The authors cite anecdotal evidence of increased e-prescribing since that period but present data only through early 2005. A striking finding of their analysis was the low use of e-prescribing, which (although increasing throughout the period studied) was less than 30% of all eligible prescriptions 1 year after adoption. Fischer et al 13 examined use and adoption of the PocketScript system, which was offered without cost to high-volume outpatient prescribers in Massachusetts. We are aware of only 1 prior study that evaluates adoption and use of commercial SEP systems by community physicians. 10,11 Indeed, recent legislation promises to increase Medicare reimbursement for e-prescribing physicians in the short term and to decrease Medicare reimbursement for paper prescribers in the long term.
Stand-alone e-prescribing (SEP) has been proposed as a possible method of transitioning community physicians toward EMR functionality without the initial investments required for a full EMR system. 7,8 As a result, only 9% to 14% of these practices have adopted EMRs compared with 23% to 50% of larger practices. 6 Unfortunately, the structure of these small community private practices is not conducive to providing the financial and time investment necessary for EMR adoption. More than 75% of physicians practice in groups of 5 or fewer. 2-5 However, few physicians practice in these types of environments. 1 Most of this evidence comes from 4 healthcare organizations at which academic physicians and employees are usually required to use homegrown electronic medical records (EMRs). There is evidence that in some settings health information technology (HIT) can improve patient outcomes and reduce healthcare costs. Higher e-prescribing use among physicians in smaller practices suggests that e-prescribing may be an appropriate manner of extending health information technology to these physicians, who traditionally are reluctant users of such technology.Efforts should be made to ensure that all patient demographics benefit from e-prescribing.Given this low use, future initiatives may need to consider more resources to increase e-prescribing use.In a health plan-sponsored e-prescribing initiative, the mean e-prescribing rate of participating primary care physicians (PCPs) was 1 prescription per 4 pharmacy claims, but some PCPs achieved high use.Some adopters achieved high levels of SEP use, and further research is needed to elucidate the factors that enabled this.Į-Prescribing is seen as a critical technology for improving medication use. On average, adopters used the SEP system for only about one-quarter of their prescriptions. 02).Ĭertain categories of physicians may need more tailored incentives to adopt SEP. Available physician characteristics explained little of the variance in use, but physicians in smaller practices had greater use (P =. Twenty percent of physicians maintained e-prescribing use ratios above 0.50. The mean (SD) e-prescribing use ratio among adopters was 0.23 (0.28).
Solo practitioners, pediatricians, and physicians with more patients from predominantly African American zip codes were underrepresented among SEP adopters.
Independent variables included characteristics of PCPs (specialty, practice size, and prescribing volume) and their patients (patient age, sex, race/ethnicity, and household income). Among 297 adopters, we studied the extent of SEP use.ĭependent variables included each physician’s adoption of SEP and his or her e-prescribing use ratio (the ratio of electronic prescriptions to pharmacy claims in the same period). Using records from an insurer-led SEP initiative, we compared the characteristics of 297 PCPs who adopted SEP through the initiative with the characteristics of 1892 eligible PCPs who did not. To quantify rates of stand-alone e-prescribing (SEP) adoption and use among primary care physicians (PCPs) participating in a SEP initiative and to determine which physician and patient characteristics were associated with higher rates of each.