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ISHN Healthwatch: E-prescribing useful, but needs improvement

Study finds renewals problematic

prescription drugsThe old joke about doctors' handwriting being difficult to read may become a quaint relic of the comedic past if electronic prescribing fulfills its potential, although a new study warns that some problems still need to be worked out before that can happen.

E-prescribing is generally viewed as a time- and money-saver that can streamline the perscription process and, yes, reduce medication errors caused by the aforementioned illegible handwritten prescriptions. Despite this, a study funded by the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ) found that while the electonic transmission of new prescriptions is getting good reviews, prescription renewals, connectivity between physician offices and mail-order pharmacies, and manual entry of certain prescription information by pharmacists—particularly drug name, dosage form, quantity, and patient instructions—continue to pose problems.

"Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, M.D.

Researchers at the Center for Studying Health System Change in Washington, D.C. found that physicians and pharmacies used e-prescribing for renewals much less often than for new prescriptions. One-third of physician practices had e-prescribing systems that were not set up to receive electronic renewals or only received them infrequently.

Physician practices reported that some pharmacies that sent renewal requests electronically also sent requests via fax or phone, even after the physician had responded electronically. At the same time, pharmacies reported that physicians often approved electronic requests by phone or fax or mistakenly denied the request and sent a new prescription.

The study noted that resolving e-prescribing challenges will become more pressing as increasing numbers of physicians adopt the technology in response to federal incentives.

jamia.bmj.com/content/early/2011/11/17/amiajnl-2011-000515.full.

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