Use Of E-prescribing Research Articles

Perception of Healthcare Professionals towards Electronic-Prescribing at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Cross-Sectional Study.

Electronic-prescribing (e-prescribing) is the most recent technological advancement in the medication use process. Its adoption and consequent realization of its potential benefits, however, mainly depend on the healthcare professionals' perception, willingness to accept, and engagement with the technology. This study is aimed at assessing the perception of healthcare professionals towards e-prescribing at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, from June 1 to August 30, 2021. A cross-sectional study was conducted using a simple random sampling technique. A self-administered questionnaire was used for data collection. Data were entered into and analyzed by using the Statistical Package for the Social Sciences (SPSS® (IBM Corporation)) version 24. Both descriptive and inferential statistics like the Kruskal-Wallis and Mann-Whitney tests were used for data analysis. A statistical significance was declared at a p value < 0.05. From 401 participants, the majority of study participants had a neutral perception of e-prescribing. More than two-thirds (68.8%) of them had a neutral perception towards the perceived usefulness of e-prescribing with a median (interquartile range (IQR)) perceived usefulness of 43.0 (7.0) (maximum score = 60). The perceived ease of use of e-prescribing was also neutral in the case of more than three-fourths (79.8%) of participants with a median (IQR) perceived ease of use of 49.0 (6) (maximum score = 75). Similarly, more than half (56.6%) of the participants had a neutral perception towards the perceived fitness of e-prescribing with a median (IQR) perceived fitness of 15.0 (2.5) (maximum score = 15). The perception of the participants showed a significant difference based on their qualifications and work and computer use experience. Participants who heard about e-prescribing and e-prescribing software had a significantly higher mean rank score of perceived usefulness, perceived ease of use, and perceived fitness of e-prescribing. Participants who previously used e-prescribing had also a significantly higher mean rank score of perceived usefulness. Conclusion and Recommendation. The majority of healthcare professionals had a neutral perception of e-prescribing. The perception of healthcare professionals differs based on their qualifications, work and computer use experience, and their exposure to e-prescribing. The hospital should take all expectations and concerns of all HCPs into consideration and provide experience-sharing opportunities for all healthcare professionals who may potentially be involved in e-prescribing.

Barriers to electronic prescribing of controlled substance, especially opioids.

Electronic prescriptions are now the standard of practice for all discharge and outpatient prescriptions. The intention is to increase patient safety, provide a more complete medication record for patients, lessen the burden on prescribers, and shorten the time it takes for medication orders to reach the pharmacy. This cross-sectional questionnaire survey study was conducted between January and August 2022 in three areas of a large urban safety net hospital. A large single academic medical center. Emergency department, inpatient clinicians, and procedural areas. The subjects of the study were trainees, attending physicians, and advance practice providers (APPs) Interventions: Data were collected from the participants using a self-reported questionnaire, including sociodemographic characteristics, ease of use, reliability, and preference. Additionally, the perception of the strengths and limitations associated with electronic prescribing (e-prescribing) were analyzed. The purpose of this study was to evaluate the barriers to e-prescribing of opioids. A total of 121 prescribers completed the survey. The majority trusted that e-prescribing were transmitted successfully (62 percent), saved time (78 percent), and did not interrupt their workflow (78 percent). However, many prescribers indicated that additional improvements are needed, such as updating the patient's preferred pharmacy in the electronic medical record during each visit (52 percent) and having a 24-hour pharmacy readily available (66 percent). Prescribers value the ease of use of e-prescribing and how time efficient the process can be. Nevertheless, there is a need to improve the system's service, design, and usefulness.

E-prescribing by midwives: The situation in Greece

Electronic prescribing (e-prescribing) offers numerous benefits but has also disadvantages. The use of e-prescribing is becoming increasingly widespread worldwide but e-prescribing for midwives may vary from country to country. Regulations in Greece have defined the right of midwives to prescribe specific medicines and diagnostic tests since 1989. However, several years later, in 2019, legislation provided for the regulation of e-prescription for midwives. Midwives play a crucial role in the healthcare system, especially in the care of women and neonates. They are trained professionals who provide a range of services, including antenatal care and can help prevent and treat health problems that may arise during a woman's lifetime. It is therefore of utmost importance to empower midwives with prescribing capabilities which will facilitate the role of Primary Health Care.

Impact of Electronic Health Record Systems on Prescribing Errors in Pediatric Clinics.

Medication errors are commonly reported in the pediatric population. While evidence supports the use of e-prescribing to prevent certain errors, prescribing with an electronic health record (EHR) system is not devoid of errors. Furthermore, the majority of EHRs are not equipped with functionalities addressing pediatric needs. This study analyzes three unique EHRs in three pediatric clinics. It describes the functionality of each system and identifies errors found in e-prescribed prescriptions. Finally, the study estimates the proportion of e-prescribing errors that could have been avoided if those EHRs had met requirements set by the American Academy of Pediatrics (AAP). The number of prescriptions reviewed for Clinics 1, 2, and 3, respectively, were: 477, 408, and 633 with total error rates of 13.2%, 8.8%, and 6.6%. The clinic EHRs included 21%, 26%, and 47% of the AAP pediatric requirements for safe and effective e-prescribing for children. If all AAP elements had been included in the EHRs, over 83% of errors in the examined e-prescriptions could have been prevented. This study demonstrates that EHR systems used by many pediatric clinic practices do not meet the standard set forth by the AAP. To ensure our most vulnerable population is better protected, it is imperative that medical technology tools adequately consider pediatric needs during development and that this is reflected in selected EHR systems.

Physicians' Perceptions of Electronic Prescribing with Electronic Medical Records in Kuwaiti Primary Healthcare Centres.

This study aimed to evaluate physicians' perceptions of electronic prescribing in Kuwaiti primary healthcare centres. This cross-sectional study was conducted between June and August 2017 among 368 physicians from 25 primary healthcare centres in Kuwait. Data were collected from the participants using a self-reported questionnaire, including sociodemographic characteristics, previous experience with computers and awareness, knowledge and use of e-prescribing systems and their functional features. In addition, perceptions of the benefits and levels of satisfaction associated with e-prescribing were explored. A total of 306 physicians completed the survey (response rate: 83%). The majority had positive perceptions regarding the use of e-prescribing, particularly in terms of time-savings (86%), healthcare quality (84%), productivity (80%) and clinical workflow and efficiency (83%). However, many respondents indicated that e-prescribing systems required additional improvements in terms of functionality. Most physicians in primary healthcare centres in Kuwait recognised the importance of e-prescribing to improve the quality of patient care, streamline workflow, increase productivity and reduce medical errors. However, there is a need to improve the design and infrastructure of e-prescribing systems, which may aid in the adoption of such systems in Kuwait.

Error types with use of medication-related technology: A mixed methods research study.

Health information technology has been integrated throughout the medication use process to enhance safety, quality, and care efficiency. However, technologies have the potential to eliminate or reduce, but also create some new types of errors. Assess specific error types before and after the incorporation of two different health information technologies (HITs), e-prescribing and automated dispensing cabinets (ADCs), into pharmacists' daily work. A mixed methods design guided use of a pre-existing database of pharmacist survey responses describing patient safety HIT-related issues in the form of errors prevented and errors observed. In vivo descriptive text responses were converted into error types. Descriptive analysis was performed to characterize the error types associated with each HIT. Four error types were eliminated with the use of e-prescribing, three new error types emerged, and three error types persisted. With ADC use, four error types were eliminated, three new error types emerged, and three error types persisted. Each technology has its own error types, and some persist regardless of HIT use. There is a need to determine optimal risk reduction approaches for each unique HIT introduced, and design safety practice improvement for error types unaffected by the introduction of HIT use.

Assessing the Physicians' Acceptance of E-Prescribing in a Developing Country

This article describes how physicians in developing countries spend much time and effort in handling manual prescriptions, which can be easily reduced with the help of online technology. Although different theoretical models for technology acceptance have been thoroughly explored, there is as yet sparse literature regarding its use in the context of healthcare in developing countries, especially with innovative models. To this end, this article uses an integrative model of Unified Theory of Acceptance and Use of Technology (UTAUT) extended by perceived credibility to better understand the acceptance of e-prescribing among physicians in a developing Asian country. In addition, the article uses perceived organizational support as a moderator between behavioral intentions and usage of technology. Using a survey method, the article collects data from 295 physicians in the capital city of Pakistan and analyzes the data through structural equation modeling (SEM) to evaluate relationships among the identified constructs. The authors' results supply empirical evidence that performance expectancy, effort expectancy, facilitating conditions, social influence, and perceived credibility all have a positive and significant impact on physicians' behavioral intentions to adopt e-prescribing. The article also concludes that the higher the perceived organizational support, the higher the use of e-prescribing. The study enriches theory and practice by giving implications for both academicians and practitioners.

Mixing Electronic and Non-Electronic Health Records Limits Physician Productivity - The Arizona Experience

Objective: Estimate the effects of electronic health records (EHRs) on physician productivity in day-to-day practice by including the combinations of EHRs with nonelectronic records that typify current practice. Study Design: Cross section of 7,725 physicians representing 70% of physicians who provided patient care in 2012-2014 in Arizona. The sample was divided into office based (OFB) and non-office based (NOFB) physicians. Methods: Information from licensing applications was combined with a survey of the uses of electronic and nonelectronic health records. Productivity was measured as patient visits per hour in a typical work week. The effects of EHRs on productivity were estimated from a regression model that compared users to non-users and an model that included combinations of electronic, paper and scanned records. The results are compared to the physicians’ rankings of the effect of each combination of records on staff and physician productivity. Results: The productivity of OFB physicians is increased by the use of e-prescribing (+17.4%, p<0.001) and intervention reminders (+5.7%, p=0.03). There are no significant effects of the different mixes of health records. Among NOFB physicians, e-prescribing is the only contributor to productivity (+7.7%, p=0.069). Physicians rank EHR-only as more productive than any combinations of EHRs with non-electronic records. Conclusion: The potential productivity of EHRs is severly limited by the typical practice of combining EHRs with non-electronic records. Reducing the number of different types of records used in a practice will increase the positive effects of EHRs on productivity. One requirement for such reductions is an increased availability of health information exchanges.

E-Prescribing and Adverse Drug Events: An Observational Study of the Medicare Part D Population With Diabetes.

Although the adoption of e-prescriptions among physicians has increased substantially under the Medicare Improvements for Patients and Providers Act and Meaningful Use programs, little is known of its impact on patient outcomes. To examine the impact of e-prescribing on emergency visits or hospitalizations for diabetes-related adverse drug events (ADEs) including hypoglycemia. This is a prospective, observational cohort study with patient fixed effects. 2011-2013 fee for service Medicare. In total, 3.1 million Medicare fee for service, Part D enrolled beneficiaries over age 66 with diabetes mellitus and at least 90 days of antidiabetic medications. E-prescribing was measured as the percentage of all prescriptions a person received transmitted to the pharmacy electronically. The outcome measure was the occurrence of an emergency department (ED) visit or hospitalization for hypoglycemia or diabetes-related ADE. Unadjusted results show that there were 21 ADEs per 1000 beneficiaries that had ≥75% of their medications e-prescribed. Beneficiaries with lower e-prescribing levels had significantly higher numbers of ADEs. We found a robust association between the greater use of electronic prescriptions in the outpatient setting and the lower risk of an inpatient or ED visit for an ADE event among Medicare beneficiaries with diabetes in our adjusted analysis. At the e-prescribing threshold of 75% and above, significant reductions in ADE risk can be seen. As an observational study, the results show an association but do not prove causation. Use of e-prescribing is associated with lower risk of an ED visit or hospitalization for diabetes-related ADE.

Associations between patients’ perceptions of care integration and organizational features of medical groups in the United States

Background: Prior studies suggest structurally integrating healthcare organizations may not yield care that is integrated for patients. This research has been limited by lack of comprehensive measures of integrated patient care. Our study establishes an evidence base of care integration from the patient’s perspective among a national sample in the United States using a reliable and valid survey. We explore the relationship between patient-perceived integration and elements of organizational integration among medical groups.Methods: We refined and administered the Patient Perceptions of Integrated Care (PPIC) survey. It was theoretically derived, refined through pilot-testing, cognitive testing, and advisory panel input, and tested for reliability and validity. Psychometric analysis supported six dimensions of patient-perceived integration: (1) Provider Knowledge of the Patient, (2) Staff Knowledge about the Patient’s Medical History, (3) Specialist Knowledge about the Patient’s Medical History, (4) Support for Self-directed Care, (5) Support for Medication and Home Health Management, and (6) Test Result Communication. We also created an index of Integration following Hospitalization. This structure achieved good model fit and internal, discriminant, and construct validity. We administered the survey across a stratified random sample of 12,364 Medicare beneficiaries with at least two chronic conditions who had received care from a sample of 150 medical groups from the National Study of Physician Organizations (NSPO3). The final sample included 3,067 Medicare beneficiaries (26% response after 412 exclusions). We extracted data on the medical groups from the NSPO3 for five dichotomized dimensions: large/small size, physician/hospital ownership, primary care/multi-specialty, an information technology sophistication index related to electronic medical record and e-prescribing use (high/low), and an index regarding key care management process intensity (high/low). We conducted analyses using ordered logistic regression models with robust standard errors and weighting by response probability, adjusting for patient demographic, health and psychological characteristics.Results: Among the seven dimensions of integration, Test Result Communication exhibited the most consistently positive responses; each of its three items had over 70% of respondents reporting the most favorable option. Support for Self-directed Care and Support for Medication and Home Health Management exhibited consistently the least favorable responses. For Support for Self-directed Care, none of its five items had more than half of responses in the most favorable option, and four of the five items had over 20% of responses in the least favorable option. For Support for Medication and Home Health Management, only one of its four items revealed a majority in the most favorable option (at 55%).We did not find evidence of strong, consistent relationships between medical group characteristics and integrated care from the patient's perspective. Being a patient in a multispecialty group was associated with higher patient-perceived integration in all domains except for test result communication, but only the relationship with staff knowledge was statistically significant (odds ratio = 1.70; p&lt;.05). There were no strong relationships between perceived integration and either hospital ownership or technological capabilities (odds ratios ranging from 0.99 to 1.01). As compared to patients of large medical groups, patients of both solo practices and small groups had greater odds of being in a higher quartile for provider knowledge, staff knowledge, and support for medication and home health management (the latter was statistically significant; odds ratio = 1.35; p&lt;.01). There was a negative relationship between care management and test result communication for large groups, but a positive relationship for small and solo groups (chow test p =.002).Discussion: According to respondents in this national survey, many opportunities exist to better integrate care for patients with multiple chronic conditions. Notably, the two dimensions exhibiting the lowest levels of integration both related to how well providers support patients in participating in their own care. Particularly for patients with complex illnesses, who require care at home and often face barriers to receiving it, this gap signals an important opportunity for investment and improvement.Our results indicate that opportunities to better integrate care exist for all organizations. No single organizational feature was associated with stronger integration across all dimensions.Conclusion: This research suggests that producing truly integrated care may be more complex than can be captured by simple measures of organizational structure, function and process. Considering patient-perceived assessments of care integration is critical to understanding delivery system transformation.

The Hidden Role of Community Pharmacy Technicians in Ensuring Patient Safety with the Use of E-Prescribing.

Objectives: It has been reported that supportive personnel, such as pharmacy technicians, are key participants in the use of health information technology. The purpose of this study was to describe how pharmacy technicians use e-prescribing and to explore the characteristics of technicians that support pharmacists in ensuring patient safety. Methods: This was a qualitative study that used observations, interviews, and focus groups to understand the role of pharmacy technicians in e-prescribing. Fourteen pharmacy technicians and 13 pharmacists from five community pharmacies participated. Observations lasted about nine hours in each pharmacy. Follow-up interviews and two separate focus groups were later conducted. Observation field notes and audio recordings were transcribed and thematically analyzed. Results: Pharmacy technicians were primarily responsible for all steps leading up to pharmacist review of the e-prescription and dispensing of medications to the patient. Technician characteristics, including experience, certification status, and knowledge of appropriate medication use, were reported as important factors in supporting a pharmacist’s role in ensuring patient safety with the use of e-prescribing. Conclusion: Study findings indicate that pharmacy technicians have an important role in supporting pharmacists to prevent medication errors. Certain characteristics of pharmacy technicians were identified with the potential to improve the e-prescription medication dispensing process and decrease patient harm through the identification and resolution of errors.

A review of the literature and proposed classification on e-prescribing: Functions, assimilation stages, benefits, concerns, and risks.

Evidence from the literature indicates that besides its benefits, e-prescribing also generates new types of unintended medication errors that have the potential to harm patient safety. Analyzing both the benefits and risks of e-prescribing can give health care organizations a better understanding of the improvements gained and errors generated by this technology. To review the primary functions of e-prescribing and its assimilation stages in the health care context. This review also aims to classify the potential benefits, risks and concerns associated with e-prescribing along with factors contributing to e-prescribing errors. A literature review was conducted primarily in Web of Sciences electronic databases. The online databases were searched for both peer-reviewed quantitative and qualitative research papers written in English and published between January 2008 and December 2014 (i.e., the last seven years). Several additional studies were also accessed through Google Scholar and the citations of the selected articles. A total of 73 publications met the study's inclusion criteria. The key benefits of e-prescribing were identified as improving the quality of health care services, increasing the efficiency and effectiveness of prescribing and dispensing medications, reducing medication errors, and health care cost savings. Failure to properly implement e-prescribing systems can also result in new types of errors that reduce workflow efficiency, increase medication cost, and threaten patient safety. In this study, factors contributing to potential errors were categorized into four primary groups (human, technical, interaction and organizational errors). This review identified the primary benefits and risks of e-prescribing services. The study contributes to the body of knowledge related to the design, adoption and use of e-prescribing by providing a clear reflection on its potential gains and risks. Based on the findings of this review, conducting research in several areas is quite promising as future work. This review also has practical implications for health care providers, e-prescribing software vendors and policy makers.

Chinese medicine students’ views on electronic prescribing: A survey in Hong Kong

IntroductionElectronic prescribing (e-prescribing) can potentially improve the quality of patient care in traditional Chinese medicine (TCM) by facilitating clinical tasks. Published survey studies investigating e-prescribing use were mostly conducted in conventional medicine, but these findings cannot be entirely generalised to TCM practice. It is important, therefore, to investigate e-prescribing in the TCM context. PurposeTo investigate Chinese medicine students’ attitudes and perceptions of e-prescribing use in Hong Kong. MethodQuestionnaires were distributed to TCM students in three Hong Kong universities between January and May 2013. There were 259 participants in this study. Questionnaires were distributed and collected during lectures. The data was analysed using descriptive statistics. ResultsThe overall response rate was 89.3%. Only 21.2% of survey respondents had previously used an e-prescribing system. However, 86.5% of the respondents stated they want to use e-prescribing after they qualify as TCM practitioners. Patient care efficiency was rated as the most favourable outcome of e-prescription compared to handwritten prescriptions. The reliability of the e-prescribing system was rated as a major concern. ConclusionTCM students in Hong Kong were generally supportive of e-prescribing uptake. However, this study raised concerns and potential barriers to e-prescribing use. Factors that may facilitate e-prescribing uptake in TCM are also suggested. Further studies investigating TCM practitioners’ views will be required to identify further facilitators and barriers to the uptake of e-prescribing.

No More Excuses: Why Pharmacists Need to Take Their e-Savvy Up a Notch

While e-prescribing is not a new concept in health care, long-term care has been slow to adopt this technology, even as facilities, practitioners, and others have embraced electronic health records (EHRs). Despite the benefits of e-prescribing, including fewer adverse events and medication-related problems, issues such as lack of interoperability created barriers to widespread and effective use of this technology. However, new regulations and the growing use of EHRs in long-term care have created a new urgency for the use of e-prescribing. Many pharmacists already are taking a leadership role on this and encouraging their colleagues to follow suit.

Towards creating the perfect electronic prescription.

Significant strides have been made in electronic (e)-prescribing standards and software applications that have further fueled the adoption and use of e-prescribing. However, for e-prescribing to realize its full potential for improving the safety, effectiveness, and efficiency of prescription drug delivery, important work remains to be carried out. This perspective describes the ultimate goal of all e-prescribing stakeholders including prescribers and dispensing pharmacists: a clear, complete, and unambiguous e-prescription order that can be seamlessly received, processed, and fulfilled at the dispensing pharmacy without the need for additional clarification from the prescriber. We discuss the challenges to creating the perfect e-prescription by focusing on selected data segments and data fields that are available in the new e-prescription transaction as defined in the NCPDP SCRIPT Standard and suggest steps that could be taken to move the industry closer to achieving this vision.

How do community pharmacies recover from e-prescription errors?

The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient's medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber's intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber's intent. Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers' intent. Future studies are needed to examine factors that facilitate or hinder recovery from e-prescription errors.

The Effects of Electronic Prescribing by Community-Based Providers on Ambulatory Medication Safety

US federal policies are incentivizing use of electronic prescribing (e-prescribing) to improve safety. However, little is known about e-prescribing's actual impact on medication safety over time. A study was conducted to assess the effect of implementing a commercial electronic health record (EHR) with e-prescribing on rates and types of prescribing errors. Understanding safety effects from e-prescribing will be important as providers increasingly e-prescribe. Prescriptions written by 20 community-based primary care providers in the Hudson Valley region of New York from November 2008 to November 2009 were retrospectively studied. All providers adopted a commercial EHR with robust clinical decision support and extensive technical support to aid in prescribing. Errors were identified by standardized prescription and chart review. Some 1,629 prescriptions were analyzed at three months postimplementation, and 1,738 prescriptions were analyzed at one year postimplementation. Use of e-prescribing resulted in relatively low error rates (6.0 errors per 100 prescriptions). These rates were sustained over time but without further improvement (6.0 versus 4.5 errors per 100 prescriptions, p = .15). Antibiotics were the class of medications most frequently involved (12.7% of overall errors), and direction errors were most common (24% of errors). This study is the first, as far as known, to quantitatively evaluate prescribing errors early after EHR implementation and after sustained use among community-based primary care providers. Relatively low rates of errors with e-prescribing were found early and after prolonged use. Extensive support for providers before, during, and after implementation may mitigate potential safety threats from implementation of an EHR system and result in sustained safety benefits over the long-term.

E-Prescribing: characterisation of patient safety hazards in community pharmacies using a sociotechnical systems approach

ObjectiveTo characterise the safety hazards related to e-prescribing in community pharmacies.MethodsThe sociotechnical systems framework was used to investigate the e-prescribing technology interface in community pharmacies by taking into consideration the...

Adoption of and experience with e-prescribing by primary care physicians

BackgroundThe impetus of electronic prescribing (e-prescribing) is the reduction of preventable medication errors by generating a legible prescription checked via e-prescribing software for drug-drug and other interactions. Although the adoption of e-prescribing among physicians is growing, the Institute of Medicine's recommendations that all prescriptions be routed electronically by 2010 certainly has not been met. ObjectivesTo provide an update on e-prescribing use among primary care physicians (PCPs), describe their experience with e-prescribing, and provide insight into prescribers' decisions to implement e-prescribing in their practices. MethodsAn Internet-based survey was administered to a national convenience sample of physicians. The respondents were categorized into e-prescribers or non-e-prescribers. Data to describe demographic characteristics, respondents' experiences with e-prescribing, and respondents' decision to implement e-prescribing were collected. Nonparametric tests were used to test differences in the factors influencing e-prescribers' and traditional prescribers' decisions about electronic prescription implementation. ResultsFour hundred forty-three PCPs participated in the study. There were no significant differences in the demographic characteristics of e-prescribers and non-e-prescribers. Most e-prescribers (83%) reported satisfaction with their e-prescribing system and a preference for e-prescribing over traditional prescribing. Although 22% of respondents indicated that they have started and stopped e-prescribing, most have resumed or intended to resume e-prescribing in the near future. More than half of the respondents reported that they are experiencing problems with their e-prescribing software. ConclusionsE-prescribing appears to be present in many types of primary care practices and geographic areas of the country. Despite their satisfaction with and preference for e-prescribing, PCPs still appear to be experiencing problems with e-prescribing software. Implications of these study results for the pharmacy profession are discussed.

PHP70 E-Prescribing Trends in the United States: 2008-2012

E-prescribing is the electronic transmittal of a prescription to a pharmacy from the point of care. Electronic health records (EHR) provide greater functionality beyond e-prescribing and improve the availability of pharmacy benefits information and patient medication histories. The objective of this study is to describe the absolute growth in e-prescribing, e-prescribing method changes, growth in pharmacies accepting e-prescriptions, and discuss the impact of federal incentives on the e-prescribing adoption rate. Pharmacy and prescriber data used for descriptive analyses are from SureScripts (12/2008 - 9/2011). Standard descriptive statistics and standard regression analyses were used to analyze the data. A total of 95% of all chain, franchise, or independently owned pharmacies in the US route through the SureScripts network. The total number of health care providers prescribing on the SureScripts network has increased significantly over time from approximately 75,000 in December 2008 to approximately 420,000 in January 2012 (p<0.001). The number of e-prescribers has significantly increased in trajectory since 2009, which may be due to the federal incentives for EHRs. Health care providers e-prescribing via EHR systems and via stand-alone e-prescribing systems also increased, although the trajectory of EHR prescribers is much higher. Among current prescribers on the SureScripts network, 80% use an EHR. Currently, prescription refills/renewals comprise only 16% of total transactions. The percentage of total physicians e-prescribing on the SureScripts network in the US increased during this study period from 2% to 50%. E-prescribing is the gateway to the improved patient care that health IT promises. Prescription refills/renewals show promising benefits, as they are bi-directional health information exchange. Despite this, physicians have faced many barriers to implementation, with cost and workflow change as the primary challenges. Government incentive programs appear to have increased e-prescribing use among health care providers.