After nearly two years of planning and policy development, health information exchange services in Oregon are now in the implementation stage. Contractor Harris Corp. has gotten the go-ahead to develop the first phase of work, with the goal of making the initial services available to users in late March.

First up will be a Direct Web Portal, which will allow enrolled participants the ability to securely send and receive electronic health information to and from any other enrolled participant.

Planning for Phase II HIE is underway and could add the query or lookup of patient records through Master Patient Index Record Locator services, EHR-to-EHR health information exchange, connectivity to federal systems such as the VA and SSA, and interface connectivity among Public Health, health insurance exchange, Medicaid and other state systems.

New numbers on e-prescribing reported to HITOC at its February meeting show a continued, steady increase in the number of prescribers using electronic methods, and the total number of e-prescriptions that have been processed. In November 2011, 6,060 prescribers used Surescripts, nearly twice as many as did a year before.

The number of e-prescriptions also rose markedly - a total of 6.4 million prescriptions in Oregon had been routed electronically by November 2011, compared with a cumulative total of 693,112 as of 2008.

OHIT also held focus group meetings with representatives from independent pharmacies and chain drug store pharmacies, resulting in some helpful observations. These include:

- Lack of e-prescription accuracy is of primary concern--participants believe there are more errors with e-prescriptions than through other transmission methods.
- There is a lack of consistent application of the specifications for meeting transmission standards across EHRs and pharmacy dispensing vendor software (leads to missing information, errors, etc.).
- Transaction fees for e-prescriptions are not a barrier for pharmacies.
- Additional training during EHR implementation would help prescribers ensure the accuracy of their e-prescription transactions.

Oregon is among the top states for physician adoption of electronic health records according to a report by the Centers for Disease Control and Prevention released in mid-December. The mail survey of office-based physicians found state rates of adoption of any EHR system ranging from 40 percent (Louisiana) to 84 percent (North Dakota). Oregon, at 74.7 percent, ranked sixth, behind North Dakota, Utah, Minnesota, Wisconsin and Washington.

The survey found a national average EHR adoption rate of 57 percent. It also found that between 2010 and 2011, the percentage of physicians reporting having a basic system increased by 36 percent.

Also, 44 percent of Oregon physicians told surveyors they intended to participate in the EHR incentive payment program, compared with a national average of 52 percent.

Among physicians planning to apply for EHR incentive payments, the percentage with systems that would allow them to meet eight Stage 1 Core Set meaningful use objectives exceeded the national average (43 percent) in eight states (Iowa, Maine, Massachusetts, Minnesota, Oregon, Utah, Washington and Wisconsin). The percent in Oregon was 65.5 percent.