Paper Kills: The National ePrescribing Patient Safety Initiative

ScribeMedia’s Peter Cervieri recently sat down with Microsoft’s Health Care Industry Director, Bill Crounse, to talk about healthcare information technology and general industry trends. According to Crounse, America is “the worst of the worst” among industrialized nations in healthcare IT, but there are some promising initiatives on the horizon.

One of the most exciting developments is the National ePrescribing Patient Safety Initiative, a free nationwide service that allows doctors to fill out prescriptions electronically. (See for more information.) Backed by Microsoft and a consortium of companies (including Aetna, Allscripts, Cisco, Dell, Fujitsu, Google, Intel, Microsoft, Sprint Nextel, SureScripts, WellPoint, Wolters Kluwer Health), payors, and academic institutions, this new web service allows doctors to write prescriptions over the Internet, and promises to clear away some of the paper clutter from the American health care system.

Paper kills—not just trees, but health care quality. Every year, some 1.5 million Americans end up in hospitals, emergency rooms, or with injuries due to prescription mistakes, according to the National Academy of Sciences’ Institute of Medicine. And many of these mistakes could be prevented by using an electronic system. Currently, only about 5% of American physicians fill prescriptions electronically, a measly statistic compared to European standards. With over 90% of physicians writing electronic prescriptions, Europe has gone almost entirely electronic.

Things are about to change. In a few years, doctors will no longer be able to practice medicine without getting up to speed on healthcare IT, says Crounse. IT is poised to transform medicine in so many ways. For example, a quarter of all office visits could be turned into virtual visits, saving money for physicians and patients. Calling to make an appointment, taking time off work, and sitting in a waiting room are not essential for every type of visit. The technology available in today’s world obviates these cumbersome steps. Doctors could be doing much more work from home, emailing and communicating over the phone as they sit in front of the fireplace. So why isn’t this happening now? In order to provide IT-mediated services, doctors must be reimbursed, and the system has yet to accommodate, explains Crounse.

Inspiring examples of healthcare IT abound across the world. Providers in Europe and Asia are practicing telemedicine, or care at a distance, via messaging, email, and broadband video over smart phones. Services traditionally delivered in hospitals and clinics are moving into are being delivered in outpatient and virtual settings. Home care and extended care are becoming increasingly sophisticated with technology; patients can receive care at home rather than in hospitals and nursing homes, and enormous amounts of money are saved in the process.

There is a reason that other countries are so far ahead of the United States, and it’s not for lack of technology, Crounse says. In other parts of the world, health care is a public sector economy, and government has pushed hard for IT development. Here in America, where health care is driven by both private and public interests, the transition away from paper is harder to organize. We need a two-pronged push in America, private and public spheres working together. Some innovative payors and self-insured employers recognize the benefits of eHealth services and have already begun reimbursing for them, but for eHealth to really get off the ground, the government must provide incentives.

Eliminating paper will not cure all of our health care woes, however. Technology can drive down health care costs, Crounse says, but Americans must also realize that their health spending habits are unsustainable. Our per capita spending rate is a whopping $6700 per year—twice that of almost every nation in the world. Health insurance as we know it, including coverage of massage therapy, acupuncture, and preventive medicine, cannot survive indefinitely. In the future, we will all be paying more as individuals, and we must take more personal responsibility for our health—deciding not to smoke, exercising regularly, etc. Attitudes must change; expectations must change.

Crounse has begun his own HealthBlog (, where he shares thoughts on health topics ranging from his personal experiences in hospitals to universal issues of health care IT, and industry trends, costs and coverage.

3 thoughts on “Paper Kills: The National ePrescribing Patient Safety Initiative

  1. I extend my thanks to Peter Cervieri and his colleagues at ScribeMedia for sharing this interview on the ScribeMedia site. This is a very exciting time in healthcare IT with unlimited opportunities to improve the quality and safety of patient care and the satisfaction of those providing and receiving care. I hope you’ll visit us at the Microsoft booth at HIMSS in New Orleans. We look forward to seeing you there.

    Bill Crounse, MD Director, Worldwide Health Microsoft

  2. Pingback: HealthBlog

  3. This is a tremendous initiative. Bravo to Allscripts, Microsoft and other members. Errors due to contradictions, transcription, handwriting, etc. all cause unnecessary mistakes in data. Computer applications to capture accurate structured data and associated web services to deliver data to other systems and clinicians carry tremendous benefits. The major challenge for software companies with viable solutions is getting clinicians to break from their current workflows and use these products. Dr. Crounse may be interested in learning about our company’s products, mTuitive ( These are the major issues we are tackling and the products are built completely on Microsoft .NET technology.

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