Electronic Medical Records (EMR) have been a great focus of discussion in the medical community for several years now. Politicians have talked about EMR in their campaigns, and physicians have discussed the pros and cons at medical conferences. But now we are only a few short weeks away from enactment of the first major legislation regarding Health Information Technology (HIT). As of January 1, new legislation designed to promote the use of technology in medical practice will be in place. Among other things, it will provide financial incentives to physicians who use technologies. It will represent a major legislative step in digitizing medicine and medical practice, a movement that will eventually culminate in all records being electronic at some point in the future.

Without EMR
Not to get to far ahead of ourselves, it's important to examine what these new laws will means for physicians in the immediate future. The first and most essential component of H.R. 6331 is that a penalty will be imposed on physicians who aren't e-prescribing by 2012. Moreover, buried in the verbiage is a stipulation that this penalty is prospective, meaning that it will affect physicians who aren't e-prescribing by approximately 2010.

The crux of the financial incentives a percentage bonus based on all Medicare income paid to physicians. Currently, the figure stands at two percent, but that may increase over time as e-prescribing is normalized into practice.

These incentives provide physicians with great motivation to purchase EMR programs, as two or three percent of Medicare returns often amounts to a substantial amount of money. It's also worth noting that these incentives are separate from and additive to Physician Quality Report Initiative (PQRI) incentives. Whether or not you qualify for PQRI bonuses will not affect the bonuses you receive from e-prescribing.

While these incentives are geared toward facilitating a massive shift in medical practice, the benefits they will provide as of January 2009 will likely not be conferred upon those who either do not use EMR programs or have only begun the process of implementing one.

Only a small number of physicians whose EMR systems are fully operational will receive maximum benefit at the outset, but there are options for the majority of physicians whose systems are not up and running that enable them to receive some benefits of e-prescribing.

For example, some websites provide varying degrees of electronic logging and documentation. The company Allscripts (www.allscripts.com ) allows physicians to "go online" and connect their practice to the larger online network of healthcare. An EMR system is not necessary for the basic functions of electronic prescribing and networking information. Physicians can input practice management data and medical records manually onto the site for free, or Allscripts can interface your practice management software for a fee. The manual option does not grant as many possibilities regarding software and organization, but it does provide a basic setup that enables physicians to prescribe electronically and bring a part of their practice online.

Depending on which option you choose, you will be able at the very least to enter a prescription into the website that is transferred directly to the pharmacy. Some advantage of open lines of communications between the practice and the pharmacy include formulary and drug interaction details, as well as insurance information, i.e. what is covered under the patient's plan. Aside from these perks, electronic prescribing may also help establish a better relationship between pharmacists and physicians through accessibility and ease of communication.

It's also important to note that no matter which version you choose, the same high standard of security still applies. Additionally, methods for documentation are the same as for Medicare, to which most physicians have already grown accustomed.

Reaping the Reward
For a variety of reasons, most of us physicians are not e-prescribing yet. Although great strides have been made to make the technology accessible and integrated into practice, physicians are still acquainting themselves with the changing conditions of healthcare that EMR brings. State and federal legislators are playing catch-up just as much right now, as some details of the 2009 legislation remain undetermined. Since we are all adjusting to the new realities of medical care, it is important to take every measure to allow for an easy transition and familiarization.

For the many physicians who haven't made the transition, taking the above measures to establish your investment in HIT is a good first step toward taking part in this new movement in healthcare by ensuring that there are no exclusions to your benefits for not e-prescribing. With the above systems in place, physicians can continue to learn about EMR in a comfortable manner while also enjoying the benefits of e-prescribing.