Wide Gap Between Vision for E-Prescribing and Reality in Physician Practices

Physicians Report Major Barriers to Using Advanced E-Prescribing Features

News Release
April 3, 2007

Alwyn Cassil (202) 264-3484 or acassil@hschange.org

WASHINGTON, DC—While physicians who have embraced e-prescribing wouldn’t go back to paper prescriptions, they report major barriers to using advanced e-prescribing features that many advocates believe offer the greatest potential to improve the safety and quality of health care, according to a study by Center for Studying Health System Change (HSC) researchers published today as a Web Exclusive in the journal Health Affairs.

"The gap between policy makers’ vision for e-prescribing to improve the safety, quality and efficiency of care and the reality in physician practices is pretty wide," said lead author Joy M. Grossman, Ph.D., a senior health researcher at HSC, a nonpartisan policy research organization funded principally by the Robert Wood Johnson Foundation. The Health Affairs study was funded by the Agency for Healthcare Research and Quality.

While physicians were positive about the basic features of e-prescribing, products often lacked advanced features, or if they had them, physicians often did not use them because of implementation hurdles or their perceptions that the features did not add value, according to Grossman and coauthors Anneliese Gerland, an HSC health research analyst; Marie C. Reed, a former HSC health researcher; and Cheryl Fahlman, a former HSC health researcher now with Mathematica Policy Research.

Advanced e-prescribing features include the ability to maintain complete patient medication lists; clinical decision-support tools, including alerts and reminders; access to patient-specific formulary data; and capacity for two-way electronic communication between the medical practices and pharmacies and pharmacy benefit managers (PBMs) to send prescriptions, clarifications and renewal requests.

The Health Affairs article, titled "Physicians’ Experience Using Commercial E-Prescribing Systems," is based on 44 discussions conducted between November 2005 and March 2006 with representatives of 26 organizations, including 15 medical practices using e-prescribing, six medical practices without e-prescribing, health plans, e-prescribing vendors and pharmacies. Two-thirds of the practices used the e-prescribing module of an electronic medical record (EMR), while the remainder used stand-alone systems. Most practices had different technology vendors.

Key study findings include the following:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.

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Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.