E-prescribing Adoption Slow Despite Benefits

When it comes to writing prescriptions, many physicians still believe the pen is mightier than the sword or, in this case, than the electronic prescribing tool.

The results of a recent study published in the Journal of the American Medical Informatics Association, found that electronic prescribing prevented 17 million medication errors in a single year. If more widely used, the technology could prevent more than 50 million drug errors annually, according to study authors.

The sticking point, the authors note, is that despite the apparent effectiveness at reducing medication error, e-prescribing is still only modestly used. Erez Lapsker, CEO of MediScripts, a point-of-prescription advertising medium, isn’t surprised by the JAMIA study results.

“One of the big issues [surrounding e-prescribing] is about ease of use,” Lapsker says. “If you look at some of the e-prescribing platforms out there, what we’ve found, especially in talking with physicians who are e-prescribing, is that it’s not easy to use. It’s actually a little bit clunky. On [a prescription] pad it takes 30 seconds to write a prescription, generally with e-prescribing it could take up to three minutes. And time is very important to physicians.”

User interface

The results of the Journal of the American Medical Informatics Association study align with data compiled by MediScripts. The company recently announced that handwritten scripts still outpace e-prescribing by more than 60%. In 2012, physicians wrote 570 million e-prescriptions compared to 916 million prescriptions generated by MediScripts physicians using a traditional prescription pad.

“More than 50% of U.S.-based physicians utilize e-prescribing technology, yet data show that among physicians, a majority are also writing prescriptions on a pad,” Lapsker explains. “Doctors use a pad because it’s not only easy to use, but it’s something that translates into their relationships with their patients. It’s something they can give to the patient as part of the interaction they have. E-prescribing doesn’t really lend itself toward that. It’s kind of faceless in a lot of ways.”

Lapsker says the key is user interface. If physicians are going to more widely adopt a mobile, e-prescribing tool or as a module on an EMR, it has to be something that is easy to use, is quick and has a user-friendly interface as opposed to what he refers to as more of an industrial, Windows operating system kind of feel.

Another roadblock is familiarity. According to Lapsker, the average physician is 50 years old and getting physicians to change after doing things one way for so long will take time.

Integration and incentives

Jim Pantaleo, executive vice president of sales and marketing for MediScripts, acknowledges that the objective e-prescribing has of reducing medication errors is a noble and worthy cause. But simply generating an e-prescription doesn’t mean patients are going to take their medication any faster than if they received the script via pen and paper. The key to greater adoption, he says, is improving the delivery channel.

“More folks are looking at how to marry the e-prescribing channel to the dissemination of information to patients,” Pantaleo says. “For example, patient education materials or coupons or vouchers. But in many of the existing systems right now, e-prescribing as a tool by itself is not enough. It needs to become a platform and a channel for adding other services that the physician can engage with the patient.”

Lapsker says there’s no question that e-prescribing is growing, and to some extent he credits government incentives toward EMR and EHR adoption for some of that growth.

“When you give doctors $65,000 to move over to EMRs and EHRs, and most of those have an e-prescription platform built into them, you get people signing up for e-prescribing,” he says. “But if you look at the average writing, you can see all that’s happening is that doctors are signing up. They have the capability of e-prescribing but they’re not actually doing it.”

Lapsker says the changeover to e-prescribing will continue to occur as younger physicians graduate from medical school and enter the profession.

“They’re all over it,” he says, of younger physicians’ use of e-prescribing tools. “They do it in medical school, so when they come out it’s sort of second nature to them. But as we stand right now, the majority of physicians still like the pen and pad because they’re easier to use.”