6–10 Because most patients in the United States receive their pharmaceutical care from a network of organizations including physician offices, retail pharmacies, prescription benefit management companies, and health plans, implementing advanced e-prescribing features requires the use of standards for exchanging data among these separate organizations. 5 Yet for e-prescribing systems to create these benefits, they need to go beyond simply authoring and storing prescriptions to incorporate more advanced decision-support features such as drug interaction alerts based on the patient's complete and current medication list and guidance in selecting medications that match the patient's drug benefits. Additional work is needed for these standards to have the desired effects.Īmbulatory electronic prescribing (e-prescribing) is a form of health information technology that is expected to have immediate benefits, including improved quality and safety of prescribing, 1–4 more cost-effective medication options for patients, 4 and improvements in ambulatory care workflow. The volume of e-prescribing was correlated with perceptions that it enhanced job performance, whereas quitting was associated with perceptions of poor usability.Ĭonclusions: E-prescribing users reported patient safety benefits but they did not perceive the enhanced benefits expected from using standardized medication history or formulary and benefit information. Most e-prescribers reported high satisfaction with their systems, but 17% had stopped using the system and another 46% said they sometimes reverted to handwriting for prescriptions that they could write electronically.
They also perceived no significant difference in calls about drug coverage problems (76 versus 71% reported getting 10 or fewer such calls per week p = 0.43).
E-prescribers ( n = 139) were more likely than non-e-prescribers ( n = 89) to perceive that they could identify clinically important drug–drug interactions (83 versus 67%, p = 0.004) but not that they could identify prescriptions from other providers (65 versus 60%, p = 0.49). Results: Of 395 eligible physicians, 228 (58%) completed the survey. Measurements: Perceptions about medication history and formulary and benefit information among all respondents, and among e-prescribing users, experiences with system usability, job performance impact, and amount of e-prescribing. Objective: To compare the experiences of e-prescribing users and nonusers regarding prescription safety and workload and to assess the use of information from two e-prescribing standards (for medication history and formulary and benefit information), as they are implemented.ĭesign: Cross-sectional survey of physicians who either had installed or were awaiting installation of one of two commercial e-prescribing systems.
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