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. 2008 Apr;23(4):358-63.
doi: 10.1007/s11606-007-0383-1.

Uptake of electronic prescribing in community-based practices

Michael A Fischer  1 , Christine Vogeli, Margaret R Stedman, Timothy G Ferris, Joel S Weissman
Affiliations

Uptake of electronic prescribing in community-based practices

Michael A Fischer et al. J Gen Intern Med. 2008 Apr.

Abstract

Background: Electronic prescribing (e-prescribing) has the potential to improve the safety and efficiency of medication use, but uptake of e-prescribing in community-based settings has been limited to date. In April 2004, 2 large insurers in Massachusetts began a program to fund e-prescribing systems for targeted clinicians and practices. We studied the adoption and uptake of e-prescribing by the targeted prescribers.

Methods: We obtained data on all e-prescriptions written from April 2004 to March 2005. We tabulated the number of clinicians using the e-prescribing system and the number of prescriptions written. We also obtained claims data from the 2 insurance companies and calculated the proportion of each clinician's prescriptions that were written electronically. We developed multivariable models to estimate the impact of different clinician characteristics on the proportional rate of e-prescribing.

Results: During the first 12 months of the e-prescribing program, 1,217 prescribers began using the e-prescribing system. In the final month of the study, over 55,000 e-prescriptions were written for patients covered by the 2 included insurance plans. The proportion of total reimbursed claims per clinician written electronically increased slowly during the study period and was still below 30% by the end of the study period. This number increased to 42% when we restricted the sample to medications normally used for acute indications. Multivariable models showed that younger clinicians, pediatricians, and prescribers in larger practices exhibited higher uptake rates as a proportion of total prescriptions.

Conclusions: Clinician use of e-prescribing increased steadily in the first 12 months of an initiative sponsoring e-prescribing systems. Uptake of e-prescribing was only partial, with younger clinicians and pediatricians more likely to use the system. Research to understand why prescribers vary in their use of e-prescribing and to develop techniques to encourage more wide-spread adoption will be an important priority for future studies.

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Figures

Figure 1
Figure 1
Number of clinicians using e-prescribing system and total volume of e-prescriptions, by calendar month, April 2004 through March 2005.
Figure 2
Figure 2
Proportion of prescriptions prescribed electronically by month since first use of e-prescribing system. The diamonds show e-prescribing proportion for all medications, and the triangles show the proportion for medications prescribed for acute indications.
Figure 3
Figure 3
Proportion of prescriptions prescribed electronically in the 1st and 12th months after the first use of e-prescribing system, by clinician characteristics. The grey bars shows the first month of e-prescribing use, and the blue bars show the twelfth month.
See this image and copyright information in PMC

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