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J Am Board Fam Med. 2012 Jan-Feb;25(1):24-32. doi: 10.3122/jabfm.2012.01.100297.

Early adopters of electronic prescribing struggle to make meaningful use of formulary checks and medication history documentation.

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1
Research Division, Department of Family Medicine and Community Health, UMDNJ-Robert Wood Johnson Medical School, Somerset, NJ, USA. jesse.crosson@umdnj.edu

Abstract

INTRODUCTION:

Use of electronic prescribing (e-prescribing) can improve safety and reduce costs of care by alerting prescribers to drug-drug interactions, patient nonadherence to therapies, and insurance coverage information. Deriving these benefits will require clinical decision support based on presentation of accurate and complete formulary and benefit (F&B) and medication history (RxH) data to prescribers, but relatively little is known about how this information is used in primary care.

METHODS:

This is a multimethod comparative case study of 8 practices, which were selected to ensure practice size and physician specialty variation, implementing a stand-alone e-prescribing program. Field researchers observed prescription workflow and interviewed physicians and office staff.

RESULTS:

Before implementation, few prescribers reported using F&B references when making medication choices; all used paper-based methods for tracking medication history. After implementation, some prescribers reported using F&B data to inform medication choices but missing information reduced confidence in these resources. Low confidence in RxH data led to paper-based workarounds.

CONCLUSIONS:

Challenges experienced with formulary checks and RxH documentation led to prescriber distrust and unwillingness to rely on e-prescribing-based information. Greater data accuracy and completeness must be assured if e-prescribing is to meet meaningful use objectives to improve the efficiency and safety of prescribing in primary care settings.

Comment in

PMID:
22218621
DOI:
10.3122/jabfm.2012.01.100297
[Indexed for MEDLINE]
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