House: Formularies must be compatible with electronic health records

Because the criteria for making meaningful use of electronic health records (EHRs) includes checking patient-specific formularies, insurers and pharmacies should be required to make this information readily available electronically, the AOA House of Delegates agreed.

The House passed a resolution on July 16 to petition the federal Centers for Medicare and Medicaid Services to require that all formularies be in a format compatible with certified EHRs.

Albert M. Salomon, DO, the chairman of the House Ad Hoc Committee, which reviewed the proposal, said committee members unanimously backed the measure.

According to Iowa delegate Kevin Vincent de Regnier, DO, the lack of quick access to formularies is a time drain. “In Iowa, our biggest insurer is Wellmark Blue Cross and Blue Shield, yet its formularies are not available to me in my EHR,” said Dr. de Regnier, a member of the Iowa Osteopathic Medical Association, which submitted the resolution.

Consequently, when he writes prescriptions for Wellmark beneficiaries, he does so blindly, he says. “And invariably I’ll get a phone call from a pharmacist saying that a medication isn’t covered in a patient’s policy.” He then has to search for an alternative.

“On the other hand, some of my formularies from other insurers are available in my EHR,” Dr. de Regnier said. “And because I know what’s preferred and what’s covered in those cases, the patient and I can decide on the best, most cost-effective therapy.”

Insurers and pharmacy benefit managers have to partner with physicians to ensure widespread, meaningful use of EHRs, Dr. de Regnier said. “This resolution is saying to CMS, ‘Since you’ve set the goal of incorporating EHRs throughout healthcare, make everyone play the game.’ ”