Although electronic prescribing tools are widely available, they are not very widely used, according to a Center for Studying Health System Change survey of 4,182 office-based physicians conducted in 2008.
In the Robert Wood Johnson Foundation-funded survey, 41.9% of responding physicians said they had access to e-prescribing technology. Of those, 64.5% said they routinely used a feature checking for adverse drug interactions; 53.7% routinely used electronically transmitted prescriptions to pharmacies; 34.3% routinely used an application that checks whether a drug is included in a patient's health plan formulary; and 22.7% used all three features routinely. The center calculated that this translated to a 9.6% routine-use rate for office-based ambulatory physicians for all three applications in 2008.
According to the 2009 National Progress Report on E-Prescribing released in March by the electronic prescription exchange service Surescripts, about 68 million prescriptions—or 6.6% of the U.S. total—were transmitted electronically in 2008. This tripled to 191 million, or about 18%, in 2009, the Surescripts report noted.
The Center for Studying Health System Change report acknowledged barriers to the use of these applications. It mentioned other studies' findings that doctors suffer "alert fatigue" from the drug-interaction feature and often stop using it. The report also noted that many physicians are reluctant to rely on health-plan-supplied formulary information because they perceive this data to be incomplete or inaccurate and that patients' pharmacies sometimes lack the capacity to receive electronic prescriptions.
The report concludes that the survey findings suggest that "policy makers should expect a substantially longer time horizon to achieve meaningful use of health IT than the five- to six-year horizon of the Medicare and Medicaid incentive programs.”