Responsible E-Prescribing Needs E-Discontinuation

Published in: JAMA, Volume 317, Number 5 (February 7, 2017), Pages 469-470. doi:10.1001/jama.2016.19908

Posted on RAND.org on March 12, 2019

by Shira H. Fischer, Adam J. Rose

Implementation of electronic prescribing, also known as e-prescribing, has been one of the successes of health information technology and an advance in health care delivery. Clinician uptake of e-prescribing has been substantial, in part because it is now required by health plans, insurers, and hospitals. As of April 2014, 70% of physicians were e-prescribing, an increase from 7% who used e-prescribing in December 2008. e-Prescribing reduces the number of illegible prescriptions and helps to address and may reduce medical errors through integrated tools that provide information on allergies, drug-drug interactions, and appropriate dosing. One primary care study involving 30 clinicians (of whom 15 adopted e-prescribing) and more than 3500 prescriptions at baseline and 1 year later showed that prescribing errors decreased among the e-prescribers from 42.5 per 100 prescriptions at baseline to 6.6 per 100 prescriptions in a single year with the adoption of e-prescribing. However, e-prescribing also has been associated with some challenges; for example, when a pharmacy is closed or does not have the requested medication and it is impossible to contact the prescribing physician; there are also issues with the many clicks it takes to order a prescription and the numerous false-positive alerts that lead to alert fatigue.

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