Teaching Old Docs New Tricks: Prescriptions to go Paperless

Persuading U.S. doctors to scrap their prescription pads for electronic prescribing so far has been a long, uphill battle. Statistics reveal only about 10 percent of doctors are taking the plunge. Even with incentives offered just a few are presently using the technology. It is difficult to teach old paper writing prescription docs new tricks.

The push for paperless prescriptions is about to get a boost. Starting in January, doctors who e-prescribe can get bonus pay from Medicare. Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts sticking to paper in 2012 will find their Medicare payments cut.

What's a paperless prescription? When the doctor writes it by computer and sends it directly to the drugstore by computer, no little piece of paper to get lost or stolen anywhere along that trail.

Some doctors do write prescriptions via computer but then hand the patient a printout, or it arrives at the drugstore as a fax. Those don't count as true electronic prescribing.

In December 2007, approximately 35,000 doctors were writing at least some paperless prescriptions, according to SureScripts-RxHub, which tracks the drugstore network. The numbers are not in for 2008 from SureScripts-RxHub, but they have reported a tremendous increase in the paperless system over last year. This is due in part to the incentives offered by Medicare to begin in January. They are gearing up for any cost savings they can have in the present economy.

The medical information technology superhighway is getting a bigger push. It is a key part of President-elect Barack Obama's health-reform plans, in hopes that moving to computerized records - not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care - ultimately could save millions of dollars a year.

The e-prescription is a win-win! It provides safety and cost-saving features to the patients. Reports have shown deaths and serious illnesses were attributed to inaccurate dispensing of medications by pharmacists because of 'chicken-scratch' handwriting. There are advantages then to pharmacists who will also save time and money, fewer lawsuits to battle.

This change for doctors requires upfront expenditures for software and staff training. Most have been reluctant to begin with paperless prescriptions because of these costs. Medicare incentives could produce $1000 to $1500 yearly for the doctors to offset their costs.

A bigger barrier stated was narcotic painkillers and other controlled substances that account for 20 percent of all prescriptions are banned from electronic prescribing. The Drug Enforcement Administration is working on rules to allow that switch.

Another stumbling block says the report, is the drugstore link. While almost all pharmacy chains are part of a national e-prescription network, smaller ones may not be - only 27 percent of independent pharmacies were in 2007 - and doctors also must use software recognized by the network.

Dr. Joe Heyman, chairman of the American Medical Association's trustees and a longtime e-prescriber said, "Change itself was a bit of a barrier."

2008 by Avis Ward of GeoVi's Home for Pregnant Teens