E-Prescribing Hits a Wall with Renewals

Despite the many potential benefits of e-prescribing, there are a number of aspects, such as prescription renewals, that continue to be problematic, according to a study funded by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.

Overall, practices and pharmacies are satisfied with e-prescriptions, especially with the improvements they bring in efficiency and patient safety. However, renewals were an area that needed more work and where there was the biggest breakdown in communication between pharmacies and physicians.

Connectivity between physician offices and mail-order pharmacies and manual entry of certain prescription information by pharmacists were other topics of concern.

"Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, MD. "This study identifies issues that need attention to improve e-prescribing for physicians, pharmacies, and patients."

The practices and pharmacies interviewed admitted that they use the technology less often for electronic renewals than for new prescriptions. More than a quarter of community pharmacies don’t send electronic renewal requests to physicians and one-third of physicians either aren’t set up to receive renewals or receive them infrequently.

In fact, when it comes to renewals, the process can be more time consuming and costly, the opposite of what the technology tries to achieve. Physician respondents reported that after receiving electronic renewal requests, they sometimes also received requests by fax or phone as well. Meanwhile, pharmacists said that physicians often approve electronic requests by phone or fax.

One problem with e-prescribing is that pharmacies sometimes have to manually edit information like drug name, dosage and quantity. The new technology requires that physicians select medicines with more specificity, when some of these decisions were typically made by pharmacists with handwritten prescriptions.

As more and more physicians adopt the technology to e-prescribe — a result of federal incentives — these challenges will become more pronounced.