Be Warned: e-Prescribing's 6 Big Challenges for Doctors

Kenneth J. Terry, MA

November 01, 2012

Introduction

Electronic prescribing is growing quickly, in part as a result of the Medicare penalties for not e-prescribing. At the end of 2011, 58% of office-based prescribers routed 36% of all prescriptions electronically to pharmacies and mail-order houses, and 91% of community pharmacies were able to receive online prescriptions.

The rapid rise of e-prescribing has not been without its growing pains. There are still issues that are likely to give you trouble. But if you're aware of what they are and what's causing them, you'll be on the road to making sure they don't bog down your practice.

At least one early problem has been ameliorated. The ability to prescribe electronically to mail-order houses -- a major issue a few years ago -- has been "largely resolved," says Steve Waldren, MD, director of the Center for Health Information Technology of the American Academy of Family Physicians. And the former problem of pharmacists overlooking e-prescriptions is no longer a threat: Far fewer pharmacists now ignore or miss electronic prescriptions compared with in the early days of e-prescribing, doctors say.

In other areas, however, e-prescribing still presents some major difficulties, even for doctors who are experienced in using the technology. The 6 greatest challenges that come with e-prescribing are:

• Workflow in the physician's office;

• How to deal with controlled substances;

• Prescription renewals;

• Decision support;

• Formularies; and

• Medication histories.

What follows is an explanation of why these aspects of e-prescribing are challenging and what physicians are doing to cope with them.