In all the excitement of the Senate vote, the Bush veto and the subsequent override of the veto that made the Medicare physician payment bill the law of the land, an important component was nearly overlooked: e-prescribing. Medicare will reward doctors who use e-prescribing through 2013, and penalize those who do not start in 2012, according to a USA Today article. E-prescribing means doctors send a prescription directly from a computer or handheld device to a pharmacy. It eliminates paper, illegible handwriting, and some of the waiting for consumers. It is of course just one  aspect of health information technology (along with electronic medical records, decision support tools, and interoperable health information networks) but e-prescribing got this push because it is “an area where significant progress could be made quickly,” according Health and Human Services Secretary Mike Leavitt.

 The Medicare bill would:

• Give doctors who use e-prescribing for Medicare patients a 2% percent bonus in 2009 and 2010, a 1% bonus the following two years and a 0.5"% bonus in 2013.
• Penalize doctors who don’t use e-prescribing with fee reductions of 1 percent in 2012, 1.5 percent in 2013 and 2 percent thereafter.
• Require the Health and Human Services Department, which administers the Medicare program, to post an online list of doctors and group practices that use e-prescribing, along with those who submit data that measures quality of care.
• Require doctors who use e-prescribing systems to comply with the standards HHS issued for Medicare Part D, the drug benefits program.

Privacy concerns remain prevalent, with the ACLU's Tim Sparagani saying, “Any time you put something in a digital format and standardize it, it becomes much more profitable and easy to move those records.” But advocates of e-prescribing hope it will make the system work more smoothly, cutting costs and preventing medical errors. Millions of prescriptions have already been written this way, and the goal is to make e-prescribing the norm.

As CBO chief Peter Orszag has said repeatedly, the carrot won’t produce as much adoption of technology as a stick. Luckily, Congress included—first rewards, then punishments. We hope this first step helps pave the way for passage of more comprehensive health IT legislation in the not too distant future.