Panelists representing many factions in American health care endorsed e-prescribing today at a meeting sponsored by a prominent Washington think tank.

The Brookings Institution invited doctors, pharmacists and representatives of businesses, consumers and older Americans to discuss the prospects for e-prescribing and why it has yet to take hold across the nation.

Without exception, the panelists said e-prescribing is a good idea. Some raised questions about its applicability in every instance - for example, in rural areas that lack broadband access. But they said most prescriptions should be written electronically because doing so cuts costs, increases patient safety and improves health care.

Although e-prescribing is increasing, it is still practiced by fewer than 85,000 of the country's more than 560,000 doctors. The holdouts tend to physicians in smaller practices who lack technical expertise.

In some cases, their local pharmacies do not accept e-prescriptions, although most large chain drug stores are equipped to handle them. Small, rural drug stores are less likely to be able to fill e-prescriptions.

"They look on it as an unfunded mandate" from the government, said Bruce Roberts, executive vice president of the National Community Pharmacists Association.

Dr. Mark McClellan, former administrator of the Centers for Medicare and Medicaid Services and now director of the Brookings Institution's Engelberg Center for Health Care Reform, was the panel's moderator. He said the group would not discuss financial incentives to encourage doctors to use e-prescribing, but the idea kept surfacing anyway, along with talk of a legal mandate.

Lawmakers have discussed including an e-prescribing mandate and incentives for doctors in the forthcoming bill to adjust Medicare fees.

Another recurring theme among panelists was the Drug Enforcement Administration's ban on e-prescribing for controlled substances - powerful painkillers and other potentially addictive drugs - which account for 20 percent of all prescriptions.

"This is a big deal," McClellan said, adding that a DEA policy change could be in the works.

Multiple panelists also brought up the need for a complete set of standards for e-prescribing under Medicare. CMS has issued three final standards, but they won't be mandatory until next year.

The Brookings Institution will hold similar forums on automating quality measures, managing chronic diseases and simplifying administrative operations in health care, McClellan said.

Although the organization holds part of a contract to transform the American Health Information Community from a federal advisory committee to one run by the private sector, the forums are not directly related to that project, he said.