Squeamish on e-prescribing, physicians become converts

DETROIT —A major new research project shows conclusively that doctors who overcome their longstanding reluctance to give up hand-written prescriptions and join the electronic prescribing revolution like the change and believe it’s good for their patients.

The research, based on a January survey of 500 physicians in Michigan participating in a multi-year test of e-prescribing, shows that 75 percent of them believe paperless prescriptions improve the safety for their patients. Almost 70 percent said it also improves quality of care.

The survey was performed by research firm Haldy-McIntosh & Associates for the Southeastern Michigan ePrescribing Initiative. Its goal: to prove that doctors, the toughest critics of e-prescribing, would actually find it useful once they began working with it and incorporating it into their day-to-day routines.

SEMI is a coalition involving the big three U.S. automakers—General Motors, Ford and Chrysler—as well as the United Auto Workers, Blue Cross Blue Shield of Michigan, CVS Caremark, SureScripts, RxHub, Medco Health Solutions, the Health Alliance Plan and Henry Ford Medical Group. The partnership was established in 2005 “to encourage the adoption and use of e-prescribing technology among Michigan physicians in order to reduce medication errors and lower healthcare costs,” according to a statement from SEMI. Nearly 3,000 doctors in the state now participate in the program, and transmit more than 300,000 prescriptions electronically each month.

Researchers turned up evidence of strong and growing support for e-prescribing among physicians who had incorporated it into their practices. Among the findings:

For 9-out-of-10 surveyed, e-prescribing met or exceeded their expectations.

More than 70 percent saw a reduction in communications with pharmacies over prescription questions; for 40 percent, the reduction was substantial. Research shows that physicians typically spend more than three hours a day handling phone calls and extra work from prescription issues.

More than half of the doctors polled strongly agreed that e-prescribing saves clinicians time and increases productivity.

One of the important benefits of e-prescribing cited by physicians is the safety alert that warns of potentially harmful drug-drug interactions and drug-allergy risks at the time of prescribing. Nearly 65 percent of physician e-prescribers reported at least one incident of changing a prescription in response to a safety alert received through the system.

Another problem that continues to emerge is the price of operating and installing the technology. Two-out-of-3 of those polled reported being more likely to prescribe a generic or plan-preferred drug when using an e-prescribing system. However, 1-in-4 physicians believes that the technology may not reduce costs for their patients or their practice.

“A majority of e-prescribers recognize the value of the system and incorporate its use in their individual practices,” noted a report from SEMI. “There was wide agreement on a substantial number of benefits e-prescribing provides, but there was less of a consensus around cost savings for both the patient and the practice.”

The report from SEMI was one of several high-profile developments in February that could spur adoption of both e-prescribing and, more generally, of a broader nationwide commitment to health information technology. Among recent initiatives:

Health and Human Services secretary Michael Leavitt called for a new mandate that would require physicians to e-prescribe for Medicare patients. He also gave strong support for use of electronic health records for those patients, but said health plan payers—including the U.S. government—should support doctors’ transition to health IT, and even for e-mail consultations with patients.

New York City mayor Michael Bloomberg said the city would begin offering doctors computer software that can track patients’ medical records in order to provide better preventive care. Seed money for the project would include $30 million from the city and another $30 million from the state and federal governments.

AT&T is partnering with Tennessee to provide the country’s first statewide system to electronically exchange patient medical information. The system is designed to securely transmit detailed patient information between medical professionals, and will allow doctors to access medical histories, prescribe medicines over the Internet and transfer such images as X-rays, MRIs and CT scans. It will also link to the state department of health for access to the immunization and disease registry, death certificate processing and medical license renewals.

Google announced new health IT initiatives, beginning with plans to store medical records of anywhere from 1,500 to 10,000 patients at the Cleveland Clinic.