Health Information Technology

Physicians weigh the costs and benefits of integrating e-prescribing systems with electronic health records

Many physicians are actively considering adopting e-prescribing either as a stand-alone system or integrated into an electronic health record. They wonder if the additional expense of moving to an integrated system would be offset by the system's benefits. The authors of a new study surveyed physicians to determine what benefits they see in ease of prescribing, office administration, and patient safety with their type of system. They found that physicians who use e-prescrbing systems integrated into an electronic health record have different characteristics, usage patterns, perceived benefits, and levels of satisfaction than those who use stand-alone systems.

For example, only 56 percent of physicians surveyed said they had checked a patient's drug history most or all of the time when they wrote a prescription. Yet those with integrated systems were significantly more likely to report doing so than colleagues with standalone systems. Physicians with integrated systems were more likely to be primary care physicians, to practice in larger groups, and to have practiced for fewer years. They were also more likely to report writing prescriptions electronically most or all of the time.

A major factor driving the spread of e-prescribing is a Centers for Medicare & Medicaid Services (CMS) incentive program to reimburse physicians for using electronic health record technology. Under the CMS program, "meaningful use" standards require the following activities related to e-prescribing: the use of computerized provider order entry, implementation of drug-drug interaction and drug allergy checks, maintenance of active medication lists in an electronic format, and electronic generation and transmission of prescriptions.

The researchers believe that integrated e-prescribing systems offered incremental benefits over stand-alone systems. Whether the benefits and the meaningful use-incentives offered by CMS will be sufficient to overcome the costs of moving to an integrated system will be a critical factor in whether the technology is widely adopted. This study was supported by the Agency for Healthcare Research and Quality (HS17151).

See "Differences between integrated and stand-alone e-prescribing systems have implications for future use," by Catherine M. DesRoches, Dr.P.H., Ritu Agarwal, Ph.D., Corey M. Angst, Ph.D., and Michael A. Fischer, M.D., in the December 2010 Health Affairs 29(12), pp. 2268-2277.

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