TechSector: ePrescribing: What to Look For

MDNG Primary CareJune 2007
Volume 9
Issue 6

Research studies published in JAMA and by the Institute of Medicine demonstrate that prescription errors account for a staggering number of deaths and adverse drug reactions in the US.

Research studies published in JAMA and by the Institute of Medicine demonstrate that prescription errors account for a staggering number of deaths and adverse drug reactions in the US. Factor in related medical malpractice insurance premiums, prescription fraud, and time spent by healthcare providers creating prescriptions and conducting pharmacy call-backs, and one can see why prescription writing is indeed a key healthcare issue. Fortunately, there have been some incredible advances in the field of electronic prescription writing that significantly improve the process, eliminating the need for handwritten prescriptions and thereby helping to reduce the number of avoidable medication errors.

Electronic prescription writing (ePrescribing) has been defined as only prescriptions sent directly over the Internet, by either pharmacy-direct fax or via a pharmacy direct messaging gateway (a secure prescription sent over the Internet to a healthcare entity). The reality is that even printed prescriptions fall within this, so long as they have been created on a computer with the help of clinical database-powered software. The benefits of ePrescribing for both physicians and patients range from decreasing medical errors and prescription fraud to saving time and money. Using the right software, users can create legible prescriptions quickly. Clinical databases that check allergy and drug-to-drug interactions help flag problems before the prescription is written and processed. With this technology, pharmacy call-backs are significantly reduced, and on-screen formulary information at the point of prescribing helps with compliance. ePrescribing software is quickly making its way from novelty to necessary tool.

The government has not required physicians to use ePrescribing software as of yet, but the technology is providing a compelling case with healthcare entity grants, Stark Law exceptions, and new rules and regulations. For example, the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) states that ePrescribing is voluntary for prescribers but establishes mandatory standards for physicians who send and receive electronic prescription data for eligible covered Part D drugs. Despite the obvious benefits, it is estimated that less than 25% of physicians use any kind of ePrescribing or EHR system, hindered by a general hesitancy to incorporate more technology, the limited functionality of many of the available products, cost concerns, and the practical considerations of training a staff and adapting office infrastructure. The reality is that ePrescribing is an excellent first step for physicians who want to integrate an electronic system of some kind with the least cost and intrusion. With the right vendor, benefits can be realized quickly.

To choose the right software, one must know what to keep an eye out for. Cost is certainly a determining factor when purchasing any software; products that are relatively inexpensive—such as ScriptSure, which is available for as low as $99 per month—will help make the switch to electronic prescribing that much easier. A software program with the flexibility to act as a stand-alone ePrescribing system or operate in conjunction with an electronic medical record (EMR) is a good place to start. Ease-of-use is another major point to consider—drug organization and selection processes that allow for one-click prescribing are ideal. Below are several key features to look for, all of which are offered by ScriptSure.

Pharmacy-direct Connectivity

The ability to print, fax, or message prescriptions directly to pharmacies provides convenient flexibility. Pharmacy-direct connectivity allows for refills to be requested online from pharmacies and can help reduce pharmacy callbacks and related communications considerably. This ability will more than likely become a requirement.

Comprehensive Clinical Drug Database

The ability to access information for nearly every drug on the market and check for possible interactions is a “must have” for any system. For example, instant access to onscreen allergy medications and drug—drug interactions based on what the patient has been prescribed provide obvious time and liability benefits.


ePrescribing systems should include flexibility with setup and customization. The ability to store relevant patient and prescription-related information and run reports on that information is crucial. The right ePrescribing software will help users avoid some of the pitfalls associated with EHRs and assist in breaking out of the mold of handwritten prescriptions. Clinicians who choose an eff ective system will likely quickly wonder how they lived so long without it. When you factor in time and cost savings, data availability, and convenience, ePrescribing makes a lot of sense.

Ensure you select the right ePrescribing software for your practice by asking prospective vendors the following questions:

· Can the software integrate with other systems?

· Is the software fast and easy to use?

· Can users print, fax, and message prescriptions?

· Does the software contain a clinical drug database with interaction and allergy checks?

· Does the software feature additional usability functionality (eg, stored data, reports, customization, and flexibility)?

· What is the cost to purchase, implement, and train staff?

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