E-prescribing stumbling blocks

The fits and starts of electronic prescribing systems show why their use and development should be encouraged but not mandated.

Editorial. March 5, 2007.

Medical information technology offers great promise to improve the efficiency and quality of health care. But it takes some time for promise to equal reality.

A much-touted technology that has been slow to live up to its potential is electronic prescribing.

E-prescribing has been around for years, and it is often promoted as a relatively inexpensive way -- at least compared with electronic medical records -- to use information technology to provide better care. State-of-the art systems allow a physician to send a prescription wirelessly from a handheld computer to a pharmacy computer. It also can alert a physician during the prescription-writing process of any drug interaction problems.

In short, e-prescribing is looked upon as the more efficient, safer and -- given the spotty reputation of physician handwriting -- neater replacement for pen and pad. Even in 2003, the U.S. House of Representatives was so confident in e-prescribing's potential and progress that it passed a measure (which got rejected by the Senate) requiring its use as a condition of participating in Medicare.

But in 2007, it seems that little progress has been made in creating workable systems that will do what their proponents say they can do. As such, e-prescribing provides a good case study illustrating why the AMA has warned against costly physician mandates to adopt not-ready-for-prime-time technology.