E-prescribing systems' advanced features often go unused

A study finds that physicians often don't use electronic prescribing to its full potential -- but sometimes that's the fault of the systems themselves.

By Pamela Lewis Dolan — Posted Aug. 12, 2010

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Federal programs are giving physicians an incentive to use electronic prescribing systems, but a recent study found that other factors may be giving physicians a disincentive to use the technology to its full potential.

The Center for Studying Health System Change published a report in July that found about a third of all physicians in ambulatory care routinely use e-prescribing technology. Of those, 65% routinely used features that checked drug interaction; 54% routinely transmitted prescriptions to pharmacies; and 34% routinely used features that checked insurance formulary lists. Less than 25% use all three features.

The study was based on a survey of 4,182 physicians in 2008, the year before incentives for e-prescribing use were offered through the Medicare Improvements for Patients and Providers Act.

Joy M. Grossman, PhD, an HSC researcher who authored the study, said that although the number of physicians adopting e-prescribing technology has increased slightly because of the incentives, which went into effect in 2009, regular use of the technology, especially advanced features, still remains an issue (link).

But it's not a case of physicians not wanting to use them, she said. "Each of these functionalities have challenges to using it."

Certain features may be turned off by some organizations because of problems, she said. The system also may prove to be inadequate and not be helpful because of things like so-called alert fatigue. Grossman said use of the functionalities also often rely on third parties.

To use formulary lists, physicians rely on insurers who need to provide the information in a technical format that can be read by the physicians' e-prescribing systems. Physicians also may encounter problems with local pharmacies that do not accept electronic transmissions of prescriptions.

Progress has been made in some areas since the incentives went into effect, however. For example, at the end of 2009, 85% of community pharmacies had e-prescribing capabilities, up from 70% in 2007, according to the 2009 National Progress Report on E-prescribing, an annual report by the nation's largest e-prescribing network Surescripts (link).

Additionally, by the end of 2009, Surescripts was able to provide prescribers with 20,000 formulary files made available by payers, according to the report.

In many ways, e-prescribing systems are more sophisticated than most electronic medical record systems, and there are many challenges to making them work. But Grossman added that the federal government's "meaningful use" criteria physicians and hospitals must meet in adopting EMR systems to receive Medicare and Medicaid financial incentives will help improve those issues, and that in turn will lead to widespread use of the functionalities, whether it's required or not.

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