Many physicians don't use the community medication histories and the formulary information available to them in electronic prescribing systems because the data is incomplete and the systems are poorly designed, according to a new study from the Center for Studying Health System Change (HSC).
HSC researchers interviewed physicians in 24 practices in markets across the country in 2010. While most of the practices reported that e-prescribing physicians had access to patient formulary information, slightly more than half reported physicians had access to patient medication histories, and many doctors did not routinely review these sources of information when making prescribing decisions.
The formularies and medication histories are available through Surescripts, the dominant company connecting physicians' offices online with pharmacies. Vendors of electronic health records and standalone e-prescribing systems link their e-prescribers to Surescripts, which also can deliver medication history and formulary data if a practice enables those features. According to the most recent Surescripts report, 62 percent of e-prescribing doctors have access to medication histories, and 60 percent to formulary information.
In the HSC sample, one-third of the 24 practices couldn't download medication histories in their e-prescribers, and three practices chose not to implement the feature. The remaining practices implemented it, but physicians did not use it routinely. One reason was that the data covered only about half of their patients, on average. Additionally, the histories were presented in a cumbersome manner that slowed physicians down and didn't fit into their workflows.
Similar problems were described with formulary information: the data was available for only some patients, because not all health plans provided it to Surescripts. Even when formulary data was available, interviewees said it often was out of date or had limited usefulness.