e-prescribing: ‘There’s no silver bullet’

DALLAS – Dave Doernemann of CCS Medical was as skeptical as the next provider about e-prescribing, but during a Medtrade session on Tuesday, he said he can no longer imagine living without the technology. 

Doernemann, senior vice president of commercial operations, said CCS has a patient base that tops 200,000 and that 40% of new orders are now coming in digitally. 

“I used to have a flip phone and a fax machine – that was my life,” he said. “When e-prescribing came out, I thought, ‘There is no way this is going to work.’ Now I can’t imagine myself living without Parachute.” 

Doernemann participated in a panel discussion at Medtrade with David Gelbard, founder and CEO of Parachute Health; Craig Douglas, senior vice president of respiratory and wellness for VGM & Associates; and Melanie Combs-Dyer, a 30-plus-year CMS official turned consultant. Kevin Ackerman, vice president of customer success for Parachute, moderated. 

Despite building momentum, getting providers to flip the switch on e-prescribing continues to be a struggle, Gelbard acknowledged.  

“There’s no silver bullet,” he said. “(It’s) thinking about every way you can start transitioning.” 

One way to start: Implement e-prescribing gradually, first with new orders, then with held-revenue and then with renewals, Gelbard said. 

“(You need to) get started but get started in a way that’s tactical,” he said. “(You need to) get used to the tooling.” 

Aside from their own struggles to adopt e-prescribing, providers must also convince referral sources it’s a good idea. Combs-Dyer pointed out that while providers have an incentive to use e-prescribing to get the “right paperwork in and on time,” the benefits for referral sources are more nuanced. 

“You have to explain to them (that e-prescribing) makes this simple,” Doernemann agreed. “(With faxing), their staff is doing all this work upfront and they’re frustrated. This makes their lives easier.” 

If CMS and the administration stick to a Jan. 1, 2027, deadline requiring Medicare Advantage, Medicaid and payers on the Health Insurance Marketplace to implement Fast Healthcare Interoperability Resources (FHIR)-based APIs for patient access and prior authorization that will speed up adoption, Combs-Dyer said. CMS built a FHIR server in 2020, but other payers haven’t followed suit, prompting the final rule, she said. 

“I do think this rule is going to stick,” she said. 

 Doernemann closed the discussion with a rallying call: “As a group we really need to get together and say, ‘This is the future,’” he said. “For us to survive (with reduced reimbursement), we need to take these next steps.”