Researchers investigating how doctors use electronic prescribing systems found that they are not using many of the system features designed to save time and prevent errors.
Although doctors liked their e-prescribing systems and would not go back to using paper, they were getting few of the benefits often touted by health information technology advocates, according to the researchers, who are affiliated with the Center for Studying Health System Change.
“It is hard to imagine that e-prescribing as it exists today can be the ‘killer app’ that will drive further IT adoption,” the article by Joy Grossman and others states. It was based on interviews with representatives of 21 medical practices and an equal number of other organizations, such as pharmacies and health plans.
Other limitations of the e-prescribing implementations included little connectivity with pharmacies and pharmacy benefits managers. Medical practices with stand-alone e-prescribing systems were more likely to use electronic transmission of prescriptions, but none of the practices where e-prescribing was built into the e-medical records system used electronic transmission.
Doctors told the researchers that keeping lists of the medications taken by each patient required manual data entry, and it was hard to determine whether patients were taking drugs prescribed by other doctors.
As for pop-up alerts warning medical employees that certain drugs should not be prescribed in certain circumstances, the researchers reported, “Respondents pointed out that alerts only work if patient-specific information such as allergies and conditions are entered into the system and maintained, which they reported was often not the case.”
As has been reported elsewhere, the doctors often disabled the pop-up alerts because they were more annoying than useful.
“Physicians in slightly more than half of practices did not have access to formulary data electronically when they wrote prescriptions, because either the systems did not have the feature or the practice had chosen not to enable it,” the article states. “Even when a plan’s formulary information was available, practices often questioned the data’s reliability for a variety of reasons.”
The medical practices found they had to spend considerable time working with outside parties, such as vendors, state regulators and local pharmacies, to implement and maintain the system, they told the researchers.
“Most physicians agreed that writing new prescriptions electronically took about the same amount of time as writing them on paper once they became familiar with the system and had created a ‘favorites’ list,” the article states.
The doctors liked their e-prescribing systems mainly because they saved time by streamlining prescription renewals, particularly for patients with multiple medications, according to the researchers.
The Agency for Healthcare Research and Quality sponsored the study. The report appears in the online edition of the journal Health Affairs.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
