wake Disorders, Chevy Chase, Maryland and a volunteer with the National Sleep Foundation was that the, “survey found that 85 percent of all respondents believed that people often or sometimes misuse prescription sleep aids.” And that it is, “It is important for patients to work with their healthcare professional to determine the best course of treatment for their insomnia, including lifestyle changes, adjusting bedtime sleep routines, cognitive behavioral therapy, and/or prescription medications that help people fall and stay asleep,” added Emsellem.

For more information about the program the Web site is www.sleepingsmart.org.

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?
PHARMACY

Cost of full EHR implementation in U.S. could reach $150 billion

BY Drew Buono

SAN FRANCISCO According to Robert Miller, a professor of health economics at the University of California, San Francisco, full implementation of networked electronic health records in doctors’ offices and hospitals in the United States could cost around $150 billion over eight years.

Miller’s projections call for hospitals to spend $35 billion to acquire and expand EHR systems and $55 billion in new operating costs over eight years. He said this level of spending would bring hospitals’ information technology spending closer to that of other industries.

Fewer than 5 percent of doctors are using fully functional EHRs, Miller said, using figures recently reported in the New England Journal of Medicine. To equip the remaining 96 percent with EHRs will cost about $15 billion in capital outlays and $24 billion in new operating costs, he said.

To those costs, he added about $20 billion for EHRs in nursing homes and the offices of other medical professionals, bringing the total to around $150 billion. However, he said the grand total could be as low as $100 billion or less because of offsetting increases in medical revenues and other factors.

keyboard_arrow_downCOMMENTS

Leave a Reply

No comments found

TRENDING STORIES

Polls

Which area of the industry do you think Amazon's entry would shake up the most?