E-Prescribing — if not why not?

e-prescribing 2011

The above map comes from Internal Medicine News.  State by state it shows where doctors are using electronic prescribing.   A simple question for those doctors in the white states:  why live in the past?  Huge numbers of pharmacies accept electronic prescriptions, patients like electronic prescriptions better than paper prescriptions, prescribing errors are much lower, patients get better care, drug interaction checks can be done BEFORE the prescription is sent (so the pharmacist does not have to call),  and a record of the prescription is available as part of the medical record.

The doctor perspective:  “Just more computer work for me”

The patient perspective:  “I like the idea of fewer errors”

How does it work?
The prescriber needs to have several things in place:

  • An electronic medical record
    (without this much of the advantage is lost)
  • An electronic list of the patient’s active prescriptions
  • An electronic list of the patient’s allergies and intolerances
  • A diagnosis associated with the prescription
  • A record entry to document the thought process for the prescription
  • An internal link to the insurance drug formulary

A very good process is to have the computer screen for prescribing where the patient can see the actions of the prescriber.  That way the patient can see what  is being prescribed, whether it is covered by insurance, where the prescription will be sent, the instructions, the amount and the refills.  If there are problems the patient can comment — it is much better to have feedback at the time of prescribing rather than the patient not take the medication or get phone calls later with questions from the patient or pharmacist.  Physicians who use e-prescribing don’t ever want to go back to the old way!  Pharmacists never liked physician handwriting anyway.

So, if your physician is not using e-prescribing give them a copy of this post!

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