Article review and analysis

Grossman, J.M., Cross, D.A., Boukus, E.R. & Cohen, G. (2011). Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies. Journal of the American Medical Association. Doi:10.1136/amiajnl-2011-000515

Electronic transmission of prescription medication requests from doctors' practices to pharmacies has the potential to improve efficiency and reduce medical errors, according to Grossman, Cross, Boukus & Cohen (2011). This paper explores the subjective experiences of physicians and pharmacists, with the intent of identifying both facilitators and barriers of use. The researchers note that use of e-prescription methods is relatively low in spite of federal financial incentives to switch to electronic medical records across the treatment spectrum. Understanding barriers to use is therefore a core component of improving the delivery of care, reducing error, and improving the cost-effectiveness of healthcare.

Grossman et al. (2011) designed a qualitative study to reveal physician and pharmacist impressions of electronic prescription handling. More than one hundred telephone interviews with various organizations including private physician practices, community pharmacies, and mail-order pharmacies provided the bulk of the data. Interview survey questions covered issues such as new prescription filing, prescription renewal, medication history, and communication of data to the insurer. Although methods and research design were limited, and population sample relatively small, the trends do reflect some reasons why physicians are reluctant to use electronic prescriptions on a consistent basis.

The results of the study reveal a general acceptance of electronic prescription formats. However, both pharmacies and private medical practice survey participations agreed that prescription renewal processes were too irregular to be used regularly and consistently. Pharmacists noted that physicians presented the greatest barrier to use, and were generally reluctant to adopt or fully embrace e-prescription methods. This was an observation that was substantiated internally within this research: a full one-third of physician practices interviewed in the current study were not yet using e-prescription renewal requests at all. Pharmacists also noted physician errors such as refusing to renew a prescription medication, and then immediately re-filing a new request for the same medication and patient, thereby defeating the purpose of the system. In addition to physician barriers to use, patients also struggle with the electronic systems offering cryptic data on proper use of medications.

This article accurately captures the resistance to employing electronic medical records on a large scale in the United States, which is woefully behind other nations in adopting electronic medical records systems. More research like this is required to point out how physicians can become more amenable to using electronic systems like e-prescriptions. When the barriers to use are identified scientifically, as in this qualitative research, systems designers can create e-prescription software that better serves the end-user populations. Small adaptations to the software and/or hardware can ensure that all physicians are on board with using the systems, which have the potential to reduce medical errors and improve patient outcomes.