Having recently completed a large AHRQ-funded study on e-prescribing standards, I read Grossman's paper with great interest. This study (conducted during November 2005-March 2006) may seem recent; however, great strides have occurred in the past year that are worth consideration.
First, at the time of the study, just over one third of U.S. community pharmacies were activated for e-prescribing. In the year since, 66% of pharmacies are now live on the Pharmacy Health Information Exchange. Ninety-five percent of all pharmacies are certified as well.[1] Whereas in
November 2005, only a few electronic medical record systems were certified for electronic prescribing, today every major EMR and stand-alone e-prescribing system (over 60 in all) is certified.
We were actually not surprised by the article's findings that prescribers want complete and accurate medication history and formulary information at the point of prescribing. Yet it is important to note that during Mitchell's study, medication history information came from payer-based sources only. During our study, we evaluated the extent to which the inclusion of community pharmacy-based data improved the accuracy and completeness of medication history at the point of prescribing.[2] In the very short window during which this complementary data source flowed to prescribers, they reported increases in the number of patients for which medication history was available, as well as the completeness of the information provided.
In short, while there is much more work to be done, the industry is rapidly moving toward the ultimate efficiency and patient-safety goals of e-prescribing.
References
1. http://www.surescripts.com, accessed April 12, 2007.
2. Lapane KL, Whittemore K, Rupp MT, Dube C, Jackson T, Dhavle A. Maximizing the effectiveness of e-prescribing between physicians and community pharmacies. Final Progress Report submitted to AHRQ on January 28, 2007.