Research Activities, January 2011: Health Information Technology: E-prescribing for managing medication refills has not reached its full potential

Health Information Technology
E-prescribing for managing medication refills has not reached its full potential

A growing number of physicians' offices are using electronic prescribing (e-prescribing), sending prescriptions to pharmacies via computers. As it continues to grow, e-prescribing will help reduce medication errors, including those due to misinterpreting handwritten prescriptions. However, the popularity of e-prescribing is being met with growing pains, particularly when it comes to refilling prescriptions. A new study looks at this dimension and finds areas where improvements can be made, not only in software design, but also at the user end. Researchers from Virginia Commonwealth University and Brown University selected six geographically diverse States with the highest e-prescribing activities. At 64 physicians' offices, they conducted focus groups and individual interviews to learn how well e-prescribing systems worked for refilling prescriptions.

Participants were asked to offer suggestions on how to improve software functionality and office procedures to optimize their e-prescribing practices. Having e-prescribing systems reduced by about 50 percent the time spent each day on medication refills. Most physicians gave positive feedback when it came to refill activities. In addition to office time saved, physicians reported patient convenience as a major benefit. Both physicians and their staff appreciated the ability to track how patients were filling and refilling their prescriptions. However, a number of difficulties were mentioned regarding managing prescription refills. Most of these were related to technical problems that were slow to be resolved by representatives at the e-prescribing software company. Other difficulties cited included the need to re-enter all patient data for each prescription, not having the ability to delete or edit data for each prescription, and the difficulty of filling prescriptions when the e-prescribing software was not linked to a patient's medical record.

Some participants also reported problems with the pharmacies not receiving refill orders, even though orders had been sent. According to the researchers, software companies need to be more responsive to troubleshooting requests and develop error-reporting systems. At the same time, usability issues need to be examined at the physician office and the pharmacy in order to identify and correct inherent problems to make e-prescribing more readily usable. The study was supported in part by the Agency for Healthcare Research and Quality (HS16394).

See "Beyond the basics: Refills by electronic prescribing," by Roberta E. Goldman, Ph.D., Catherine Dubé, Ed.D, and Kate L. Lapane, Ph.D. in the International Journal of Medical Informatics 79, pp. 507-514, 2010.
Research Activities, January 2011: Health Information Technology: E-prescribing for managing medication refills has not reached its full potential