The eHealth Initiative, a Washington, D.C.-based not-for-profit consortium of clinical healthcare information technology boosters, issued a report today saying that while progress has been make toward physician adoption of electronic tools, widespread use remains a long way off.
Various surveys cited by the report indicate just 5% to 18% of physicians are using some form of e-prescribing system, depending on the definition of the tool.
"While this represents a significant increase over the past 3-5 years, it certainly does not qualify electronic prescribing as a standard practice," states the report, released at conference in information technology hosted by eHealth Initiative in Washington.
"We see e-prescribing as a significant thing on its own, but also a major step on doing the same thing for electronic health records," said Jonathon Teich, M.D., chairman of the eHealth Initiative's Electronic Prescribing Initiative. Teich is senior vice president and chief medical officer of Healthvision, an Irvine, Texas, provider of e-prescribing and other healthcare information services. He also is an assistant professor of medicine at Harvard University Medical School and a physician in the Department of Emergency Medicine at Brigham and Women?s Hospital, Boston.
A key barrier to wider adoption of outpatient e-prescribing systems is that the cost of buying, installing and operating them is borne by physicians, whose workflow, at least in the short run, is also slowed by the technology.
Continued progress in system design, particularly with an eye to speed and ease of use, is likely to help adoption, the report said, but incentive programs must be put in place to compensate physicians to align costs with benefits, which accrue to pharmacies, health plans, pharmaceutical companies and patients.
Teich said not all PDA systems are fast enough for physicians, but some are.
"I think it's gotten there, and there are systems now that have gone past the neutral point where there is net workflow benefit," Teich said.
Money flows are another matter, though Teich said he was heartened by a half dozen or so pilot programs under way with payers willing to subsidize physician outlays for e-prescribing systems.
For example, Wellpoint Health Networks announced in January that it would provide $40 million in free equipment, including computers, printers and hand-held prescribing units, to almost 19,000 of its network doctors in California, Georgia, Missouri and Wisconsin.
"All of these things are beginning to gain momentum," Teich said. "I think people are very curious about it and are thinking this is the right thing to do."
Also, doctors still need to be sold that the systems improve patient safety and quality of care, the report said.
The report reiterates conclusions from earlier surveys that the nation could save as much as $27 billion from e-prescribing through reduction of adverse drug events and better utilization of drugs prescribed (Agency for Healthcare Research and Quality, 1999) and that more than 8.8 million ADEs occur in ambulatory care each year (Center for Information Technology Leadership, 2003).
A how-to on implementing an e-prescribing system is included in Appendix D of the report, available at ehealthinitiative.org.