eRx barriers could be onerous for docs aiming for Meaningful Use

While the transition to electronic prescribing for new prescriptions is progressing nicely, work is still needed with regard to e-prescribing of renewals, adoption by mail order pharmacies, and staff processing of the prescriptions, a new study by the Center for Studying Health System Change concludes.

According to the study, which was funded by the Agency for Healthcare Research and Quality and published online this week in the Journal of the American Medical Information Association, physician practices and pharmacies generally are satisfied with the electronic transmission of new prescriptions. The electronic renewal process, however, is used inconsistently.

What's more, electronic communication with community pharmacies is more successful than with mail order pharmacies, and pharmacy staffs still have to conduct manual processing of many e-prescriptions.

The study included e-prescriptions generated both from electronic health records and stand alone e-prescribing systems. Some of the particular problems identified include:

  • Patients often arriving at the pharmacy to pick up their new prescriptions before the pharmacy receives the e-prescription;
  • Community pharmacies not sending electronic renewal authorization requests because either they lack the functionality or don't want to pay for it;
  • Inconsistent pharmacy renewal requests that cause inconsistent and duplicative responses from physicians' offices;
  • Practices having problems with the way mail order pharmacies handle and fill e-prescriptions;
  • More pharmacy follow-up made necessary by the more-specific instructions in e-prescribing regarding medication form, packaging and quantity. Staff in the past could complete the instruction with the patient, but now can't contradict the physician order.

The authors of the study expressed concern that some of these problems may cause physicians to be "penalized inadvertently" for being unable to meet the Meaningful Use requirements of the Medicare and Medicaid EHR incentive programs. They recommended that the problems be addressed, that e-prescribing be expanded and that more research be conducted.              

To learn more:
- here's the study (.pdf)