Lapane KL, Rosen RK, Dubé C. "Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care."

Lapane KL, Rosen RK, Dubé C. Perceptions of e-prescribing efficiencies and inefficiencies in ambulatory care. Int J Med Inform 2011 Jan;80(1):39-46.
INTRODUCTION: Recent studies have demonstrated that e-prescribing takes longer than handwriting. Additional studies documenting the perceived efficiencies realized from e-prescribing from those who have implemented electronic prescribing are warranted. METHODS: We used a mixed method study design. We report on qualitative date from 64 focus groups with clinicians and office staff from six US states. Participants used one of six e-prescribing software packages. Qualitative data from the focus groups (276 participants) were coded and analyzed using NVivo software. Quantitative data regarding perceived efficiencies were extracted from a survey of 157 clinicians using e-prescribing. RESULTS: Perceptions of e-prescribing included 64% reporting e-prescribing as very efficient. The next closest method was computer generated fax and prescriptions in which approximately 25% rated the method as very efficient. Improvements in workflow and record keeping were noted. Perceived efficiencies were realized by decreased errors, availability of formularies at the point of prescribing and refill processing. Perceived inefficiencies noted included the need for dual systems owing to regulations preventing e-prescribing of scheduled medications as well as those introduced with incorrect information on formularies, pharmacy used, and warnings. DISCUSSION: Overwhelmingly, clinicians and their staff confirmed the perceived efficiencies realized with the adoption of e-prescribing. Perceived efficiencies were realized in knowing formularies, processing refills, and decreasing errors. Opportunities to improve efficiencies could be realized by assuring correct information in the system.

To report healthcare providers' opinions about the role of e-prescribing applications in improving efficiency.

Tools Used
Type Clinic
Primary care
not applicable
Other Information
Physician practices (solo to HMO) with patient mix of at least 25% Medicare eligible patients in six states.
Type of Health IT
Electronic prescribing (e-Rx)
Type of Health IT Functions
Specific functions of e-prescribing software were not specified in the article per agreement with multiple vendors to participate in the study.
Workflow-Related Findings
Workflow is more efficient, reduced redundancy. Clinicians appreciated the efficiency of the technology, including that it allowed them to write and send prescriptions directly to the pharmacy while they were meeting with patients, and also that it allowed them to approve prescriptions from remote locations (e.g., at home, in another office).
Another software feature that improved the efficiency of workflow was information about prior authorization. The feature was noted to improve efficiency of the prescribing process because the physician would know before suggesting a medication that it would require additional work.
Study Design
Only postintervention (no control group)
Study Participants
Physicians and staff at 64 practices in six states: Florida, Massachusetts, New Jersey, Nevada, Rhode Island, Tennessee. 276 people participated in the focus groups; in the 64 focus groups, 36% of office staff were involved in e-prescribing process. Internal medicine (45%) and family medicine (39%) dominated the sample. Nearly 25% were solo practices.