DETROIT – The announcement last week that three of the largest automakers in the United States would join forces to get physicians to abandon handwritten prescriptions and use electronic prescribing technology is the latest in a string of initiatives to reduce medication errors and lower costs through e-prescribing. But as several earlier projects have shown, the road to adoption isn't always easy.

General Motors, Ford and DaimlerChrysler on Wednesday announced an initiative with the United Auto Workers, Blue Cross Blue Shield of Michigan, Henry Ford Health Systems, the Health Alliance Plan and pharmacy benefit manager Medco Health Solutions to get physicians to transmit prescriptions electronically.

Under the Southeast Michigan e-prescribing initiative, 17,000 physicians eventually will write prescriptions on a computer or personal digital assistant and send that information to the pharmacy. RxHub is providing the technology infrastructure for physicians to transmit patient information to pharmacy benefit managers and to send electronic prescriptions to the pharmacy.

Henry Ford Health System started the e-prescribing project in January through the Henry Ford Medical Group, an 800-member practice, and its affiliated payer, the Health Alliance Plan. The test began with 25 physicians using e-prescribing software from DrFirst. Henry Ford hopes to have 100 doctors using the software by the end of March. In addition, Blue Cross Blue Shield of Michigan plans to implement the program with 6,400 physicians. Michigan is one of a handful of states that still has laws unfavorable to electronic transfer, so the prescriptions are transmitted to pharmacies via fax, according to Peter Kaufman, MD, chief medical officer for DrFirst.

The automakers hope the project will eliminate medication errors and lower costs by encouraging physicians to prescribe generic drugs. They also envision implementing the plan in other states. The Centers for Medicare & Medicaid Services estimates that e-prescribing could eliminate close to two million adverse drug events each year.

While the e-prescribing project in Michigan may be the largest employer-sponsored effort, it isn't the first time such large-scale projects have been attempted. Most notably, the eRX Collaborative is attempting to deploy e-prescribing technology in 3,400 Massachusetts physicians' offices. The group said that by the end of 2004, nearly 2,700 physicians and their clinical staff were participating in the program. In addition, California-based insurer WellPoint Health Network in 2004 launched a program to provide physicians with free desktop computers or handheld devices with e-prescribing software.

"E-prescribing is a high-yield patient safety and quality area," said Michael Tooke, MD, chief medical officer of the Delmarva Foundation, a group that is part of a recently announced project in Maryland to educate physicians about the value of e-prescribing.

Medicare legislation, which calls for standards for electronic prescribing, also is playing a role in the popularity of these programs, according to Mark Bard, president of consulting firm Manhattan Research. But the challenge, as Bard sees it, is getting physicians to adopt such technology when insurers typically accrue the benefits. "A lot of the people who you put this to don't see the value," Bard said. "Doctors say you have to pay me [to use the technology]." He estimates that less than 50,000 physicians nationwide use e-prescribing technology.

WellPoint found out the hard way that giving technology for free to physicians might not be enough. The insurer is still gathering data on the project, but far fewer physicians selected the e-prescribing software than those who chose the desktop computer. Automakers involved in the Michigan project say they would offer doctors financial incentives to use the technology, although physicians would still have to purchase the hardware needed to transmit the prescriptions.