eRx worthwhile, but still problematic for docs, pharmacies
A new study by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality finds that physician practices and pharmacies are both keen on e-prescribing's ability to improve safety and save time – but that both groups face barriers to realizing its full benefit.
The study, published online in the Journal of the American Medical Informatics Association, focuses on the electronic exchange of prescription data between physician practices and pharmacies, which can save time and money by streamlining the way in which new prescriptions and renewals are processed. It finds that e-prescribing helps reduce the risk of medication errors caused by illegible or incomplete handwritten prescriptions.
[See also: E-prescribing grows despite complaints.]
Physician practices and pharmacies generally were positive about the electronic transmission of new prescriptions, the study found. But prescription renewals, connectivity between physician offices and mail-order pharmacies, and manual entry of certain prescription information by pharmacists – particularly drug name, dosage form, quantity, and patient instructions – continue to pose problems.
"Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, MD. "This study identifies issues that need attention to improve e-prescribing for physicians, pharmacies, and patients."
[See also: eRx rate in NY state to see 'explosive growth'.]
Researchers at the Center for Studying Health System Change in Washington, D.C., conducted 114 interviews with representatives of 24 physician practices, 48 community pharmacies and three mail-order pharmacies using e-prescribing. Community pharmacies were divided between local and national companies.
Physician practices and pharmacies used e-prescribing features for electronic renewals much less often than for new prescriptions. More than 25 percent of the community pharmacies reported they did not send electronic renewal requests to physicians. Similarly, one-third of physician practices had e-prescribing systems that were not set up to receive electronic renewals or only received them infrequently.
Physician practices reported that some pharmacies that sent renewal requests electronically also sent requests via fax or phone, even after the physician had responded electronically. At the same time, pharmacies reported that physicians often approved electronic requests by phone or fax or mistakenly denied the request and sent a new prescription.
[See also: E-prescribing cuts drug costs, study reveals .]
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Green_Leaf say: Reply to comment
One of the biggest shortcomings or ePrescribing is that it is a unidirectional communication.
The ordering physician sends and order and the receiving pharmacy cannot respond elecrtornically. It is a classic example of “send and forget”.
To make this a useful tool the pharmacist must have the ability to respond to the ordering provider for clarification if needed.
The second is the cost. Currently the receiving pharmacy is charged for the service and pays a significant portion of their profit margin for this privilege. This cost should be born by the consumer because they are the benefinciary of the service.
Dr Duncan say: Orthopedic surgeons will be penalized because of their specialty
As an orthopedic surgeon nearly all of my prescriptions are for controlled substances. CMS representatives said I should prescribe Ultram instead of some of the narcotics I prescribe. I is hard for me to do that when I know Ultram won't work. Most of the patients I see have already tried NSAIDS and have plenty at home. That is why they are referred to me so that leaves NSAIDS out as a possibility. Sometimes I can talk a patient into letting me prescribe a generic NSAID from a pharmacy to replace the OTC ones they already have so I can get the 25 prescriptions before the end of this year so I won't be penalized 1% on all of my Medicare charges in 2013. Apparently that is what the government wants me to do or they wouldn't be penalizing me. That expectation by the government doesn't seem ethical. Until the government allows orthopedic specialists and other similar specialist to e-Rx narcotics I don't think they should be penalized. Currently we are being penalized by the goverment for following their rules.
Doug Duncan MD