The report also concluded that the percentage of physicians across the U.S. who use the technology doubled from 2008 to 2009,  the Rochester Democrat and Chronicle reports.

Benefits of E-Prescribing Systems

E-prescribing systems transmit prescriptions from the health care provider directly to pharmacies.

The report found that use of the systems by every upstate New York physician would prevent two million adverse reactions or events annually, including:

• 35 deaths;
• 160 permanent disabilities;
• 400 hospitalizations; and
• 3,000 physician consultations.

In addition, the report found that greater use of the technology overall would:

• Increase the use of more cost-efficient drugs;
• Provide greater security;
• Limit “doctor shopping” and illegal prescription practices;
• Boost efficiency for physicians, patients and pharmacies; and
• Save money for insurers (Matthews, Rochester Democrat and Chronicle, 7/15).

Predicted Increase in Use

On an annual basis, 3.6 million new and renewed prescriptions are handled regionally using the technology. That number is likely to grow as the systems become more affordable and as government incentives to spur the use of health IT take effect, the report predicted.

Source  :  http://www.ihealthbeat.org/articles/2010/7/16/report-on-eprescribing-in-new-york-predicts-growth-in-technology.aspx

The Agency for Healthcare Research and Quality wants to know just how many medical practices and pharmacies have implemented functional e-prescribing systems–and what factors help or hurt adoption.

At present, the agency notes, many e-prescribing systems don’t have the same features, which makes it difficult to build a seamless national system. Meanwhile, pharmacies seem to be having technical problems in rolling out e-prescribing software. Also, both seem to struggle with IT system problems and integrating e-prescribing into workflow, as well as training and regulatory issues.

To see how these issues play out in the real world, AHRQ is planning to survey physicians, medical directors, IT administrators, pharmacists and other relevant staff members at 110 organizations. It plans to spend two years on the survey.

Survey topics will include electronic transmission, how physicians use data from the list of accepted drugs covered by a patient’s health plan, and how pharmacies handle changes in communication with practices about accepted drugs.

Above article published on

http://www.fiercehealthit.com/story/ahrq-look-state-e-prescribing/2009-09-07

In a recent study, researchers found that physicians override more than three-quarters of drug interaction alerts provided by e-prescribing software. These alerts are decision support tools for physicians in order to avoid errors related to drug interaction and/or allergic reactions, together called adverse drug events or ADEs.

ADEs are a major focus of the Obama administration in eradicating human error and in turn increasing overall health care system efficiency. A reduction in adverse effects increases the quality of patient care while reducing health care costs through the elimination of unnecessary medical care (fixin’ you up after an ADE injury).

The scientific literature reports that one-quarter of patients experience an ADE episode and one-third of those are preventable. Yikes. In this recent study, a tri-state approach yielded similar findings to traditionally smaller studies—physicians override alerts frequently. Physicians, on average, received an alert for almost 7 percent of their prescriptions (over 3 million records were sampled)—of those, they accepted only 9.2 percent of drug interaction alerts and 23 percent of allergy alerts. There is no specialty that overrides more than another though the majority of the sample was primary care physicians. Should we be concerned? Well, yes and no.

Luddite Distrust or Decision Support Overkill?

Why are physicians overriding alerts at such high rates? Researchers are not clear about why physicians override the alerts but they suggest that 1) generally, the alerts are inadequate; 2) physicians discriminate based on the type of drugs a patient is taking (heart issues are weighed more seriously than less potentially emergent conditions); 3) unless addressed, physicians will develop “alert fatigue” and continue to be dismissive of alerts to the detriment of patient health.

So, maybe docs don’t trust technology to guide them in their decision-making and are uncomfortable using an electronic format? The study found that, on average, physicians had over a year’s worth of experience using an e-prescribing system. It appears that Luddite tendencies are not to blame for physicians overriding habits but rather an annoyance with many alerts that do not mirror the clinician’s knowledge base. According to users, the e-prescribing alerts are like a hyperactive child that asks you ten times to eat candy when you said “no” the first time. The complaint is that by alerting doctors numerous times and hyping up potential threats (not discriminating enough regarding what is a high alert interaction versus a more moderate ADE) threatens the utility of the entire system. The problem is a lack of congruency between clinical decision support and physician’s experience and practice style.

Matching Physician Insight with Electronic Ease

Clinical decision support regarding ADEs must be an important part of patient care. The system, however, is clearly imperfect. Physicians maintain that the clinical decision support around prescribing is inadequate. Researchers argue that software companies and their partners should take into account clinician insight and alert override practices. In short, software systems should alter alerts based on the acceptance and override rates by clinicians themselves.

While this appears to be good advice, there also needs to be attention paid to the patient outcome. How did the patient fare when there was a drug prescription override? Is the physician prudent in overriding an ADE alert? These are important questions yet to be addressed by researchers and software companies engaged in clinical decision support.

Above article published on

http://ohmygov.com/blogs/general_news/archive/2009/05/04/e-prescribing-systems-challenged-by-doctors.aspx