More Doctors Prescribing Meds Electronically

Doctors are increasingly prescribing medications electronically, abandoning the traditional paper scripts that can result in drug errors due to hard-to-read writing or coverage denials by a patient's insurer.


The number of e-prescriptions nearly tripled last year to 191 million from the previous year's 68 million, representing about 12% of the 1.63 billion original prescriptions, excluding refills, according to Surescripts LLC, whose online network handles the bulk of the electronic communications. The growth has accelerated. For the first three months of this year, nearly one in five prescriptions was filed electronically, Surescripts says. About 25% of all office-based doctors currently have the technology to e-prescribe, more than twice as many as at the end of 2008, Surescripts says.

E-prescription programs display lists of drugs for doctors to select from. Symbols may indicate the cheapest or best option for the patient.

Industry officials expect the growth in e-prescribing to continue, helped in part by a regulatory ruling last month that will soon allow doctors to start prescribing controlled medications such as narcotics and anti-depressants electronically. Under Drug Enforcement Administration rules, doctors previously had to hand out paper prescriptions for controlled drugs, even while other drugs could be e-prescribed.

The recent DEA ruling "is what we've all been waiting for," says John Halamka, an emergency-room physician at Beth Israel Deaconess Medical Center in Boston, who has used e-prescribing for three years. Being able to digitally zap some prescriptions to a pharmacy, while having to use a pad and paper for other medicines has disrupted work flow at the hospital, he says. "Now we can write prescriptions for [cholesterol drug] Lipitor and Valium [a controlled anti-anxiety medication] on the same program," he says.

Doctors transmit e-prescriptions via a secured Internet network directly to pharmacies from their computers or hand-held devices. Nearly all chain drug stores and 62% of independent pharmacies now accept e-prescriptions that are uploaded directly to their computers. For medical practices, the cost of e-prescribing software and hardware, such as laptops, as well as training can range from about $1,000 to $1,750 per physician, according to software makers.

Displayed on the doctor's e-prescribing screen are an array of drugs and their prices. Doctors select among different doses and either generic or name-brand medications. Also listed are which medications are covered, and which are not, by a patient's insurance company. For some e-prescribing programs, symbols in the form of small faces appear on the screen: A green smiley face means the medication will be the cheapest for a patient, or that it's the preferred drug based on other medications the patient is taking. Yellow and red faces indicate less desirable options.

"Wall Street Journal April 20, 2010"