February 19, 2010
“Why hasn’t electronic prescribing (eRx) gone mainstream yet?”
One of the biggest challenges physicians face is that while internet connectivity has improved and expanded nationwide dramatically, the transmission speeds and cost can still be a problem in some rural areas. In addition, many practices – particularly in solo and small groups – do not have a need for a high-speed internet connection in their offices, and they consider purchasing one to be part of the expense of their e-prescribing system.
In fact, most physicians who bill their services electronically should already be expensing their cost of connectivity. The added benefit of email, searching medical journals, the National Library of Medicine and other clinical knowledgebases online often comes “free” especially if a physician subscribes to a “print” journal already. Retrieving patient specific clinical results online easily, such as labs, images, consultations ED and hospital discharge summaries, etc. is another proven benefit. Once practices begin using the internet for more of their daily activities, then the cost of the system will be considered simply a necessary business expense that should increase productivity if used appropriately.
Until recently, the greatest beneficiaries of e-prescribing were the health plans, employers, the government, and patients. However, aside from a few payers, most are generally unwilling to pay for physicians to adopt the technology. Unfortunately, many physicians still feel that they receive marginal benefits from e-prescribing but have to shoulder most of the burden, which includes both cost of system (hardware upgrades or new purchases), workflow change, training, and, in some cases, schedule disruption (the last issue is atypical for e-prescribing but common for EHR implementation). The greatest “bang for the buck” in e-prescribing is for high volume prescribers. These practices tend toward primary care and the sub-specialties of internal medicine and pediatrics. Nevertheless, many surgeons and procedure oriented specialties have seen a good “ROI” from e-prescribing.
With the recent and new Federal incentives, for MIPPA and PQRI, physicians can reduce the financial burdens. In addition by selecting the right electronic prescribing system for their offices, they can minimize workflow and schedule disruptions.