E-prescribing still has too many drawbacks to be practical

LETTER — Posted Sept. 18, 2006

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Regarding "E-prescribing urged as one strategy to prevent medication errors" (Article, Aug. 21): I tried e-prescribing. It is not a system ready for a surgical practitioner. It has flaws that need to be addressed before it can be considered mature technology suitable for surgical practitioners in a busy setting:

  • One cannot use it for schedule II narcotics.
  • It does not cover the complete range of durable medical equipment we prescribe, including bandaging, prostheses, surgical stockings, wheelchairs; and it does not have the facility to embed diagnosis codes or medical necessity information that can be written on prescriptions now.
  • Finding the pharmacy for faxing was cumbersome.
  • It was faster to write rather than point and click for a new drug, although saving favorites and setting a drug list, over time, was fast.
  • It failed to allow access to a complete drug profile for a patient across all pharmacies in my region.
  • It did not help me stop a patient from receiving multiple narcotic prescriptions from multiple practitioners filled at multiple pharmacies.
  • The interface with our office computer system often failed, so it would not print locally or fax out.

Worst of all, when I added up the costs, they ranged from 50 cents to $1 per prescription, depending on the number of prescriptions for which I could use the system each month. That was too much.

I will gladly use e-prescribing when it is adapted for a surgeon and when the flaws are fixed.

Jeffrey L. Kaufman, MD, Springfield, Mass.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/09/18/edlt0918.htm.

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