Effective Use of e-Prescribing in Physician Practices and Pharmacies - 2010

Target Population: General

Summary: This project addresses the need for qualitative research about the effects of electronic prescribing (e-prescribing) on physician and pharmacy practice and communication. The potential gains from e-prescribing assume that prescribers and pharmacists have access to and make use of the required features. Limited research on the topic suggests that not all e-prescribing systems have the full range of features promoted under financial incentive programs established by the Medicare Improvements for Patients and Providers Act of 2008 and the American Recovery and Reinvestment Act of 2009. Further, even when the features are available, physician practices face barriers to implementing them effectively. Even when the features are implemented at the practice level, physicians may not use them. To gain the benefits from electronic transmission of prescriptions, both physician practices and pharmacies must routinely use systems enabled for two-way electronic communications. Several studies have identified obstacles in both the physician and pharmacy settings that include information technology system limitations, workflow and training issues, and real or perceived regulatory barriers.

The Center for Studying Health System Change (HSC), a non-partisan health policy research organization in Washington, D.C., is conducting a qualitative study exploring physician use of third-party information (i.e., medication histories, formularies, and generic medication alternatives) at the point of prescribing and physician practice and pharmacy use of electronic routing features. Information collected by the study will inform strategies for governmental and private health care organizations to promote adoption and effective use of e-prescribing capabilities.

• Explore how e-prescribing features are implemented and used by physicians and pharmacies with a focus on selected features that have the potential to yield health care quality and cost benefits but that prior research has shown not to be available or used routinely by significant proportions of e-prescribers. (Ongoing)

2010 Activities: The project team completed data collection during 2010. Approximately 115 interviews were conducted with representatives of physician practices and pharmacies located in twelve nationally representative communities that have been studied longitudinally since the mid-1990s as part of HSC’s Community Tracking Study, as well as with other local and national stakeholder organizations. The purpose of the interviews was to explore the effects of e-prescribing among users who electronically send or receive prescriptions directly to or from their e-prescribing system, rather than by stand-alone or computer-generated fax. Interviews collected information on physician access to and use of third-party information, physician practice and pharmacy use of electronic routing features, facilitators of and barriers to their use, and the effects of e-prescribing on pharmacies ability to process prescriptions and physician practice-pharmacy communications.

Preliminary Impact and Findings: Findings will be made available in two publications: one on physician use of third-party information at the point of prescribing and a second on physician practices’ and pharmacies’ experiences transmitting and processing electronic prescriptions.

Strategic Goal: Develop and disseminate health IT evidence and evidence-based tools to improve the quality and safety of medication management via the integration and utilization of medication management systems and technologies.

Business Goal: Knowledge Creation