Electronic prescribing in ambulatory practice: promises, pitfalls, and potential solutions.
OBJECTIVE
To examine advantages of and obstacles to electronic prescribing in the ambulatory care environment.


METHODS
MEDLINE and International Pharmaceutical Abstract searches were conducted for the period from January 1980 to September 2000. Key words were electronic prescribing, computerized physician order entry, prior authorization, drug utilization review, and consumer satisfaction. In September 2000, a public search engine (www.google.com) was used to find additional technical information. In addition, pertinent articles were cross-referenced to identify other resources.


METHODS
Articles, symposia proceedings, and organizational position statements published in the United States on electronic prescribing and automation in healthcare are cited.


RESULTS
Electronic prescribing can eliminate the time gap between point of care and point of service, reduce medication errors, improve quality of care, and increase patient satisfaction. Considerable funding requirements, segmentation of healthcare markets, lack of technology standardization, providers' resistance to change, and regulatory indecisiveness create boundaries to the widespread use of automated prescribing. The potential solutions include establishing a standardizing warehouse or a router and gaining stakeholder support in implementation of the technology.


CONCLUSIONS
Electronic prescribing can provide immense benefits to healthcare providers, patients, and managed care. Resolution of several obstacles that limit feasibility of this technology will determine its future.
Papshev
D
D
Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, 600 South 43rd Street, Philadelphia, PA 19104-4495, USA. d.papshe@usip.edu
Peterson
A M
AM
D000555:Ambulatory Care Information Systems; D016303:Clinical Pharmacy Information Systems; D003195:Computer Communication Networks; D011307:Drug Prescriptions; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D017060:Patient Satisfaction; D019095:Point-of-Care Systems; D011787:Quality of Health Care; D014481:United States; D014584:User-Computer Interface