January 2011

Back to school

Drug and Disease Updates
Clinical Editorial: A New Year, a New Day for EHR Incentives
FDA MedWatch Safety Alerts
DocAlert Messages: Readers' Picks
Epocrates Essentials for Android™ is here!
TRICARE Prescription Formulary
Meaningful Use and Epocrates EHR
What's This Disease?

In 2010, Epocrates continued to develop clinical information and decision support tools that enabled healthcare professionals to find answers more quickly and confidently at the point of care.

Now over 1,000,000 healthcare professionals, including more than 45% of U.S. physicians, are using Epocrates' innovative mobile and web-based products to help them reduce medical errors, improve patient care and increase productivity.

We are looking forward to more innovations this year – with Epocrates EHR coming this spring, premium applications for Android now available and much more.

Stay tuned to future issues for more of what's to come in 2011 …

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Clinical Editorial

Anne Meneghetti, MD
Director, Clinical Communications, Epocrates

A New Year, a New Day for EHR Incentives

On January 3rd, registration began for the Medicare EHR Incentive Program, and states now have the option to launch Medicaid incentive programs as well. You can register even before having an EHR up and running, since the attestation necessary for 2011 incentive payments does not begin until late springtime.

Widespread EHR use is inevitable. Policymakers tout the advantages of automated drug-allergy and drug interaction checking, built-in decision support, and improved accessibility to medication lists, labs, and medical history. For years, clinicians using Epocrates have asked for the convenience of electronic prescribing as an extension of the drug look-up process in our reference software. Yet, transitions to new technology are not always easy. Especially in solo and small group practices, each individual already wears many different hats; EHR implementation and maintenance is a significant investment in many ways.

As I observe how my colleagues are responding to the opportunities and challenges of EHR implementation, I have noticed a few different patterns emerging:

The Early Adopter. Among the first to use e-prescribing and EHRs, enjoys tinkering with and customizing systems to enhance productivity. Has a reputation for waiting in long lines outside of stores in order to be the first on his block with the latest gadget. Spends countless hours online.

The Aligner. Affiliated with a larger system such as a hospital, integrated delivery network, accountable care organization, or multi-specialty clinic. Relied upon the informatics committee or resident technical wiz to figure out the best solution for the entire system. Hopes that they know what they are doing.

Look Before Leaping. Knows that an EHR is in his or her near-term future, but prefers not to be the guinea pig. Willing to let other people figure out which systems have the best overall profile for technical ease of use, implementation, connectivity, adherence to meaningful use standards, and cost.

Drug and Disease
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Running the Numbers. It's all about return on investment. Incentive figures up to $44,000 through Medicare ($63,750 through Medicaid) per clinician sound great in theory, but net results depend on practice-specific factors. Plans to run the numbers and jump in when the money starts to really matter.

Don't Fence Me In. Until absolutely mandated or forced to use an EHR, will stick to the familiar homegrown paper and pen method. With luck, may retire before having to transition to anything electronic. Wonders if seeing more patients per day could offset the losses from staying with paper.

Certainly, 2011 is another pivotal year for the medical profession. We would love to hear from you about your experience responding to the opportunities and challenges of implementing an EHR in your practice. Which category above best reflects your attitudes about EHR implementation? Let us know at youropinion@epocrates.com

Important Dates: View a detailed timeline from CMS

Path to Payment:

Use certified EHR technology. Make sure the EHR technology you're using or are considering buying has been certified by the Office of the National Coordinator for Health Information Technology.
Be a Meaningful User. Demonstrate "meaningful use" for a consecutive 90-day period in your first year of participation (and for a full year in each subsequent years) to receive EHR incentive payments.

Attest for incentive payments: Attest (legally state) through Medicare's secure Web site (available in April 2011) that you've demonstrated "meaningful use" with certified EHR technology.

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FDA Medwatch Safety Alerts

Prescription drugs: Lipitor (atorvastatin): specific bottles recalled due to uncharacteristic odor; Avastin (bevacizumab): removal of breast cancer indication; Anzemet (dolasetron mesylate): abnormal heart rhythms; Recombinant Human Growth Hormone (somatropin): possible increased risk of deathTessalon (benzonatate): accidental ingestion by children; Dexamethasone Sodium Phosphate: particulates in multiple-dose vials 

OTC products:  Rolaids Extra Strength Softchews, Extra Strength plus Gas Softchews, and Multi-Symptom plus Anti-Gas Softchews: foreign materials in products; Guaifenesin: mislabeled tablets; Undeclared drug ingredients: Man Up Now Capsules, Fruta Planta, RockHard Weekend, Pandora; Tainted products marketed as dietary supplements: Slimming Beauty, Solo Slim, Slim-30, Tren Xtreme, ArimaDex, Clomed, Vigor-25, Duro Extend Capsules for Men, Magic Power Coffee

Medical devices:  Abbott Glucose Test Strips: False Low Blood Glucose Results; Micromedics Surgical Sealant Dispensers, Nasal Septal Buttons, Otological Ventilation Tubes; Fresenius Kabi LLC, RBC Exchange Sets; Penumbra System Reperfusion Catheter 032Baxter Colleague Infusion Pumps; B. Braun addEASE Binary Connector; WalkMed Triton Pole Mount Infusion Pump; HiRes 90K Cochlear Implant Device  

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DocAlert Messages

Here are the most popular DocAlert messages of 2010:

Investigating Mildly Abnormal Serum Aminotransferases (British Medical Journal)
Approach to Evaluation and Management of Syncope (BMJ)
Assessing Cardiovascular Risk in Asymptomatic Adults: ACC Guidelines (Cardiosource)
Interpretation of 12-Lead ECG in the Athlete (Cardiosource)
Diagnosis and Management of Vitamin D Deficiency (BMJ)
How Much Sunlight Is Equivalent to Vitamin D Supplementation? (Journal Watch)
Can SSRIs Affect Morality? (Journal Watch)
Lifestyle vs. Metformin for Delaying Diabetes (InfoPOEMs)
Long Term Treatment With SSRIs and Newer Antidepressants (BMJ)
Top 10 General Medicine Stories of 2009 (Journal Watch)
What Is the Value of Mammograms for Women in Their 40s? (Journal Watch)
Jet Lag: 10 Points to Remember (Cardiosource)
Management of Angina With Normal Coronary Arteries (Harrison's Online)
Metformin in Patients Undergoing Procedures Requiring Iodinated Contrast (BMJ)
Recommended Adult Immunization Schedule Update for 2010 (CDC)

Were there others you found helpful that didn't make the list? Let us know at youropinion@epocrates.com. DocAlert messages are often tailored by specialty; update your specialty by logging into My Account.

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Epocrates Essntials for Android Epocrates Essntials for Android
Epocrates Essntials for Android

Epocrates Essentials comes packed with:

Peer-reviewed disease content with evidenced-based treatment options

Specific/empiric treatments for hundreds of infectious diseases

600+ alternative medications (herbs, supplements) with drug interactions

Hundreds of diagnostic and laboratory tests that include lab prep, interpretation, and follow-up

Learn more about all Epocrates products for Android >

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TRICARE Prescription Formulary

TRICARE's prescription formulary is now available on Epocrates mobile and web-based clinical drug reference! TRICARE is the health care program serving Uniformed Service members, retirees and their families. We currently partner with over 100 commercial and Medicaid health insurance plan clients covering ~100 million lives. We also work with CMS to host all Medicare Part D plans.

Add this formulary to your Epocrates reference by logging into My Account and then select "Edit Formularies."

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Meaningful Use and Epocrates EHR

On February 17, 2009, the government passed the HITECH Act, which provides incentives for physicians and offices converting to EHR systems. In order to receive the full amount of the incentive, practices must demonstrate meaningful use of an EHR by the end of 2012, which means there is still plenty of time to choose the right system.

Epocrates EHR has been developed by doctors for doctors and features a simple and intuitive interface, customizable documentation tools, and extensive training and support.

It's the system that can help you achieve meaningful use while simplifying your workflow and it's coming in the spring of 2011. To find out more about meaningful use and Epocrates EHR, visit ehr.epocrates.com.

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January 2011 Test your knowledge!
Can you identify the disease in this image?


Find this image and many others in Epocrates® Essentials for BlackBerry®, iPhone®, Android, and Epocrates Essentials® Deluxe for iPhone and BlackBerry.
Log in to Epocrates Online for continually updated drug information and disease content and images.

Mobile Updates

Update (sync) your device regularly to download free clinical content and news, including new drugs and DocAlert messages.

We always love to hear from our members about Epocrates products or any other topic at youropinion@epocrates.com. We occasionally select reader comments to feature in future newsletters. All readers featured in the newsletter will receive a free one-year subscription to the premium product of their choice.

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