Cost remains a barrier to e-prescribing, despite benefits

While e-prescribing has the potential to increase patient safety and medication adherence while save money, implementation costs remain one of the biggest barriers to adoption in ambulatory practices, according to research published at Perspectives in Health Information Management.

Sending prescriptions electronically to pharmacists has the potential to save the U.S. healthcare system an estimated $27 billion a year, the article points out. It potentially can help prevent more than two million adverse drug events a year, 130,000 of them life-threatening.

The literature review of 47 sources found e-prescribing responsible for cutting medication errors to as little as a seventh of their previous level. Improved patient outcomes and fewer patient visits have saved an estimated $140 billion to $240 billion over 10 years.

Fewer pharmacies call back for clarification, streamlining clinical practice workflow. There's less paperwork and reduced risk of mistakes due to poor handwriting.

E-prescribing systems can be incorporated into electronic health record (EHR) systems or can be stand-alone systems in the ambulatory care setting.

However, 80 percent of primary care physicians cite lack of financial support as the major barrier to implementation. New technology requires training and information technology support for installation and upkeep. Federal incentives aren't enough to lure some providers to adopt the systems, however. Some worry about having access to a complete patient record through e-prescribing systems.

Others worry about technology glitches and workflow issues creating e-prescribing errors--particularly alert fatigue. Privacy and legal issues remain a concern. Web-based and wireless systems create the potential for protected patient information to be stolen. And though the U.S. Drug Enforcement Administration has allowed e-prescribing of controlled substances, the security requirements make these systems expensive and cumbersome, according to the paper.

A study by officials from the Office of the National Coordinator for Health IT and Surescripts, a health information network that connects disparate parties to each other via their EHRs, found federal incentives a major factor in the adoption of e-prescribing.

Surescripts' most recent national report, issued last May, found that in 2012, 44 percent of prescriptions dispensed were routed electronically and 69 percent of physicians used e-prescribing in 2012.

To learn more:
- find the research

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