Doctors Are Slow to Start Writing Prescriptions Online

Tamara Sobel orders a perscription via laptop.
Tamara Sobel orders a perscription via laptop. (By James A. Parcell For The Washington Post)
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By Ceci Connolly
Washington Post Staff Writer
Tuesday, November 25, 2008

Samuel Benesh, an internist who practices in Owings Mills, Md., tossed his prescription pad nearly three years ago, and he hasn't missed it since.

Patients still get their medications, but now there are no more lost slips of paper or long waits in line at the pharmacy. They don't even need to phone in for refills. It all happens electronically -- or magically, as one of Benesh's patients put it.

Benesh is among a small group of physicians nationwide using technology to transmit prescription orders from a computer to the pharmacy. In an effort to nudge more physicians in that direction, the federal government will begin offering bonuses in January to Medicare physicians who write electronic prescriptions.

Patients say the system, known as "e-prescribing," is much more convenient. More important, it offers the hope of sharply reducing dangerous and costly medication errors.

Each year, more than 3.52 billion prescriptions are written in the United States, and at least 1.5 million preventable adverse drug reactions occur, according to the Institute of Medicine. Many errors are due to doctors' infamously illegible handwriting. Other mistakes involve allergies or problematic interactions with another medication.

Electronic prescribing helps minimize errors because the computer automatically checks a patient's record and alerts a doctor to potential trouble.

"This definitely improves quality and safety," said Benesh, who began e-prescribing as part of a pilot project with CareFirst BlueCross BlueShield.

E-prescribing is one small attempt to make medicine a bit more modern. Experts say technology is an underappreciated medical tool that could bring accurate, fast information to physicians and consumers.

For some doctors, such as Brian Yeaman and his colleagues at Norman Regional Health system in Oklahoma, writing prescriptions electronically has not only increased accuracy, but also was the first step toward creating a fully integrated electronic medical record-keeping system.

"Using the computer templates," said Yeaman, a family physician, "it is hard to select the wrong drug or make up a wrong dose."

But Yeaman and Benesh are the exceptions. Overall, just 2 percent of eligible prescriptions written in the United States are transmitted electronically, according to the eHealth Initiative, a nonprofit group that promotes technology in medicine. Officials at the Medical Society of the District of Columbia could not identify a single local doctor who e-prescribes.

"When we talk to clinicians across the country, the key barrier to getting to electronic prescribing is financing," said Janet Marchibroda, chief executive officer of the eHealth Initiative. Some Web-based systems, including the DrFirst portal used by Benesh, are free. But others -- especially those that combine e-prescribing with full electronic medical records -- can cost tens of thousands of dollars.

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